Predictors of sputum culture conversion among patients with tuberculosis in the era of tuberculosis resurgence.

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Abstract
EARLY IDENTIFICATION and effective treatment of active tuberculosis (TB) have been the key elements in TB control and prevention.1 Adequate therapy for patients with TB is the single most important strategy for prevention of drug-resistant TB.2,3 Effective treatment of infectious patients can also significantly reduce the number of new transmissions. However, TB must be treated for a relatively long duration (6-24 months) as compared with the treatment of many other infectious diseases. Because of the potential for the emergence of multidrug-resistant TB (MDR TB) and patient nonadherence to prescribed treatment, it is extremely essential to monitor the effectiveness of treatment. Sputum culture conversion of Mycobacterium tuberculosis is the major indicator to monitor the effectiveness of antituberculosis therapy for patients with initially culture-positive pulmonary TB. Pulmonary TB constitutes more than 80% of all TB cases reported in the United States.4 Patients with pulmonary TB are the major source for the spread of TB. Sputum culture conversion, therefore, is also an important indicator for the infectivity of a patient with pulmonary TB. The Centers for Disease Control and Prevention (CDC) has included sputum culture conversion as one of the few follow-up measures for national TB surveillance.5,6