International Journal of Mycobacteriology最新文献

Background: Tuberculosis (TB), caused by Mycobacterium tuberculosis complex, results in approximately 1.5 million annual deaths globally. Diagnosing extrapulmonary TB (EPTB) remains challenging due to the invasive nature of sample collection and limitations in conventional diagnostic sensitivity. This study evaluates the diagnostic performance of Xpert®Mycobacterium tuberculosis/Rifampicin (MTB/RIF), a nucleic acid amplification test, against direct microscopy for EPTB specimens. In addition, we compare the detection of first-line anti-tubercular drug resistance between Xpert® MTB/RIF and the MTB-DR plus line probe assay.

Methods: From January 2022, to April 2023, 2839 clinically suspected EPTB specimens were collected from patients referred to tertiary care hospitals in Gorakhpur, India. Specimens included lymph node aspirates, pleural fluid, cerebrospinal fluid, and tissue biopsies, processed according to the Indian National Tuberculosis Elimination Program protocols. Diagnostic evaluations employed microscopy (acid-fast bacilli staining), Xpert® MTB/RIF, and MTB-DR plus assays.

Results: Of 2839 specimens, Xpert® MTB/RIF detected M. tuberculosis in 339 cases (11.9%), significantly outperforming microscopy (183 cases, 6.4%). The highest positivity rates occurred in tissue biopsies and lymph node aspirates (29%), while genitourinary TB was least frequent. Rifampicin resistance was identified in 14 cases (4.13%), all confirmed as multidrug-resistant TB (MDR-TB) by MTB-DR plus.

Conclusion: Xpert® MTB/RIF demonstrated superior sensitivity over microscopy, supporting its utility for EPTB diagnosis in low-resource settings. The high MDR-TB prevalence (4.13%) underscores the need for rapid molecular diagnostics to guide treatment. However, global EPTB burden estimates remain inconsistent, necessitating standardized surveillance and diagnostic protocols to improve detection accuracy and inform public health strategies.

Background: Tuberculosis (TB) remains a global health challenge, necessitating comprehensive research to understand genetic factors influencing susceptibility and drug resistance. This study aimed to investigate the presence of drug resistance, analyze single nucleotide polymorphisms (SNPs) in IFN-γ (reference SNP. 2430561, +874 Adenine/Thymine) and IL-10 (reference SNP.1800896, -1082 Adenine/Guanine), and assess their associations with age and sex among a cross section of TB patients in Kaduna state.

Methods: A total of 140 participants, comprising drug-resistant TB (DR-TB) patients, drug-susceptible TB (DS-TB) patients, and Apparently Healthy controls (AHCs), were enrolled. Genomic deoxyribonucleic acid was extracted, and SNPs were genotyped using polymerase chain reaction-based techniques. Associations between genotypes, alleles, age, and sex were analyzed. Odd ratios and Hardy-Weinberg equilibrium were employed for demographic and genetic analyses.

Results: In DR-TB, significant associations were observed between IFN-γ genotypes/alleles and increased susceptibility, with thymine thymine (TT) genotype and T allele showing higher frequency. For IL-10, guanine guanine (GG) genotype and G allele were prevalent, indicating potential associations with DR-TB risk. In DS-TB, similar trends were observed, highlighting potential genetic influences on susceptibility. HWE analysis revealed significant deviations in some groups, suggesting genetic variations.

Conclusions: The prevalence of specific genotypes and alleles indicates potential genetic markers for risk assessment. Deviations from HWE suggest population-specific genetic variations. These findings underscore the importance of genetic factors in TB outcomes and advocate for tailored interventions for different populations.

Background: Mycobacterium lepare-induced leprosy continues to pose a significant public health threat. Drug-resistant strains pose a major challenge for effective management, necessitating molecular studies to identify resistance-associated mutations and guide appropriate therapy.

Methods: A cross-sectional analysis of a total of 47 samples, including slit-skin smear and biopsy specimens, were collected along with relevant clinical details. Fifteen samples that tested positive for acid-fast bacilli were further processed. Amplification of folP1, rpoB and gyrA genes was performed using polymerase chain reaction, followed by automated capillary sequencing to identify mutations associated with dapsone, rifampicin, and ofloxacin resistance, respectively, in M. leprae.

