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Regional and National Trends in Tuberculosis Research in South Asian Association for Regional Cooperation Countries: Post-COVID-19 Pandemic Machine Learning Factorial Analysis. 南亚区域合作联盟国家结核病研究的地区和国家趋势:COVID-19大流行后的机器学习因子分析》(Post-COVID-19 Pandemic Machine Learning Factorial Analysis)。
IF 1.6 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-09-14 DOI: 10.4103/ijmy.ijmy_151_24
Tauseef Ahmad, Sa'ed H Zyoud, Manal Abdulaziz Murad, Mukhtiar Baig

Background: The number of tuberculosis (TB)-related morbidities and mortalities is still high in the South-east Asian region. This study was performed to characterize and visualize the post-coronavirus disease 2019 (COVID-19) TB research in South Asian Association for Regional Cooperation (SAARC).

Methods: The Web of Science Core Collection database was utilized. A total of 4822 documents were included in the final analysis according to the predefined eligibility criteria. The data were exported to the R package and VOSviewer software for factorial analysis and network visualization, respectively.

Results: The included documents were published in English between 2020 and 2024 in 1255 journals. These documents were authored by 17005 authors (3.53 authors/document). The authors collaboration index was noticed 3.61. In total, 74.16% documents were published as the article. The highest number of documents were published in 2022 (n = 1089). The documents published in 2020 received the highest number of mean total citations per article (n = 8.64). The most published journal was Cureus Journal of Medical Science (n = 228). The most prolific author was Gupta A (n = 115). The most active institution was the All India Institute of Medical Sciences (n = 587). The top most trending topics were Mycobacterium tuberculosis, TB elimination, molecular docking, extrapulmonary TB, Cartridge Based Nucleic Acid Amplification Test, and multidrug resistance. India was the most productive country and had the strongest research collaboration with the United States of America (USA), the United Kingdom (UK), and South Africa. Pakistan was mainly collaborating with the USA, the UK, Saudi Arabia, and China. The India and Pakistan collaboration was observed only in 66 documents.

Conclusion: There is a poor output of scientific publication on TB in most SAARC countries. However, it is recognized that India has produced the highest number of scientific publications. The detection of undiagnosed post-COVID-19 pandemic TB cases is crucial to control further cases in the region. An effective regional cooperation should be established among institutions, universities, and countries to achieve the World Health Organization End TB goals.

背景:在东南亚地区,与结核病(TB)相关的发病率和死亡率仍然居高不下。本研究旨在对南亚区域合作联盟(SAARC)2019 年冠状病毒病(COVID-19)后结核病研究的特点进行描述和可视化:方法:利用科学网核心数据库。根据预先设定的资格标准,共有 4822 篇文献被纳入最终分析。数据被导出到 R 软件包和 VOSviewer 软件中,分别用于因子分析和网络可视化:纳入的文献是 2020 年至 2024 年间在 1255 种期刊上发表的英文文献。这些文献由 1,7005 位作者撰写(3.53 位作者/篇文献)。作者合作指数为 3.61。共有 74.16% 的文献以文章形式发表。2022年发表的文献数量最多(n = 1089)。2020 年发表的文件平均每篇被引用次数最多(n = 8.64)。发表论文最多的期刊是《Cureus 医学科学杂志》(n = 228)。最多产的作者是古普塔-A(n = 115)。最活跃的机构是全印度医学科学研究所(n = 587)。最热门的话题是结核分枝杆菌、消除结核病、分子对接、肺外结核病、盒式核酸扩增试验和耐多药。印度是成果最多的国家,与美利坚合众国(美国)、联合王国(英国)和南非的研究合作最为紧密。巴基斯坦主要与美国、英国、沙特阿拉伯和中国合作。印度和巴基斯坦的合作仅出现在 66 份文件中:结论:大多数南亚区域合作联盟国家在结核病方面的科学出版物产出较少。结论:大多数南亚区域合作联盟国家的结核病科学出版物数量较少,但印度的科学出版物数量最多。发现 COVID-19 大流行后未确诊的肺结核病例对于控制该地区更多的病例至关重要。各机构、大学和国家之间应建立有效的区域合作,以实现世界卫生组织终结结核病的目标。
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引用次数: 0
Affecting Factors Unfavorable Treatment Outcomes of Rifampicin-resistant/Multidrug-resistant Tuberculosis Patients Treated with Long-term Regimen. 耐利福平/耐多药肺结核患者接受长期治疗后治疗效果不佳的影响因素。
IF 1.6 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-09-14 DOI: 10.4103/ijmy.ijmy_132_24
Aylin Babalik, Ahmet Balikçi, Ayla Turkar, Nazli Huma Teke, Fatma Kübra Demir, Simge Yavuz, Emine Nur Koç, Senem Gündüz, Büşra Ergeç, Hasan Can Alagöz, Eren Sarioğlu, Zeki Kiliçaslan

Background: Drug-resistant tuberculosis (DR-TB) poses a significant threat to global TB control and remains a major public health issue. This study aims to evaluate treatment outcomes and identify risk factors for unfavorable outcomes in patients with multi-DR-TB (MDR-TB) treated at a major reference hospital in Istanbul.

Methods: We conducted a retrospective analysis of 413 patients with rifampicin-resistant and MDR-TB who received treatment between January 1, 2013, and December 31, 2023, at the University of Health Sciences Süreyyapaşa Chest Diseases Training and Research Hospital. Patients were treated following the World Health Organization and national guidelines, with regimens tailored to individual drug resistance profiles and side effect management. Demographic data, comorbidities, microbiological follow-up, drug resistance patterns, treatment regimens, and radiological findings were analyzed.

