Introduction: India bears the highest global burden of tuberculosis (TB), with multidrug-resistant TB (MDR-TB) posing substantial treatment challenges. Sputum culture conversion is a vital indicator of treatment response and an early predictor of success in drug-resistant TB (DR-TB). This study aimed to evaluate the time to early sputum culture conversion (within 6 months) in DR-TB patients and identify factors influencing this outcome across different resistance patterns: MDR, MDR with fluoroquinolone resistance, MDR with second-line injectable resistance, and extensively DR-TB (XDR-TB). Methods: This prospective cross-sectional observational study was conducted in India. Seventy-four DR-TB patients enrolled between January and October 2019 were assessed. Demographic data, comorbidities, and culture conversion times were analyzed using Chi-square tests and univariate logistic regression. P <0.05 was considered statistically significant. Results: Among the 74 patients (62.2% male; mean age 30 years), most MDR-TB patients (52%) achieved culture conversion within 3 months, while pre-XDR and XDR cases mostly converted within 2 months. Smoking ( P = 0.03), low body mass index (BMI) ( P = 0.025), cavitary lesions on chest X-ray ( P = 0.01), and lower socioeconomic status ( P = 0.02) were significantly associated with delayed conversion. Conclusion: Early sputum culture conversion is a key milestone in DR-TB treatment. Addressing modifiable risk factors such as smoking, undernutrition, and cavitary disease may improve outcomes. Further studies are needed to identify interventions to accelerate culture conversion and enhance treatment success.
Kotokey et al. (Thu,) studied this question.