Endobronchial Valve Treatment of Tuberculous Cavities in Patients with Multidrug-Resistant Pulmonary Tuberculosis: A Randomized Clinical Study

An, Huiru1; Liu, Xiao1; Wang, Tianhao2; Liu, Lin1; Yan, Mengdie1; Xu, Jing1; Wang, Tao1; Gong, Wenping1; Wang, Zhongyuan1,3

2022-08-01

10.3390/pathogens11080899

PATHOGENS   Impact Factor & Quartile

2076-0817

Background: Multidrug-resistant pulmonary tuberculosis (MDR-PTB) has become a major cause of high morbidity and mortality related to TB. Conventional drug regimens are ineffective for the treatment of MDR-PTB patients with cavities. This study aimed to evaluate the clinical efficacy and safety of one-way endobronchial valves (EBVs) for the treatment of cavities in MDR-PTB patients. Methods: MDR-PTB patients with positive sputum cultures, sputum smears, and cavities were treated with EBVs in the drainage bronchus of the pulmonary cavity between November 2013 and March 2018. The participants comprised those who had failed previous anti-tuberculosis therapy, as determined by drug susceptibility testing. Results: Thirty-five MDR-PTB patients were included, three of whom were lost during follow-up. The size of the lung cavity was reduced in all of the patients after EBV implantation, including the three lost to follow-up. In the remaining 32 patients, the sputum culture conversion (SCC) rate reached 100%, and the cavity closure rate was 68.8%. There were no significant differences in the cavity closure rate between patients aged <= 40 and >40 years, between the upper and lower lobes, or between the use and non-use of linezolid groups (p > 0.05). Interestingly, the cavity closure rate was higher in women than in men (p = 0.005). Moreover, the cavity closure rate correlated with the time to SCC (correlation coefficient, 0.8933; p < 0.0001). There were no severe adverse events in the patients treated with EBV implantation. Conclusion: EBV installation is effective and safe for the treatment of cavities in MDR-PTB patients. The efficacy of EBV treatment may not be affected by age, disease course, or the location of the lung lobe in the cavity.

pulmonary tuberculosis (PTB) multidrug-resistant pulmonary tuberculosis (MDR-PTB) endobronchial valves (EBVs) cavity closure efficacy

SCI

English

Corresponding

Beijing Municipal Science & Technology Commission["Z151100004015015","Z171100001017187"]

Microbiology

Microbiology

WOS:000846564000001

MDPI

Web of Science

1.Peoples Liberat Army Gen Hosp, TB Prevent & Control Key Lab, Beijing Key Lab New Techn TB Diag & Treatment, Senior Dept TB,Med Ctr, Beijing 100091, Peoples R China
2.Peoples Liberat Army Gen Hosp, Dept Emergency, Med Ctr 8, Beijing 100091, Peoples R China
3.Southern Univ Sci & Technol, Shenzhen Peoples Hosp 3, Natl Clin Res Ctr Infect Dis Shenzhen, Guangdong Prov Clin Res Ctr Infect Dis TB, Shenzhen 518112, Peoples R China

An, Huiru,Liu, Xiao,Wang, Tianhao,et al. Endobronchial Valve Treatment of Tuberculous Cavities in Patients with Multidrug-Resistant Pulmonary Tuberculosis: A Randomized Clinical Study[J]. PATHOGENS,2022,11(8).

An, Huiru.,Liu, Xiao.,Wang, Tianhao.,Liu, Lin.,Yan, Mengdie.,...&Wang, Zhongyuan.(2022).Endobronchial Valve Treatment of Tuberculous Cavities in Patients with Multidrug-Resistant Pulmonary Tuberculosis: A Randomized Clinical Study.PATHOGENS,11(8).

An, Huiru,et al."Endobronchial Valve Treatment of Tuberculous Cavities in Patients with Multidrug-Resistant Pulmonary Tuberculosis: A Randomized Clinical Study".PATHOGENS 11.8(2022).