Results: Treatment success was achieved in 350 patients (84.74%). Thirty-two patients (7.74%) were lost to follow-up, and 32 patients (7.74%) died. Logistic regression analysis identified several factors associated with unfavorable treatment outcomes: comorbidities (odds ratio [OR]: 7.555, P = 0.001), quinolone resistance (OR: 3.695, P = 0.030), and bronchiectasis (OR: 4.126, P = 0.013). Additional significant factors included male gender (P = 0.007), foreign-born status (P = 0.013), age over 35 years (P = 0.002), previous treatment history (P = 0.058), and drug side effects (P = 0.012).

Conclusion: The long-term regimen for MDR-TB was found to be highly successful, with an 84.74% treatment success rate. Effective treatment regimens, close patient follow-up, early recognition of side effects, and comprehensive management are crucial for achieving successful outcomes. Identifying and addressing risk factors such as comorbidities, drug resistance, and specific patient demographics can further improve treatment success rates. This study underscores the importance of tailored treatment strategies and robust patient management in combating MDR-TB.

背景:耐药结核病(DR-TB)对全球结核病控制构成重大威胁,仍然是一个重大的公共卫生问题。本研究旨在评估在伊斯坦布尔一家大型参考医院接受治疗的多重耐药结核病(MDR-TB)患者的治疗效果,并确定导致不利治疗效果的风险因素:我们对2013年1月1日至2023年12月31日期间在健康科学大学Süreyyapaşa胸部疾病培训与研究医院接受治疗的413名利福平耐药和MDR-TB患者进行了回顾性分析。患者按照世界卫生组织和国家指南接受治疗,并根据个人耐药性情况和副作用控制情况制定了治疗方案。对人口统计学数据、合并症、微生物学随访、耐药模式、治疗方案和放射学检查结果进行了分析:350名患者(84.74%)治疗成功。32名患者(7.74%)失去随访,32名患者(7.74%)死亡。逻辑回归分析确定了与不利治疗结果相关的几个因素:合并症(几率比 [OR]:7.555,P = 0.001)、喹诺酮耐药(OR:3.695,P = 0.030)和支气管扩张(OR:4.126,P = 0.013)。其他重要因素包括男性性别(P = 0.007)、外国出生身份(P = 0.013)、35 岁以上(P = 0.002)、既往治疗史(P = 0.058)和药物副作用(P = 0.012):结论:MDR-TB 的长期治疗方案非常成功,治疗成功率高达 84.74%。有效的治疗方案、对患者的密切随访、副作用的早期识别以及全面的管理是取得成功结果的关键。识别并解决合并症、耐药性和特定患者人口统计等风险因素可进一步提高治疗成功率。这项研究强调了量身定制的治疗策略和强有力的患者管理在抗击耐药结核病中的重要性。
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引用次数: 0
Molecular Identification of Mycobacterium leprae in the Leprosy Patients. 麻风病人麻风分枝杆菌的分子鉴定
IF 1.6 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-09-14 DOI: 10.4103/ijmy.ijmy_127_24
Utma Laela Warka, Mochammad Hatta, Lisa Tenriesa Muslich, Fadhilah Syamsuri, Firdaus Hamid, Andi Rofian Sultan

Background: Several discoveries about leprosy indicate that Mycobacterium leprae transmission mainly occurs by inhalation, and the nose is a major port of entry and exit. Molecular probes have shown certain potential for the detection and identification of M. leprae in patients. The aim of this study was to identify M. leprae in nasal swab specimens using polymerase chain reaction (PCR)-based assays followed by gene sequencing methods. This observational study examines 64 anterior nasal swab samples taken from pretreatment leprosy patients, on-treatment and completed leprosy treatment in Bulukumba, South Sulawesi, Indonesia.

Methods: samples were analyzed by molecular detection methods according to the standard methods at the Clinical Microbiology Laboratory of Hasanuddin University. Descriptive statistics were utilized to summarize patient demographics and outcomes.

Results: This study uses PCR to detect the M. leprae deoxyribonucleic acid (DNA) from nasal swab specimens. Data were collected from 64 patients with a percentage of male patients 51.54%. Based on the age category, the group 45-46 years was the most frequent (39.05%). PCR detection proline-rich antigen gene of a 531 bp DNA fragment from M. leprae, was positive in eight patients, and they were multibacillary. Furthermore, PCR was positive in 5 (31.25%) of 16 new leprosy patients, 2 (8.69%) of 23 on-treatment patients, and 1 (4%) of 25 treatment completed patients. Based on the results of the phylogenetic tree and analysis of 8 positive results detected by M. leprae from leprosy patients, almost all samples have a level of similarity, except for sample Ua7.

Conclusions: M. leprae cannot grow in vitro, so molecular diagnostic tools were used to confirm the disease. This study predominantly of males with the age above 45 years of age being the most common. Eight M. leprae were positive from nasal swab leprosy patients. The sequencing findings provide insight into the genetic diversity of the genus M. leprae, so it is necessary to consider the detection of whole-genome sequence.

