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Predictive Value of Nutritional Status in Sputum Culture Conversion Among Patients with Nontuberculous Mycobacterial

Bo Zhang¹, Xiangyu Yin², Jinxing Li²

¹Department of Public Health, Weifang Second People's Hospital, Weifang, 261000, People's Republic of China.

Infection and Drug Resistance

|May 1, 2026

Abstract

Background:

Nutritional status has been increasingly recognized as an important determinant of outcomes in nontuberculous mycobacterial pulmonary disease (NTM-PD), but its predictive value for sputum culture conversion remains unclear.

Methods:

This retrospective cohort study included 416 patients with NTM-PD between January 2016 and September 2024. Patients were categorized based on nutritional status and sputum culture conversion. Logistic regression was used to identify independent predictors, and a combined predictive model was evaluated using ROC curves. Kaplan-Meier analysis assessed time to culture conversion. Internal validation was performed using bootstrap resampling.

Results:

Among 416 patients, 109 (26.2%) achieved sputum culture conversion. Malnourished patients had significantly lower conversion rates. Multivariable analysis showed age (OR=1.048, 95% CI: 1.012-1.085), BMI (OR=0.746, 95% CI: 0.668-0.835), hemoglobin (OR=0.936, 95% CI: 0.906-0.967), and total protein (OR=0.920, 95% CI: 0.853-0.992) were independent predictors. The combined model demonstrated strong predictive performance (AUC=0.925, sensitivity=89.3%, specificity=78.0%).

Conclusion:

Nutritional status is significantly associated with sputum culture conversion in NTM-PD. A combined model incorporating nutritional indicators may assist in risk stratification, although further validation is required.

Keywords:

Kaplan–meier analysis nontuberculous mycobacteria nutritional status pulmonary disease sputum culture conversion

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