Correlation Between Chest Radiographic Findings, Sputum Bacterial Load, and Treatment Outcomes in Extensively Drug-resistant Tuberculosis Patients
Keywords:
XDR-TB, Chest Radiography, Treatment OutcomesAbstract
Background: Extensively drug-resistant tuberculosis (XDR-TB) presents significant challenges in management due to its resistance to most first- and second-line anti-tuberculosis drugs. The relationship between chest radiographic features, sputum bacterial load, and treatment outcomes in XDR-TB remains under-explored, which impedes the optimization of treatment strategies. Objective: To find out the association between chest radiographic characteristics, sputum bacterial load, and treatment outcomes in patients with XDR-TB. Methods: This study at 2Department of Medicine, Lahore Medical and Dental College/Ghurki Trust Teaching Hospital, Lahore, where data from XDR-TB patients was reviewd from January to December 2021. It explored the link between chest X-ray findings, sputum bacterial load, and treatment outcomes. Data were retrospectively collected and analyzed, with XDR-TB confirmed through drug susceptibility testing. Chest X-rays and sputum samples assessed lung damage and bacterial load. Treatment outcomes, based on clinical improvement and sputum culture conversion, were analyzed to identify correlations with radiographic and bacterial characteristics. Results: In our study of 120 XDR-TB patients, most showed extensive lung damage, with 62.5% being male and 70% aged 16-45. Rural residents made up 65% of the cohort, and 60% were married. The median age was 35 years. Extensive lung involvement was seen in 67.5%, and 53% had high sputum bacterial loads. Sputum culture converters were slightly older (median age 36), mostly male (72.2%), and had a higher median weight (55.25 kg). Non-converters had a higher prevalence of diabetes (14.2%), and previous DR-TB significantly lowered conversion chances (p = 0.05). Unfavorable outcomes were more common in non-converters (p < 0.0001). Conclusion: Chest radiographic characteristics and sputum bacterial load are crucial factors influencing treatment outcomes in XDR-TB. Extensive lung damage and high bacterial load are linked to poorer prognoses and prolonged treatment times. These findings highlight the importance of incorporating radiographic and microbiological assessments into treatment planning to enhance patient outcomes in XDR-TB.References
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