背景:有关麻风病的一些发现表明,麻风分枝杆菌主要通过吸入传播,而鼻子是主要的出入口。分子探针在检测和鉴定病人体内的麻风分枝杆菌方面已显示出一定的潜力。本研究的目的是利用聚合酶链反应(PCR)为基础的检测方法和基因测序方法鉴定鼻拭子标本中的麻风杆菌。本观察性研究对印度尼西亚南苏拉威西省布卢昆巴(Bulukumba)地区麻风病人治疗前、治疗中和治疗结束后的64份前鼻拭子样本进行了检测。方法:样本在哈桑努丁大学(Hasanuddin University)临床微生物实验室按照标准方法进行分子检测分析。结果:该研究采用 PCR 方法检测了痢疾杆菌:本研究采用 PCR 技术检测鼻拭子标本中的麻风杆菌脱氧核糖核酸(DNA)。研究收集了 64 名患者的数据,其中男性患者占 51.54%。根据年龄分类,45-46 岁的患者最多(39.05%)。通过 PCR 检测麻风杆菌 531 bp DNA 片段的富脯氨酸抗原基因,8 名患者呈阳性,且均为多疱性。此外,16 名新麻风病人中有 5 人(31.25%)、23 名正在治疗的病人中有 2 人(8.69%)、25 名完成治疗的病人中有 1 人(4%)PCR 检测呈阳性。根据系统发生树的结果和对麻风病人检测到的 8 个麻风杆菌阳性结果的分析,除样本 Ua7 外,几乎所有样本都有一定程度的相似性:结论:麻风杆菌不能在体外生长,因此需要使用分子诊断工具来确诊麻风病。这项研究的患者以男性为主,年龄在 45 岁以上的患者最多。鼻拭子麻风病人中有 8 例麻风杆菌呈阳性。测序结果有助于深入了解麻风杆菌属的遗传多样性,因此有必要考虑检测全基因组序列。
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引用次数: 0
Pyrazinamide-induced Hyperuricemia in Pulmonary Tuberculosis Patients. 肺结核患者由吡嗪酰胺引发的高尿酸血症
IF 1.6 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-09-14 DOI: 10.4103/ijmy.ijmy_178_23
Oki Nugraha Putra, Telly Purnamasari, Nindya Maskurisna Hamami

Background: Pyrazinamide is one of the antitubercular drugs used for 2 months in the intensive phase. One of the adverse effects of pyrazinamide is hyperuricemia, with a symptom of arthralgia. This study aims to analyze the incidence of hyperuricemia and arthralgia and their causality in pulmonary tuberculosis (TB) patients undergoing treatment in the intensive phase.

Methods: It was an analytic observational study with a prospective cohort design. Three ml of blood from each pulmonary TB patient was withdrawn to examine uric acid levels before and after 2 months of treatment with pyrazinamide. The Wilcoxon test was used to analyze changes in uric acid levels and the Chi-square test to analyze the association between uric acid levels and arthralgia. Naranjo algorithm is used to analyze the causality of hyperuricemia.

Results: Twenty pulmonary TB patients met the inclusion criteria in this study. Eight out of 12 (60%) TB patients showed uric acid levels ≥7 mg/dl and 8 of them (66.6%) showed symptoms of arthralgia. The median uric acid level increased significantly before (5.14 mg/dl) and after 2 months of treatment (7.74 mg/dl), P-value = 0.001. Uric acid levels ≥7 mg/dl were significantly associated with arthralgia (P-value = 0.017; odds ratio 14.00; 95% confidence interval 1.25-156.61). Based on the Naranjo algorithm, those with hyperuricemia, eight and four patients had a total score of 7 and 8, respectively, which are classified as probable.

Conclusion: Uric acid levels significantly increased during the intensive phase. Pulmonary TB patients with hyperuricemia are a risk factor for arthralgia.

背景:吡嗪酰胺是一种抗结核药物,在强化治疗阶段可使用 2 个月。吡嗪酰胺的不良反应之一是高尿酸血症,并伴有关节痛症状。本研究旨在分析在强化期接受治疗的肺结核(TB)患者中高尿酸血症和关节痛的发生率及其因果关系:这是一项前瞻性队列设计的分析性观察研究。每位肺结核患者抽取 3 毫升血液,在接受吡嗪酰胺治疗 2 个月前后检测尿酸水平。采用 Wilcoxon 检验分析尿酸水平的变化,采用 Chi-square 检验分析尿酸水平与关节痛之间的关联。纳兰霍算法用于分析高尿酸血症的因果关系:20名肺结核患者符合本研究的纳入标准。12 名肺结核患者中有 8 人(60%)尿酸水平≥7 mg/dl,其中 8 人(66.6%)出现关节痛症状。治疗前(5.14 mg/dl)和治疗 2 个月后(7.74 mg/dl),中位尿酸水平明显升高,P 值 = 0.001。尿酸水平≥7 毫克/分升与关节痛明显相关(P 值 = 0.017;几率比 14.00;95% 置信区间 1.25-156.61)。根据纳兰霍算法,8 名和 4 名高尿酸血症患者的总分分别为 7 分和 8 分,被归类为可能:结论:尿酸水平在强化阶段明显升高。肺结核患者伴有高尿酸血症是关节痛的危险因素。
{"title":"Pyrazinamide-induced Hyperuricemia in Pulmonary Tuberculosis Patients.","authors":"Oki Nugraha Putra, Telly Purnamasari, Nindya Maskurisna Hamami","doi":"10.4103/ijmy.ijmy_178_23","DOIUrl":"10.4103/ijmy.ijmy_178_23","url":null,"abstract":"<p><strong>Background: </strong>Pyrazinamide is one of the antitubercular drugs used for 2 months in the intensive phase. One of the adverse effects of pyrazinamide is hyperuricemia, with a symptom of arthralgia. This study aims to analyze the incidence of hyperuricemia and arthralgia and their causality in pulmonary tuberculosis (TB) patients undergoing treatment in the intensive phase.</p><p><strong>Methods: </strong>It was an analytic observational study with a prospective cohort design. Three ml of blood from each pulmonary TB patient was withdrawn to examine uric acid levels before and after 2 months of treatment with pyrazinamide. The Wilcoxon test was used to analyze changes in uric acid levels and the Chi-square test to analyze the association between uric acid levels and arthralgia. Naranjo algorithm is used to analyze the causality of hyperuricemia.</p><p><strong>Results: </strong>Twenty pulmonary TB patients met the inclusion criteria in this study. Eight out of 12 (60%) TB patients showed uric acid levels ≥7 mg/dl and 8 of them (66.6%) showed symptoms of arthralgia. The median uric acid level increased significantly before (5.14 mg/dl) and after 2 months of treatment (7.74 mg/dl), P-value = 0.001. Uric acid levels ≥7 mg/dl were significantly associated with arthralgia (P-value = 0.017; odds ratio 14.00; 95% confidence interval 1.25-156.61). Based on the Naranjo algorithm, those with hyperuricemia, eight and four patients had a total score of 7 and 8, respectively, which are classified as probable.</p><p><strong>Conclusion: </strong>Uric acid levels significantly increased during the intensive phase. Pulmonary TB patients with hyperuricemia are a risk factor for arthralgia.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identification of Nontuberculous Mycobacterium Species by Polymerase Chain Reaction - Restriction Enzyme Analysis (PCR-REA) of rpoB gene in Clinical Isolates. 通过聚合酶链式反应--rpoB 基因的限制酶分析(PCR-REA)鉴定临床分枝杆菌中的非结核分枝杆菌。
IF 1.6 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-09-14 DOI: 10.4103/ijmy.ijmy_134_24
Raj Narayan Yadav, Yellanki Yashwanth Chowdary, Manpreet Bhalla, Ajoy Kumar Verma

