Attenuated tuberculin skin test responses associated with Mycobacterium intracellulare sputum colonization in an adolescent TB prevalence survey in Western Kenya

IF 2.8 3区医学 Q3 IMMUNOLOGY Tuberculosis Pub Date : 2024-05-05 DOI:10.1016/j.tube.2024.102514

Lilian N. Njagi , Grace Kaguthi , Jared O. Mecha , Thomas R. Hawn , Videlis Nduba

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Abstract

Introduction

Exposure to Non-tuberculous Mycobacteria (NTM) varies regionally and may partly explain the disparate outcomes of BCG vaccination and tuberculosis (TB) susceptibility.

Methods

We examined NTM sputum colonization, associations with clinical characteristics, and tuberculin skin test (TST) responses in an adolescent TB prevalence survey.

Results

Among 5004 adolescents screened, 2281 (45.5 %) were evaluated further. TB and NTM prevalence rates were 0.3 % and 8.0 %, respectively. Among 418 NTM isolates, 103 were unidentifiable, and 315 (75 %) comprised 15 species, the most frequent being M. intracellulare (MAC) (108, 26 %), M. scrofulaceum (96, 23 %) and M. fortuitum (51, 12 %). “NTM colonized” adolescents had less frequent chronic cough and night sweats (adjusted odds ratio [aOR] 0.62, 95 % confidence interval [CI] 0.44-0.87and aOR 0.61, CI 0.42–0.89 respectively), and lower TST induration (median 11 mm (interquartile range [IQR] 0–16) vs 13 mm (IQR 6–17; p = 0.006)) when compared to “NTM not colonized” participants. MAC, but not M. scrofulaceum or M. fortuitum, was associated with decreased TST induration (median 7.5 mm (IQR 0–15) vs 13 mm (IQR 6–17) among “MAC colonized” vs “not colonized”, p = 0.001).

Conclusion

We observed high NTM prevalence rates with species-specific associations with TST induration, consistent with a model of species-dependent heterologous immunity among mycobacteria.

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肯尼亚西部一项青少年结核病患病率调查显示，结核菌素皮试反应减弱与结核分枝杆菌痰内定植有关

导言接触非结核分枝杆菌（NTM）的情况因地区而异，这可能是卡介苗接种和结核病（TB）易感性结果不同的部分原因。方法我们在一项青少年结核病患病率调查中研究了非结核分枝杆菌（NTM）痰定植、与临床特征的关联以及结核菌素皮试（TST）反应。肺结核和非结核菌感染率分别为 0.3% 和 8.0%。在 418 株 NTM 分离物中，103 株无法识别，315 株（75%）包含 15 个菌种，其中最常见的是细胞内 M. (MAC)（108 株，26%）、瘰疬 M. (96 株，23%) 和 M. fortuitum (51 株，12%)。与 "NTM未定植 "的参与者相比，"NTM定植 "的青少年慢性咳嗽和盗汗的频率较低（调整后的几率比[aOR]为0.62，95%置信区间[CI]分别为0.44-0.87和aOR为0.61，CI为0.42-0.89），TST压痕较小（中位数为11毫米（四分位距[IQR]为0-16）对13毫米（四分位距[IQR]为6-17；p = 0.006））。结论我们观察到，NTM 的高流行率与 TST 压积的物种特异性相关，这与分枝杆菌间物种依赖性异源免疫模型一致。

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来源期刊

Tuberculosis 医学-呼吸系统

CiteScore

4.60

自引率

3.10%

发文量

审稿时长

49 days

期刊介绍： Tuberculosis is a speciality journal focusing on basic experimental research on tuberculosis, notably on bacteriological, immunological and pathogenesis aspects of the disease. The journal publishes original research and reviews on the host response and immunology of tuberculosis and the molecular biology, genetics and physiology of the organism, however discourages submissions with a meta-analytical focus (for example, articles based on searches of published articles in public electronic databases, especially where there is lack of evidence of the personal involvement of authors in the generation of such material). We do not publish Clinical Case-Studies. Areas on which submissions are welcomed include: -Clinical TrialsDiagnostics- Antimicrobial resistance- Immunology- Leprosy- Microbiology, including microbial physiology- Molecular epidemiology- Non-tuberculous Mycobacteria- Pathogenesis- Pathology- Vaccine development. This Journal does not accept case-reports. The resurgence of interest in tuberculosis has accelerated the pace of relevant research and Tuberculosis has grown with it, as the only journal dedicated to experimental biomedical research in tuberculosis.