Results: Sequencing revealed no folP1 and rpoB gene mutations in any of the 15 isolates sequenced in this study, indicating wild-type status and susceptibility to dapsone and rifampicin, respectively. A mutation was identified at codon 91 (alanine [GCA] → valine [GTA]) in the gyrA gene (20%), resulting in an alanine-to-valine change known to cause resistance to ofloxacin. Five samples did not provide adequate chromatogram quality for analysis.

Conclusion: The study identified mutations in the gyrA gene which is associated with ofloxacin resistance in M. leprae in Central India. While the absence of resistance to first-line anti-leprosy drugs is reassuring, the emergence of resistance to fluoroquinolones is a cause for concern. Early detection of resistant strains facilitates prompt initiation of drug therapies, reducing their spread and advancing the global leprosy eradication effort.

Background: Bovine tuberculosis (bTB) is a disease primarily caused by Mycobacterium bovis. Currently, no commercial vaccines exist for controlling bTB, making the development of effective vaccine candidates and testing models a high priority. Mouse models are widely used in preclinical trials of anti-TB vaccines. Determining the appropriate cultivation time to assess the mycobacterial load in animal organs or biological samples is crucial to establishing a reliable model that can accurately evaluate the effectiveness of a vaccine candidate. The aim of this study was to assess the growth dynamics and the appearance of colony-forming units (CFUs) in lung homogenates from mice infected with M. bovis. We compared the CFU counts from vaccinated and challenged mice with M. bovis using data from a previous experiment.

Methods: CFUs obtained from the lungs of vaccinated and M. bovis-challenged mice of a previous experiment were registered at 3 and 4 weeks of culturing in solid media. The statistical analysis was performed with Kruskal-Wallis, followed by a Dunn's multiple comparison test.

Results: On analyzing the CFU dynamics from lung homogenates, we found that mice vaccinated with Bacillus Calmette-Guérin preserved stable CFU counts after 3 weeks of cultivation on a solid medium. In contrast, both the unvaccinated group and the group vaccinated with an attenuated M. bovis triple mutant strain reached their final CFU counts only after 4 weeks of culturing.

Conclusion: These findings underscore the importance of prolonged follow-up to accurately assess CFU counts, which are crucial for determining vaccine efficacy in trials.

Background: Tuberculosis (TB) is the second concern of a fatal infectious disease in the world caused by Mycobacterium tuberculosis (MTB). Indonesia has many regions that is known as a hotspot region for MTB cases, one of the most cities high newly case detected in 5 years was Surabaya. In 2022, Surabaya reported a higher pulmonary TB (PTB) prevalence rate of 0.35%. This study aimed to investigate the genomic and phylogenetic characteristics of MTB from isolates of rifampicin-sensitive PTB patients in Surabaya using whole genome sequencing (WGS).

Methods: This study is a cross-sectional study to descriptively analyses WGS data using bioinformatics. Out of 8 enrolled drug-sensitive PTB patients; however, only three cultured isolates successfully grew on MB 7H11/OADC agar and subjected for WGS analysis.

Results: Whole genome analysis revealed that all the samples were drug sensitive. The identified samples were majority belonged to lineage 4.4.1 (Euro-American [S-type]) and we found a novel strain in East Java region known as Lineage 4.10 (Euro-American [Uganda 1]). In addition, we identified a novel SNVs predicted to be associated with genomic adaptation in fgd1, embC, embA, and rv0565c under antibiotic pressures.

Conclusion: WGS predicts that all the samples from pulmonary rifampicin-sensitive TB patients in this study were drug sensitive. We report the first discovery of a novel L4.10 strain, classified as Uganda 1, in Surabaya, Indonesia.

Background: Tuberculosis (TB) is a significant public health issue, and drug-induced liver injury (DILI) from anti-TB medications poses a major challenge to treatment efficacy. This study aims to evaluate the protective effects of a blended polyherbal extract consisting of Moringa oleifera Lam., Camellia sinensis, Curcuma zanthorrhiza, and Caesalpinia sappan L. against DILI induced by TB drugs.