Background: Nontuberculous mycobacteria (NTM) infections are an emerging global health concern with increasing incidence. Conventional identification methods for NTM species in clinical settings are prone to errors. This study evaluates a newer method, polymerase chain reaction-restriction enzyme analysis (PCR-REA) of the rpoB gene, for NTM species identification. The study identified NTM species in clinical samples using conventional biochemical techniques and compared the results with PCR-REA of the rpoB gene. This cross-sectional study was conducted at a tertiary health-care center in North India over 18 months, analyzing both pulmonary and extrapulmonary samples.

Methods: Two hundred and forty-seven NTM isolates were identified using phenotypic and biochemical methods. The same isolates were subjected to rpoB gene amplification by PCR followed by REA using Msp I and Hae III enzymes.

Results: Conventional methods identified 12 different NTM species (153 slow-growing and 94 rapid-growing), whereas PCR-REA identified 16 species (140 slow-growing, 107 rapid-growing). The Mycobacterium avium intracellulare complex was the most common species isolated. PCR-REA demonstrated higher resolution in species identification, particularly in differentiating within species complexes.

Conclusions: PCR-REA of the rpoB gene proves to be a simple, rapid, and more discriminative tool for NTM species identification compared to conventional methods. This technique could significantly improve the diagnosis and management of emerging NTM infections in clinical settings.

背景:非结核分枝杆菌(NTM)感染是一个新出现的全球健康问题,发病率不断上升。在临床环境中,NTM 物种的传统鉴定方法容易出错。本研究评估了一种用于鉴定 NTM 物种的较新方法,即 rpoB 基因的聚合酶链反应-限制酶分析(PCR-REA)。研究采用传统生化技术鉴定了临床样本中的 NTM 物种,并将结果与 rpoB 基因的 PCR-REA 进行了比较。这项横断面研究在印度北部的一家三级医疗保健中心进行,历时 18 个月,分析了肺部和肺外样本:方法:采用表型和生化方法鉴定了 247 株 NTM 分离物。这些分离物通过 PCR 进行 rpoB 基因扩增,然后使用 Msp I 和 Hae III 酶进行 REA:结果:传统方法鉴定出 12 种不同的非结核分枝杆菌(153 种生长缓慢,94 种生长迅速),而 PCR-REA 鉴定出 16 种(140 种生长缓慢,107 种生长迅速)。细胞内分枝杆菌复合体是最常见的分离菌种。PCR-REA 在物种鉴定方面表现出更高的分辨率,尤其是在物种复合体内部的区分方面:结论:与传统方法相比,rpoB 基因的 PCR-REA 被证明是一种简单、快速且更具鉴别力的非结核分枝杆菌物种鉴定工具。这项技术可大大改善临床环境中对新出现的 NTM 感染的诊断和管理。
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引用次数: 0
Factors Associated with Absence of Active Pulmonary Tuberculosis in HIV Patients with Latent Tuberculosis, Beyond Isoniazid Preventive Therapy. 在异烟肼预防性疗法之外,与潜伏肺结核 HIV 患者无活动性肺结核相关的因素。
IF 1.6 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-09-14 DOI: 10.4103/ijmy.ijmy_146_24
Shinta Karina Yuniati, Tutik Kusmiati

Background: Tuberculosis (TB) is a leading cause of death in patients with human immunodeficiency virus (HIV)/AIDS. About 60% of HIV-positive individuals with latent TB infection (LTBI) develop active TB. Isoniazid preventive therapy (IPT) is recommended by the World Health Organization to prevent the progression of active TB in people living with HIV/AIDS (PLWHA). However, IPT implementation has been limited in some countries like Indonesia. The objective of this study was to assess the effect of IPT administration on the incidence of active TB in HIV patients with latent TB.

Methods: This was a quasi-experimental prospective cohort study conducted in an academic hospital in Indonesia. Interferon-gamma release assay-positive HIV-TB patients were randomly divided into an IPT group (received 6 months of IPT) and a non-IPT group. The incidence of active pulmonary TB was compared between the two groups after 6 months of follow-up.

Results: Of the 23 eligible patients, 22 were enrolled (10 in the IPT group, 12 in the non-IPT group). The incidence of active pulmonary TB was 0% in both groups. Factors associated with the absence of TB in both groups were the use of antiretroviral therapy for >4 years and a CD4+ T lymphocyte count >200 cells/μL. IPT was found to be safe with minimal adverse effects.

Conclusions: In this setting, the use of long-term antiretroviral therapy and higher CD4+ counts, rather than just IPT, were the key factors associated with preventing active TB in latent HIV-TB patients. These findings suggest that comprehensive HIV management may be more important than IPT alone for TB control in PLWHA. Further research is needed to optimize TB prevention strategies in this high-risk population.

