Culture conversion and drug susceptibility in drug-resistant pulmonary tuberculosis with type 2 diabetes mellitus on oral regimens

Table 1 Clinical and demographic characteristics by diabetic status

Variable	Diabetic (n = 61)	Pre-diabetic (n = 66)	Non-diabetic (n = 137)	P value
Proportion	23.1	25.0	51.9	-
DM control, controlled/uncontrolled	14.8/85.2	-	-	-
Age, year	50.9 ± 13.2	40.7 ± 14.0	27.1 ± 8.1	< 0.001
BMI, kg/m2	17.5 ± 3.8	19.4 ± 3.4	18.9 ± 3.3	0.006
Sex, male	73.8	59.1	52.6	0.020
Smoking, yes	67.2	40.9	21.2	< 0.001
Alcohol, yes	36.1	28.8	13.9	0.001
On OHA	93.4	1.5	0.0	< 0.001
On insulin	4.9	0.0	0.0	0.007
Dyspnea, yes	88.5	53.0	13.9	< 0.001
Weight loss, yes	72.1	97.0	93.4	< 0.001
Hemoptysis, yes	41.0	19.7	31.4	0.033

Data are presented as mean ± SD or %.

BMI: Body mass index; DM: Diabetes mellitus; OHA: Oral hypoglycemic agent.

Table 2 Association of diabetic status with newly diagnosed multidrug-resistant pulmonary tuberculosis

Newly diagnosed MDR-PTB	Diabetic (n = 61)		Pre-diabetic (n = 66)		Non-diabetic (n = 137)		P value
	n	%	n	%	n	%
No	52	85.25	61	92.42	134	97.81
Yes	9	14.75	5	7.58	3	2.19	0.004
Total	61	100.00	66	100.00	137	100.00

MDR-PTB: Multidrug-resistant pulmonary tuberculosis.

Table 3 Association of diabetic status with previously treated drug-sensitive tuberculosis and drug-resistant tuberculosis

Previously treated	Diabetic (n = 61)		Pre-diabetic (n = 66)		Non-diabetic (n = 137)
	n	%	n	%	n	%
DS-TB	51	83.61	60	90.91	116	84.67
DR-TB	5	8.20	0	0.00	0	0.00

DS-TB: Drug-sensitive tuberculosis; DR-TB: Drug-resistant tuberculosis.

Table 4 Association of diabetic status with radiological, microbiological, and drug resistance features

Category	Variable	Diabetic (n = 61)	Pre-diabetic (n = 66)	Non-diabetic (n = 137)	P value
Radiological findings	Cavity	63.9	28.8	65.7	< 0.001
	Nodule	26.2	30.3	32.8	0.646
	Consolidation	42.6	36.4	39.4	< 0.001
	Bilateral involvement	50.8	47.0	50.4	0.024
	Upper zone involvement	63.9	68.2	62.0	0.695
	Middle zone involvement	55.7	45.5	49.6	0.508
	Lower zone involvement	70.5	48.5	53.3	0.028
Sputum smear grade	3+/2+ (high bacillary load)	80.3	60.6	72.2	0.087
	Scanty/negative	6.6/0.0	12.1/3.0	5.1/0.7
LPA resistance	rpoB	98.4	100.0	99.3	0.567
	inhA	31.1	13.6	12.4	0.004
	katG	95.1	84.9	94.2	0.043
Second-line LPA	LFX/MOXI/SLID (resistant)	0.0	0.0	0.0	0.000
DST (Z/MOXI/LZD)	Z resistance	83.6	74.2	68.6	0.086
	MOXI/LZD resistance	0.0	0.0	0.0

DST: Drug susceptibility testing; Z: Pyrazinamide; LFX: Levofloxacin; LPA: Line probe assay; LZD: Linezolid; MOXI: Moxifloxacin; SLID: Sitafloxacin.

Table 5 Association of diabetic status with sputum culture results from third month to sixth month

