| Objective: To explore the influencing factors of sputum conversion after six months treatment in retreated smear-positive pulmonary tuberculosis patients with drug resistance.Method: The patients with retreated smear positive pulmonary tuberculosis in Kashgar area of Xinjiang were taken as the object of study.The distribution of drug resistance was observed and divided into 6-month negative group and 6-month negative group according to the treatment results to explore the influencing factors of sputum negative conversion.Result: Of 141 enrolled participants,115 were negative at the end of6 months with the sputum conversion rate of 81.6%(95% CI=0.751-0.880).The univariate analysis revealed 8 factors associated with non-conversion after six months treatment(P<0.1):gender,age,smear grading before treatment,previous tuberculosis medication history,Isoniazid resistance,ethambutol resistance,streptomycin resistance.Multivariate logistic analysis revealed that 3 independent risk factors for non-conversion at the end of 6 month of treatment: female(OR =3.216,95%CI=1.232-8.396),ethambutol resistance(OR=5.698,95%CI=1.548-20.970),smear grading before treatment≥3+(OR=4.227,95% CI=1.630-10.960).It showed the highest resistance to RFP(90.78%,128/141),followed by INH(28.37%,40/141),Sm(17.02%,24/141),Ofx(16.31%,23/141)and EMB(9.93%,14/141);there were 19 types of drug resistance spectrum,which included 2 mono-resistance,4 poly-drug resistance,8 multi-drug resistance,and 5 kinds of poly-drug resistance of second-line drugs.Conclusion : The influencing factors of non-negative conversion of sputum bacteria at the end of 6 months after treatment in patients with retreated smear-positive drug-resistant pulmonary tuberculosis in Kashi area were ethambutol resistance and newly diagnosed bacteria≥3,and the drug resistance spectrum in Kashgar area had high diversity and complexity. |
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