背景:结核病(TB)是导致人类免疫缺陷病毒(HIV)/艾滋病患者死亡的主要原因。在潜伏肺结核感染(LTBI)的艾滋病毒阳性患者中,约有 60% 会发展为活动性肺结核。世界卫生组织推荐使用异烟肼预防疗法(IPT)来预防艾滋病毒/艾滋病感染者(PLWHA)发展为活动性肺结核。然而,在印度尼西亚等一些国家,IPT 的实施却很有限。本研究的目的是评估 IPT 对潜伏肺结核艾滋病患者活动性肺结核发病率的影响:这是一项准实验性前瞻性队列研究,在印度尼西亚的一家学术医院进行。γ干扰素释放检测呈阳性的艾滋病病毒感染者-结核病患者被随机分为IPT组(接受6个月的IPT)和非IPT组。随访 6 个月后,比较两组患者活动性肺结核的发病率:结果:在 23 名符合条件的患者中,22 人被选入(10 人在 IPT 组,12 人在非 IPT 组)。两组活动性肺结核发病率均为 0%。两组患者均未发生肺结核的相关因素包括:使用抗逆转录病毒疗法超过 4 年,CD4+ T 淋巴细胞计数超过 200 cells/μL。IPT安全且不良反应极小:在这种情况下,使用长期抗逆转录病毒疗法和较高的 CD4+ 细胞数,而不仅仅是 IPT,是潜伏的 HIV-TB 患者预防活动性结核病的关键因素。这些研究结果表明,对于 PLWHA 的结核病控制而言,全面的 HIV 管理可能比单纯的 IPT 更为重要。要优化这一高风险人群的结核病预防策略,还需要进一步的研究。
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引用次数: 0
Agreement between Phenotypically Detected Linezolid Resistance and Mutations in rrl and rplC Genes of Mycobacterium tuberculosis Isolates Using Nanopore Sequencing. 利用纳米孔测序技术检测结核分枝杆菌对利奈唑胺的表型耐药性与 rrl 和 rplC 基因突变之间的一致性
IF 1.6 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-09-14 DOI: 10.4103/ijmy.ijmy_139_24
Senjuti Sengupta, Parul Jain, Rashmi Ratnam, Bhoopendra Kumar Pandey, Urmila Singh, Vijay Kumar, Ashutosh Paliwal, Amita Jain

Background: Phenotypic drug susceptibility testing (DST) is considered the gold standard for detecting linezolid (LZD) resistance in Mycobacterium tuberculosis (MTB), but it is time-consuming. Nanopore sequencing offers a potentially faster alternative approach. This study evaluated the agreement between phenotypically detected LZD resistance and mutations in the rrl and rplC genes of MTB isolates using nanopore sequencing.

Methods: Consecutive drug-resistant MTB isolates from pulmonary samples collected in 2021 underwent liquid culture (LC) DST for LZD. All resistant isolates and an equal number of susceptible isolates were subjected to targeted sequencing of the rrl and rplC genes using nanopore technology.

Results: Sequencing identified a C154R mutation in the rplC gene in only one LZD-resistant isolate. No mutations were detected in the rrl gene. The agreement between sequencing and LC-DST for detecting LZD resistance was poor (Cohen's kappa: 0.03571, 95% confidence interval [CI]: -0.034-0.105). Additionally, no significant association was found between LZD resistance and clinical or microbiological outcomes at 6-month follow-up.

Conclusion: This study revealed a considerable discrepancy between phenotypic and genotypic detection of LZD resistance in MTB. Further research is needed to better understand the genetic mechanisms underlying LZD resistance and to develop reliable molecular diagnostics for rapid resistance detection.

背景:表型药敏试验(DST)被认为是检测结核分枝杆菌(MTB)对利奈唑胺(LZD)耐药性的黄金标准,但这种方法非常耗时。纳米孔测序提供了一种可能更快的替代方法。本研究利用纳米孔测序技术评估了表型检测到的LZD耐药性与MTB分离株rrl和rplC基因突变之间的一致性:方法:对2021年采集的肺部样本中的耐药MTB分离株进行液体培养(LC)DST检测LZD。对所有耐药分离株和相同数量的易感分离株采用纳米孔技术对 rrl 和 rplC 基因进行靶向测序:结果:测序结果表明,只有一个抗 LZD 的分离株的 rplC 基因发生了 C154R 突变。在 rrl 基因中未检测到突变。测序与 LC-DST 检测 LZD 耐药性的一致性较差(科恩卡帕:0.03571,95% 置信区间 [CI]:-0.034-0.105)。此外,在6个月的随访中,LZD耐药性与临床或微生物学结果之间未发现明显关联:本研究揭示了 MTB 对 LZD 耐药性的表型检测和基因型检测之间存在相当大的差异。为了更好地了解LZD耐药性的遗传机制,并开发出用于快速检测耐药性的可靠分子诊断方法,还需要进一步的研究。
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引用次数: 0
Diagnostic Utility of the "Lancet Consensus Scoring System" in Suspected Cases of Tuberculous Meningitis in Patients Attending a Tertiary Care Hospital in Central India. 柳叶刀共识评分系统 "在印度中部一家三级医院疑似结核性脑膜炎患者中的诊断效用。
IF 1.6 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-09-14 DOI: 10.4103/ijmy.ijmy_147_24
Sakshi Patel, Malti Dadheech, Pushpendra Sahu, Chandrashekhar Pathe, Jitendra Singh, Shashank Purwar, Nirendra Kumar Rai, Sagar Khadanga, Radha Sarawagi Gupta, Anand Kumar Maurya

Background: Tuberculous meningitis (TBM) is a challenging condition to diagnose, and current laboratory methods have limitations, especially in developing countries. This study evaluated the diagnostic utility of the Lancet consensus scoring (LCS) system in suspected TBM cases at a tertiary care center in India.

