{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T10:39:35Z","timestamp":1776767975875,"version":"3.51.2"},"reference-count":35,"publisher":"PAGEPress Publications","issue":"1","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>This study aimed to evaluate how the time to sputum culture conversion (SCC) predicts cure and to identify factors associated with delayed SCC and cure among multidrug-resistant tuberculosis (MDR-TB) patients receiving longer treatment regimens of 18-24 months. This multicenter retrospective cohort study was conducted at eight programmatic management units. A total of 462 patients with confirmed pulmonary MDR-TB were enrolled at eight Programmatic Management of Drug-resistant Tuberculosis sites between January 2017 and August 2018 with available treatment outcomes till 30th June 2020. Survival analysis was done using the Kaplan-Meier curve, and Cox proportional hazards model and binary logistic regression were performed to determine factors associated with time to SCC and cure. Statistical significance was set at p&lt;0.05. A total of 424\/462 (91.8%) patients achieved SCC, with a cure rate of 75.5%. The mean time to SCC was 2.4 months (interquartile range = 1-3 months). Factors such as employment [hazard ratio (HR)=0.654, p=0.001], sputum smear grading score +2+3 (HR=0.638, p=0.014), resistance to first-line drugs HREZ (HR=0.716, p=0.014), and resistance to second-line drugs, fluoroquinolones (HR=0.698, p\u22640.001) were significantly associated with SCC. In the current study, the cure rate was 75.5% (349\/462). In the binary logistic regression, month 1 [odds ratio (OR)=2.601, p\u22640.001), month 2 (OR=3.14, p\u22640.001), month 3 (OR=5.219, p\u22640.001), month 4 (OR=6.788, p\u22640.001), month 5 (OR=21.512, p\u22640.001), and month 6 (OR=31.806, p\u22640.001) had a statistically significant association with cure. In predicting cure, the overall sensitivities of SCC at 1, 2, 3, 4, 5, and 6 months were 37.2%, 64.1%, 85.9%, 91.1%, 97.4%, and 98.2%, respectively, and the specificities were 81.4%, 63.7%, 46.0%, 39.8%, 36.2%, and 35.3%, respectively. Interestingly, the combined sensitivity and specificity of SCC at 3 and 4 months in predicting cure were similar to those observed at 5 and 6 months.<\/jats:p>","DOI":"10.4081\/monaldi.2025.3200","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:39:04Z","timestamp":1745465944000},"source":"Crossref","is-referenced-by-count":0,"title":["Time to sputum culture conversion as a predictor of cure in multidrug-resistant tuberculosis patients: a multicenter retrospective cohort study in Pakistan"],"prefix":"10.4081","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6954-8766","authenticated-orcid":false,"given":"Abdul","family":"Wahid","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nafees","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahad","family":"Saleem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amjad","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asad","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faiz Ullah","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farman Ullah","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"55893","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201909-1874ST"},{"key":"55894","unstructured":"WHO. Global tuberculosis report 2021. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240037021."},{"key":"55895","doi-asserted-by":"publisher","DOI":"10.3126\/saarctb.v14i1.17724"},{"key":"55896","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02363-2016"},{"key":"55897","unstructured":"WHO. Consolidated guidance on tuberculosis data generation and use. Module 1. Tuberculosis surveillance. 2024. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240075290."},{"key":"55898","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-144-9-200605020-00008"},{"key":"55899","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm025"},{"key":"55900","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00036-3"},{"key":"55901","doi-asserted-by":"crossref","unstructured":"Ige O, Akindele Y, Adebiyi O, et al. Sputum culture conversion among the first cohorts of MDR-TB patients managed in Nigeria at a tertiary care hospital. 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