Month	Finding	Status						P value
		Diabetic (n = 61)		Pre-diabetic (n = 66)		Non-diabetic (n = 137)
		n	%	n	%	n	%
Third	Positive	10	16.4	1	1.5	2	1.5	< 0.001
	Negative	46	75.4	44	66.7	107	78.1
	Contaminated	4	6.6	4	6.1	11	8.0
	NA	0	0.0	17	25.8	16	11.7
	LFU	1	1.6	0	0.0	1	0.7
	Death	0	0.0	0	0.0	0	0.0
	Total	61	100.0	66	100.0	137	100.0
Fourth	Positive	6	9.8	0	0.0	0	0.0	< 0.001
	Negative	40	65.6	33	50.0	114	83.2
	Contaminated	7	11.5	5	7.6	13	9.5
	NA	5	8.2	28	42.4	7	5.1
	LFU	3	4.9	0	0.0	3	2.2
	Death	0	0.0	0	0.0	0	0.0
	Total	61	100.0	66	100.0	137	100.0
Fifth	Positive	0	0.0	0	0.0	0	0.0	0.055
	Negative	45	73.8	53	80.3	115	83.9
	Contaminated	0	0.0	0	0.0	2	1.5
	NA	9	14.8	7	10.6	6	4.4
	LFU	5	8.2	6	9.1	14	10.2
	Death	2	3.3	0	0.0	0	0.0
	Total	61	100.0	66	100.0	137	100.0
Sixth	Positive	0	0.0	0	0.0	0	0.0	0.001
	Negative	34	55.7	51	77.3	104	75.9
	Contaminated	1	1.6	0	0.0	3	2.2
	NA	10	16.4	5	7.6	12	8.8
	LFU	9	14.8	11	16.7	18	13.1
	Death	7	11.5	0	0.0	0	0.0
	Total	61	100.0	66	100.0	137	100.0

LFU: Lost to follow-up; NA: Not available.

Table 6 Association of diabetic status with sputum microscopy results from third month to sixth month

Month	Finding	Status						P value
		Diabetic (n = 61)		Pre-diabetic (n = 66)		Non-diabetic (n = 137)
		n	%	n	%	n	%
Third	Positive	8	13.1	1	1.5	1	0.7	0.002
	Negative	52	85.2	64	97.0	134	97.8
	NA	0	0.0	1	1.5	1	0.7
	LFU	1	1.6	0	0.0	1	0.7
	Death	0	0.0	0	0.0	0	0.0
	Total	61	100.0	66	100.0	137	100.0
Fourth	Positive	3	4.9	0	0.0	0	0.0	0.0012
	Negative	51	83.6	65	98.5	129	94.2
	NA	4	6.6	1	1.5	5	3.6
	LFU	3	4.9	0	0.0	3	2.2
	Death	0	0.0	0	0.0	0	0.0
	Total	61	100.0	66	100.0	137	100.0
Fifth	Positive	0	0.0	0	0.0	0	0.0	< 0.001
	Negative	43	70.5	59	89.4	120	87.6
	NA	11	18.0	1	1.5	3	2.2
	LFU	5	8.2	6	9.1	14	10.2
	Death	2	3.3	0	0.0	0	0.0
	Total	61	100.0	66	100.0	137	100.0
Sixth	Positive	0	0.0	0	0.0	0	0.0	< 0.001
	Negative	38	62.3	55	83.3	111	81.0
	NA	7	11.5	0	0.0	8	5.8
	LFU	9	14.8	11	16.7	18	13.1
	Death	7	11.5	0	0.0	0	0.0
	Total	61	100.0	66	100.0	137	100.0

LFU: Lost to follow-up; NA: Not available.

Table 7 Association of diabetic status with sputum microscopy and culture results from third month to sixth month

Month	Category	Diabetic, positive	Diabetic, negative	Pre-diabetic, positive	Pre-diabetic, negative	Non-diabetic, positive	Non-diabetic, negative	P value
Third	Microscopy	13.1	85.2	1.5	97.0	0.7	97.8	0.002
Third	Culture	16.4	75.4	1.5	66.7	1.5	78.1	< 0.001
Fourth	Microscopy	4.9	83.6	0.0	98.5	0.0	94.2	0.0012
Fourth	Culture	9.8	65.6	0.0	50.0	0.0	83.2	< 0.001
Fifth	Microscopy	0.0	70.5	0.0	89.4	0.0	87.6	< 0.001
Fifth	Culture	0.0	73.8	0.0	80.3	0.0	83.9	0.055
Sixth	Microscopy	0.0	62.3	0.0	83.3	0.0	81.0	< 0.001
Sixth	Culture	0.0	55.7	0.0	77.3	0.0	75.9	0.001

Table 8 Association of diabetic status with outcome and time to culture conversion

Parameter	Diabetic (n = 61)	Pre-diabetic (n = 66)	Non-diabetic (n = 137)	P value
Outcome				< 0.001
Alive	43 (70.5)	55 (83.3)	119 (86.9)
Dead	9 (14.8)	0 (0.0)	0 (0.0)
Lost to follow-up	9 (14.8)	11 (16.7)	18 (13.1)
Total participants	61 (100.0)	66 (100.0)	137 (100.0)
Time to culture conversion, days
mean ± SD	132.97 ± 22.28	112.58 ± 7.55	96.90 ± 10.82	< 0.001

Data are presented as n (%) unless otherwise indicated.

SD: Standard deviation.