Methods: The clinical manifestations of 75 patients with suspected TBM were prospectively evaluated using the LCS system, which categorizes cases as "definite" (laboratory confirmed), "probable" (>10 points without imaging or > 12 points with imaging), and "possible" (6-9 points without imaging or 6-11 points with imaging). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the LCS system were compared to GeneXpert and mycobacterial growth indicator tube (MGIT) liquid culture, which are considered the gold standard tests.

Results: Out of 75 recruited cases, 11 were confirmed as definite TBM cases. The LCS system correctly identified 8 of these as "probable" and 3 as "possible" cases. Compared to GeneXpert, the LCS system had a specificity of 100%, sensitivity of 54.55%, NPV of 92.7%, and PPV of 100%. Compared to MGIT liquid culture, the LCS system had a specificity of 100%, sensitivity of 81.82%, NPV of 96.97%, and PPV of 100%. The diagnostic accuracy was higher for MGIT liquid culture (97.33%) than GeneXpert (93.33%).

Conclusion: The LCS system is a practical and easily applicable tool that can aid the diagnosis of suspected TBM cases, particularly in resource-limited settings. Despite some limitations, the LCS system demonstrated good diagnostic performance, suggesting its potential utility in improving TBM diagnosis and management.

背景:结核性脑膜炎(TBM)的诊断具有挑战性,目前的实验室方法存在局限性,尤其是在发展中国家。本研究评估了柳叶刀共识评分(LCS)系统在印度一家三级医疗中心疑似结核性脑膜炎病例中的诊断效用:该系统将病例分为 "确诊"(实验室确诊)、"可能"(无影像学检查>10分或有影像学检查>12分)和 "可能"(无影像学检查6-9分或有影像学检查6-11分)。将 LCS 系统的灵敏度、特异性、阳性预测值 (PPV) 和阴性预测值 (NPV) 与 GeneXpert 和分枝杆菌生长指示管 (MGIT) 液体培养进行了比较,后者被认为是金标准检测方法:在招募的 75 个病例中,有 11 个被确诊为 TBM 确诊病例。LCS 系统正确识别了其中 8 个 "可能 "病例和 3 个 "可能 "病例。与 GeneXpert 相比,LCS 系统的特异性为 100%,灵敏度为 54.55%,NPV 为 92.7%,PPV 为 100%。与 MGIT 液体培养相比,LCS 系统的特异性为 100%,灵敏度为 81.82%,NPV 为 96.97%,PPV 为 100%。MGIT 液体培养的诊断准确率(97.33%)高于 GeneXpert(93.33%):LCS系统是一种实用且易于使用的工具,可帮助诊断疑似TBM病例,尤其是在资源有限的环境中。尽管存在一些局限性,但 LCS 系统仍表现出良好的诊断性能,表明它在改善 TBM 诊断和管理方面具有潜在的实用性。
{"title":"Diagnostic Utility of the \"Lancet Consensus Scoring System\" in Suspected Cases of Tuberculous Meningitis in Patients Attending a Tertiary Care Hospital in Central India.","authors":"Sakshi Patel, Malti Dadheech, Pushpendra Sahu, Chandrashekhar Pathe, Jitendra Singh, Shashank Purwar, Nirendra Kumar Rai, Sagar Khadanga, Radha Sarawagi Gupta, Anand Kumar Maurya","doi":"10.4103/ijmy.ijmy_147_24","DOIUrl":"https://doi.org/10.4103/ijmy.ijmy_147_24","url":null,"abstract":"<p><strong>Background: </strong>Tuberculous meningitis (TBM) is a challenging condition to diagnose, and current laboratory methods have limitations, especially in developing countries. This study evaluated the diagnostic utility of the Lancet consensus scoring (LCS) system in suspected TBM cases at a tertiary care center in India.</p><p><strong>Methods: </strong>The clinical manifestations of 75 patients with suspected TBM were prospectively evaluated using the LCS system, which categorizes cases as \"definite\" (laboratory confirmed), \"probable\" (>10 points without imaging or > 12 points with imaging), and \"possible\" (6-9 points without imaging or 6-11 points with imaging). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the LCS system were compared to GeneXpert and mycobacterial growth indicator tube (MGIT) liquid culture, which are considered the gold standard tests.</p><p><strong>Results: </strong>Out of 75 recruited cases, 11 were confirmed as definite TBM cases. The LCS system correctly identified 8 of these as \"probable\" and 3 as \"possible\" cases. Compared to GeneXpert, the LCS system had a specificity of 100%, sensitivity of 54.55%, NPV of 92.7%, and PPV of 100%. Compared to MGIT liquid culture, the LCS system had a specificity of 100%, sensitivity of 81.82%, NPV of 96.97%, and PPV of 100%. The diagnostic accuracy was higher for MGIT liquid culture (97.33%) than GeneXpert (93.33%).</p><p><strong>Conclusion: </strong>The LCS system is a practical and easily applicable tool that can aid the diagnosis of suspected TBM cases, particularly in resource-limited settings. Despite some limitations, the LCS system demonstrated good diagnostic performance, suggesting its potential utility in improving TBM diagnosis and management.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence and Temporal Trends of Multidrug-resistant Tuberculosis in Iran from 1981 to 2023: A Systematic Review and Meta-analysis. 1981-2023年伊朗耐多药结核病的流行率和时间趋势:系统回顾与元分析》。
IF 1.6 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-09-14 DOI: 10.4103/ijmy.ijmy_162_24
Saman Ayoubi, Parissa Farnia, Poopak Farnia, Jalaledin Ghanavi, Ali Akbar Velayati

Background: Multidrug-resistant tuberculosis (MDR-TB) is a serious threat to global tuberculosis (TB) control efforts. This study aims to investigate the trend of MDR-TB prevalence in Iran over 20 years.

Methods: A systematic literature search was conducted in various databases, including PubMed, Embase, and Web of Science, from 1981 to 2023. Studies reporting the prevalence of MDR-TB in Iran were included in the meta-analysis. Statistical analysis was performed using Comprehensive Meta-Analysis software.

