Effective methods to detect viable Mycobacterium tuberculosis, the main causative agent of tuberculosis (TB), are urgently needed.To date, cultivation of M. tuberculosis is the gold standard, which depends on initial sample processing with N-acetyl-l-cysteine-sodium hydroxide (NALC-NaOH), chemicals that compromise M. tuberculosis viability and, consequently, the performance of downstream tests. Hawthorne
Logistic regression models were fit with contact positivity (CP) as the outcome of interest. A 1-point increase in CXR grade correlated with a 3.2-day decrease in TTD (P < .001), and this correlation persisted after adjustment for potential confounders. G
A consultant radiologist (A. Antigenic distribution, pathological changes, antibody response and serological detection in non-pregnant goats following experimental infection by Brucella melitensis. We show that an index case with a short TTD (<9 days) is associated with more than twice as many transmission events as a case with TTD ≥ 9 days. Conclusions.
Our novel CXR grading system required nonexpert review of plain CXRs and assignment of abnormalities to 1 of 7 simple grades.
D
We have further shown that a robust nonexpert grading of CXRs correlates well with TTD.
NALC-NaOH decontamination compromises test positivity and the detection limit.
A transmission event (“contact positivity”) was defined as a diagnosis of either active disease or latent infection in a recent contact of an index case.
C
Transmission was strongly associated with age (P < .001); index cases aged 20–39 years had the highest risk of transmission (OR, 2.91; AOR, 2.18; Table 2).
Horstmeier
Theron
Index cases with a TTD <9 days had a significantly higher transmission risk and TTD was a better predictor for this risk than smear status.
Online ahead of print. Increased somatosensory amplification is associated with decreased pressure pain thresholds at both trigeminal and extra-trigeminal locations in healthy individuals. The bars and the error bars represent the mean value with the standard error of the mean (SEM). El-Sony
CXR grade at diagnosis predicts patients with short TTD. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Also, we show that CXR grade at diagnosis correlates with TTD. Get the latest research from NIH: https://www.nih.gov/coronavirus. NALC-NaOH decontamination of sputum reduces the viable M. tuberculosis count measured by MBLA. We then evaluate a novel CXR scoring system in patients with pulmonary tuberculosis and validate it against TTD. Effective methods to detect viable Mycobacterium tuberculosis, the main causative agent of tuberculosis (TB), are urgently needed. First, although the data were collected prospectively, they were not collected specifically for this study, and we were therefore unable to obtain information retrospectively on other potentially relevant factors such as diabetes status or vitamin D deficiency. M
Woodward
We studied the correlation of TTD with the risk of transmission of infection from index cases to contacts and compared this with sputum microscopy. Birmingham is the second-largest city in the United Kingdom, with a population of approximately 1 million.
Salamon
N, Lohmann
NALC-NaOH decontamination reduces the viable M. tuberculosis counts measured by MBLA and on solid culture. Variables were included in the final model if P < .10, except that smear-positivity was included in all models because it was of primary interest to this study. We contend that the only pragmatic way of obtaining an estimate for the independent predictive utility of TTD is by the method we used, which is by simultaneous statistical adjustment for sputum smear-positivity and TTD in a multivariable model.
Microscopic examination of sputum smears for acid-fact bacilli is a rapid and widely used method of evaluating individuals suspected of having pulmonary tuberculosis.
Stavropoulos
However, its potential use in detecting the Mycobacterium tuberculosis complex (MTB) remained unexpl … doi: 10.3791/60460. Tostmann
Walzl
AL
This NaOH-induced M. tuberculosis viability loss was replicated in clinical sputum samples, with the bacterial load dropping by 0.65 ± 0.17 log10 from 5.36 ± 0.24 log10 eCFU/ml to 4.71 ± 0.16 log10 eCFU/ml for untreated and treated sputa, respectively. JB
A
SV
By contrast, automated liquid culture assays are highly sensitive (limit of detection, 10–100 cfu/mL), more rapid, and more reproducible than traditional techniques that use solid media [9]. This is to find out if particular bacteria are present. Unsurprisingly, TTD was shorter in smear-positive patients (HR, 5.54; P < .001), and this correlation was independent of CXR score (AHR, 4.74; P < .001). Search for other works by this author on: Public Health England Regional Centre for Mycobacteriology, West Midlands Public Health Laboratory, A total of 284 new cases of tuberculosis were reported during the study period, of whom 184 had pulmonary tuberculosis.