Results: A total of 58 studies from different provinces of Iran were included in the meta-analysis. The majority of studies were from Tehran (n = 33), Kermanshah (n = 5), Mashhad (n = 4), and Tabriz (n = 4) provinces. Overall, 1885 cases of MDR-TB were reported in Iran during the study period. The highest number of MDR-TB cases was reported in 2000 (582 cases) and the lowest in 2001 (1 case). An increasing trend in MDR-TB prevalence was observed, particularly between 2018 and 2019. The pooled prevalence of MDR-TB in Iran was 12.31% (95% CI: 11.83-12.80) using the fixed-effects model and 20.21% (95% CI: 15.70-26.01) using the random-effects model. No evidence of publication bias was found.

Conclusion: The results of this comprehensive meta-analysis highlight the increasing trend of MDR-TB in Iran over the past two decades. This underscores the urgent need for strengthening TB control strategies, including improved surveillance, case detection, treatment, and management of MDR-TB in the country. Developing diagnostic and treatment approaches for MDR-TB should be prioritized by Iranian medical universities and public health authorities.

背景:耐多药结核病(MDR-TB)对全球结核病(TB)控制工作构成严重威胁。本研究旨在调查伊朗 20 年来 MDR-TB 的流行趋势:在各种数据库(包括 PubMed、Embase 和 Web of Science)中对 1981 年至 2023 年的文献进行了系统检索。报告伊朗 MDR-TB 患病率的研究被纳入荟萃分析。统计分析使用 Comprehensive Meta-Analysis 软件进行:荟萃分析共纳入了来自伊朗不同省份的 58 项研究。大多数研究来自德黑兰省(33 项)、克尔曼沙阿省(5 项)、马什哈德省(4 项)和大不里士省(4 项)。在研究期间,伊朗共报告了 1885 例耐药结核病例。2000 年报告的耐药结核病例数量最多(582 例),2001 年最少(1 例)。观察到 MDR-TB 患病率呈上升趋势,尤其是在 2018 年至 2019 年期间。采用固定效应模型,伊朗MDR-TB的汇总流行率为12.31%(95% CI:11.83-12.80);采用随机效应模型,伊朗MDR-TB的汇总流行率为20.21%(95% CI:15.70-26.01)。没有发现发表偏倚的证据:这项综合荟萃分析的结果突出表明,在过去二十年里,伊朗的耐药结核病呈上升趋势。这突出表明,伊朗急需加强结核病控制策略,包括改进 MDR-TB 的监测、病例检测、治疗和管理。伊朗医科大学和公共卫生当局应优先考虑开发 MDR-TB 的诊断和治疗方法。
{"title":"Prevalence and Temporal Trends of Multidrug-resistant Tuberculosis in Iran from 1981 to 2023: A Systematic Review and Meta-analysis.","authors":"Saman Ayoubi, Parissa Farnia, Poopak Farnia, Jalaledin Ghanavi, Ali Akbar Velayati","doi":"10.4103/ijmy.ijmy_162_24","DOIUrl":"10.4103/ijmy.ijmy_162_24","url":null,"abstract":"<p><strong>Background: </strong>Multidrug-resistant tuberculosis (MDR-TB) is a serious threat to global tuberculosis (TB) control efforts. This study aims to investigate the trend of MDR-TB prevalence in Iran over 20 years.</p><p><strong>Methods: </strong>A systematic literature search was conducted in various databases, including PubMed, Embase, and Web of Science, from 1981 to 2023. Studies reporting the prevalence of MDR-TB in Iran were included in the meta-analysis. Statistical analysis was performed using Comprehensive Meta-Analysis software.</p><p><strong>Results: </strong>A total of 58 studies from different provinces of Iran were included in the meta-analysis. The majority of studies were from Tehran (n = 33), Kermanshah (n = 5), Mashhad (n = 4), and Tabriz (n = 4) provinces. Overall, 1885 cases of MDR-TB were reported in Iran during the study period. The highest number of MDR-TB cases was reported in 2000 (582 cases) and the lowest in 2001 (1 case). An increasing trend in MDR-TB prevalence was observed, particularly between 2018 and 2019. The pooled prevalence of MDR-TB in Iran was 12.31% (95% CI: 11.83-12.80) using the fixed-effects model and 20.21% (95% CI: 15.70-26.01) using the random-effects model. No evidence of publication bias was found.</p><p><strong>Conclusion: </strong>The results of this comprehensive meta-analysis highlight the increasing trend of MDR-TB in Iran over the past two decades. This underscores the urgent need for strengthening TB control strategies, including improved surveillance, case detection, treatment, and management of MDR-TB in the country. Developing diagnostic and treatment approaches for MDR-TB should be prioritized by Iranian medical universities and public health authorities.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostics Evaluation of Smart Sure™ Mycobacterium tuberculosis Screening Kit and Smart Sure™ Multidrug-resistant Tuberculosis Detection Kit on Nonsputum Specimens at a Tertiary Care Center of North India. 印度北部一家三级医疗中心对 Smart Sure™ 结核分枝杆菌筛查试剂盒和 Smart Sure™ 耐多药结核病检测试剂盒在非痰标本上的诊断评估。
IF 1.6 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-09-14 DOI: 10.4103/ijmy.ijmy_140_24
Pankaj Jorwal, Binit Kumar Singh, Ankita Anand, Faisal Khan, Krisha Khandelwal, Payal Sharma, Neeraj Nischal, Manish Soneja, Prayas Sethi, Shikha Dhawan, Naveet Wig

Background: Tuberculosis (TB) is caused due to the infection of Mycobacterium tuberculosis (MTB) and it can infect the various parts of the human body. The disease is highly prevalent and is the second most common cause of death worldwide after COVID-19. Apart from sputum specimen, it is exceedingly difficult to diagnose due to its paucibacillary nature. The current study was intended to evaluate the accuracy of Smart Sure™ MTB and multidrug-resistant-TB (MDR-TB) kits (Genetix Biotech Asia Pvt. Ltd., India) with Xpert ultra and Mycobacterium growth indicator tube (MGIT) culture on nonsputum specimens from TB suspects.

Methods: A total of 205 nonsputum specimens were received between October 2023 and May 2024 at Intermediate Reference Laboratory, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India. Xpert ultra and Smart Sure™ MTB and MDR-TB tests were done directly on samples. However, processed specimens were used for MGIT culture and drug-susceptibility testing (DST). Invalid and MGIT contaminated specimens were excluded from the final calculation.

Results: Overall, sensitivity and specificity of Smart Sure™ MTB screening kit was 71.59% and 98.28%, respectively, with Xpert ultra and 68.35% and 90.83%, respectively, with MGIT culture. While comparing with both Xpert ultra and MGIT-DST to detect rifampicin (RIF) resistant, Smart Sure™ MDR-TB kits showed sensitivity of 75.0% and 100% of specificity. However, for isoniazid (INH) resistance, Smart Sure™ MDR-TB kits showed 100% of sensitivity and specificity with MGIT-DST.

Conclusion: For the detection of MTB and its drug-resistance patterns (RIF and INH) in the specimens other than sputum, Smart Sure™ MTB and MDR-TB kits could play a vital role in TB endemic countries. While comparing the set-ups and skilled staffs, it required almost same as compared with previously approved WHO diagnostics used in resource-limited countries.

背景:结核病(TB)是由结核分枝杆菌(MTB)感染引起的,它可以感染人体的各个部位。该病发病率很高,是继 COVID-19 之后全球第二大常见死因。除痰标本外,由于其贫弱性,该病极难诊断。本研究旨在评估 Smart Sure™ MTB 和耐多药结核病(MDR-TB)检测试剂盒(印度 Genetix Biotech Asia Pvt:方法:2023 年 10 月至 2024 年 5 月期间,印度新德里全印度医学科学研究所医学系中间参考实验室共收到 205 份非痰标本。样本直接进行 Xpert ultra 和 Smart Sure™ MTB 和 MDR-TB 检测。然而,经过处理的样本则用于 MGIT 培养和药敏试验 (DST)。最终计算结果不包括无效标本和受 MGIT 污染的标本:总体而言,与 Xpert ultra 相比,Smart Sure™ MTB 筛查试剂盒的灵敏度和特异性分别为 71.59% 和 98.28%;与 MGIT 培养相比,灵敏度和特异性分别为 68.35% 和 90.83%。与 Xpert ultra 和 MGIT-DST 检测利福平(RIF)耐药性相比,智确™ MDR-TB 检测试剂盒的灵敏度为 75.0%,特异性为 100%。然而,对于异烟肼(INH)耐药性,Smart Sure™ MDR-TB 试剂盒与 MGIT-DST 相比,灵敏度和特异性均为 100%:结论:在结核病流行国家,Smart Sure™ MTB 和 MDR-TB 检测试剂盒可在痰以外的标本中检测 MTB 及其耐药模式(RIF 和 INH),发挥重要作用。与以前在资源有限的国家使用的世卫组织批准的诊断方法相比,该方法所需的设置和熟练工作人员几乎相同。
{"title":"Diagnostics Evaluation of Smart Sure™ Mycobacterium tuberculosis Screening Kit and Smart Sure™ Multidrug-resistant Tuberculosis Detection Kit on Nonsputum Specimens at a Tertiary Care Center of North India.","authors":"Pankaj Jorwal, Binit Kumar Singh, Ankita Anand, Faisal Khan, Krisha Khandelwal, Payal Sharma, Neeraj Nischal, Manish Soneja, Prayas Sethi, Shikha Dhawan, Naveet Wig","doi":"10.4103/ijmy.ijmy_140_24","DOIUrl":"https://doi.org/10.4103/ijmy.ijmy_140_24","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is caused due to the infection of Mycobacterium tuberculosis (MTB) and it can infect the various parts of the human body. The disease is highly prevalent and is the second most common cause of death worldwide after COVID-19. Apart from sputum specimen, it is exceedingly difficult to diagnose due to its paucibacillary nature. The current study was intended to evaluate the accuracy of Smart Sure™ MTB and multidrug-resistant-TB (MDR-TB) kits (Genetix Biotech Asia Pvt. Ltd., India) with Xpert ultra and Mycobacterium growth indicator tube (MGIT) culture on nonsputum specimens from TB suspects.</p><p><strong>Methods: </strong>A total of 205 nonsputum specimens were received between October 2023 and May 2024 at Intermediate Reference Laboratory, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India. Xpert ultra and Smart Sure™ MTB and MDR-TB tests were done directly on samples. However, processed specimens were used for MGIT culture and drug-susceptibility testing (DST). Invalid and MGIT contaminated specimens were excluded from the final calculation.</p><p><strong>Results: </strong>Overall, sensitivity and specificity of Smart Sure™ MTB screening kit was 71.59% and 98.28%, respectively, with Xpert ultra and 68.35% and 90.83%, respectively, with MGIT culture. While comparing with both Xpert ultra and MGIT-DST to detect rifampicin (RIF) resistant, Smart Sure™ MDR-TB kits showed sensitivity of 75.0% and 100% of specificity. However, for isoniazid (INH) resistance, Smart Sure™ MDR-TB kits showed 100% of sensitivity and specificity with MGIT-DST.</p><p><strong>Conclusion: </strong>For the detection of MTB and its drug-resistance patterns (RIF and INH) in the specimens other than sputum, Smart Sure™ MTB and MDR-TB kits could play a vital role in TB endemic countries. While comparing the set-ups and skilled staffs, it required almost same as compared with previously approved WHO diagnostics used in resource-limited countries.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
International Journal of Mycobacteriology
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