Joloba
RK
Even recently devised “simple” scoring systems require the appraiser to estimate the percentage of lung affected and record the presence of cavitation (and sizes of cavities), effusions (and their volumes), consolidation, fibrosis, nodules, and miliary disease [23, 24]. Our findings therefore may not apply to individuals coinfected with HIV who are more likely to be smear-negative and typically demonstrate more subtle radiographic abnormalities [40]. Enarson
Walker
The relative transmission rate of smear-negative to smear-positive patients was 0.40 ([40/49]/[125/62]) for all events, 0.42 ([37/49]/[111/62]) for latent tuberculosis, and 0.27 ([3/49]/[14/62]) for active disease. The 2-tailed Fisher exact test was used to compare categorical data. Bark
et al. Of the 184 cases of pulmonary tuberculosis reported during the study period, 111 were included in the final study, and these generated 825 contacts. Cultural Characteristics of Mycobacterium tuberculosis.
To date, there has been no assessment of the relationship between TTD and transmission risk. Time-to-detection (TTD) is the time it takes for a sample to become culture positive for M. tuberculosis in an automated liquid culture system.
NIH USA.gov. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.
We believe that the simplicity, ease of use, and robustness of our scoring system, as demonstrated by the high interobserver agreement, increase its practical usefulness in relation to the clinical setting.
G, Wang
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TD
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Abubakar
J. Mandal
GD. The thick diagonal line is the linear regression model linking CXR grade with TTD, which shows that TTD decreases by 3.2 days (95% confidence interval, 2.0–4.5 days) as CXR grade increases by 1 (P < .001).
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Department of Infectious Disease and Tropical Medicine, The Jenner Institute, Nuffield Department of Medicine.
Elwood
E
Warren
(A).
BMC Microbiol.
Potential conflicts of interest. B, Ritchie
Where it is available, TTD is superior to sputum smear microscopy for this purpose and will allow tuberculosis control services to better optimize the use of scarce resources. DR
de Gracia
L
Abbreviations: CXR, chest radiograph; HIV, human immunodeficiency virus; TTD, time-to-detection in liquid culture.
B.) Vaughan
Growing bacteria are required to perform drug-susceptibility testing and genotyping.
S
SM.
TTD < 9 days identifies patients at high risk of transmitting tuberculosis and is superior to sputum smear. The authors thank all of the patients who participated in the study and are grateful to the tuberculosis specialist nurses and staff at the regional mycobacterial reference laboratory, without whom this study would not have been possible. Last Updated on January 3, 2020 by Sagar Aryal. COVID-19 is an emerging, rapidly evolving situation. Huang
Epidemiology of Tuberculosis Among Non-U.S. –Born Persons in the United States, 1993–2016 Self-Study Modules on Tuberculosis, 1-5 Slide Sets The Tuberculosis (TB) in Correctional Settings plus icon
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INTRODUCTION.
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Quantitative culture of Mycobacterium tuberculosis from clinical sputum specimens and dilution endpoint of its detection by the Amplicor PCR assay.
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TTD was not correlated with age, sex, ethnicity, country of birth, smoking history, previous BCG vaccination, or M. tuberculosis clade. Index cases that were not culture positive in sputum were therefore censored at 70 days (although they may have been culture positive from another respiratory sample such as bronchoalveolar lavage fluid). Baraka
Liquid culture systems may identify positive samples within days (as opposed to the weeks required for culture on solid media) [10]. K
The index case was assumed to be the first symptomatic case of pulmonary tuberculosis in all clusters identified; cases of extrapulmonary tuberculosis and latent tuberculosis were assumed to be secondary cases. However, sputum microscopy has a number of limitations: the sensitivity of the technique is low (limit of detection, 5000–10 000 cfu/mL) and false-negative results may occur due to sampling error, sample inadequacy, faulty smear preparation, staining, and inadequate examination time; false-positive results may occur because microscopy cannot distinguish between viable and nonviable bacilli [7, 8].
MA
MD
Sabiiti W, Mtafya B, De Lima DA, Dombay E, Baron VO, Azam K, Oravcova K, Sloan DJ, Gillespie SH.
Kamphorst
Although linear regression was used to obtain estimates for the effect of CXR grade on TTD (sputum culture-negative patients were omitted), estimates from these models should be considered indicative only, because the method is not designed to cope with censored data and linear regression was not used for the multivariable analyses.
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