Methods: A total of 25 male Wistar rats were divided into five groups: a control group, a DILI group receiving anti-TB drugs, and three groups receiving varying doses of the polyherbal extract. Key parameters, including CYP450 expression and liver enzyme levels (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]), were assessed using colorimetric techniques.

Results: The administration of the highest dose of the polyherbal extract significantly reduced CYP450 expression and lowered ALT and AST levels compared to the DILI group. These findings suggest that the polyherbal remedy effectively protects the liver from damage caused by TB medications.

Conclusions: The study concludes that the polyherbal extract MOC3 exhibits hepatoprotective properties, indicating its potential as a preventive treatment for DILI in TB therapy. Further clinical investigations are recommended to explore its applicability in human subjects.

Urogenital tuberculosis (TB) is a common manifestation of extrapulmonary TB, accounting for approximately 30%-40% of all cases, with the kidneys being the most frequently affected organ. Despite its prevalence, renal TB often presents diagnostic challenges due to nonspecific clinical symptoms, which can lead to delayed diagnosis and treatment. Increased occurrences of extrapulmonary TB have been observed in recent decades, linked to a rise in organ transplants and the prevalence of acquired immune deficiency syndrome. The urogenital form of the disease may arise from either disseminated infection or primary genitourinary localization. Symptoms typically include pyuria, dysuria, fever, flank pain, and burning micturition, often revealing a mass related to hydronephrosis of the affected kidney. Clinicians in regions with high TB prevalence, such as India, should maintain a high index of suspicion for renal TB, especially in patients with recurrent urinary tract infections. Early identification and treatment are crucial to prevent the development of nonfunctioning kidneys and associated complications. This case report highlights the importance of recognizing the clinical presentation of renal TB to improve diagnosis and management in affected patients.

Background: The objective is to re-evaluate treatment outcomes of all bacteriologically positive patients with tuberculosis (TB) registered at Facility X in 2023.

Methods: A retrospective cohort study was conducted on treatment outcomes of patients with TB using TB treatment and laboratory TB registers and treatment cards. Patients with incorrect treatment outcomes and those who were not evaluated by the facility had correct treatment outcomes assigned. In addition, treatment outcomes for patients who were transferred out were retrieved.

Results: A total of 350 patients with bacteriologically positive TB were registered at facility X in 2023. The number of male patients was 274 (78%), the age of the patients ranged from 2.9 to 80 years, and 262 (74.9%) were new patients. The health facility managed to evaluate 340 (97%) patients, of whom 334 (95.4%) were correctly evaluated, while 16 (4.6%) were either incorrectly evaluated or not evaluated at all. As a result of this re-evaluation, the proportion of the evaluated patients increased from 97% (340 of 350 patients) to 99.4% (348 of 350 patients). The cure rate rose from 90.6% to 92.2% and the treatment success rate increased from 90.9% to 92.9%.

Conclusion: This study has demonstrated that it is possible to evaluate almost all patients with TB at the end of their treatment. Inaccuracies in reporting TB data can negatively affect the implementation of TB programs. Health facilities should strive to correctly evaluate all patients with TB.

Background: This study assessed the effects of social support, resilience, temporal discounting, and stigma on medication adherence among people with drug-resistant tuberculosis (PwDR-TB) in Lagos, Nigeria.

Methods: A cross-sectional study was conducted between September and December 2023 among 203 adults on DR-TB treatment. The Morisky Medication Adherence Scale-8, Redwood DR-TB scale, multidimensional scale of perceived social support, brief resilience scale, and deferment of gratification scale were used to assess adherence, stigma, social support, resilience, and temporal discounting respectively. Pearson's correlation and hierarchical linear regression analysis were conducted to explore the relationships between adherence, stigma, social support, resilience, and temporal discounting.

Results: The prevalence of low, medium, and high adherence was 20.7%, 73.4%, and 5.9%, respectively. Adherence was positively associated with social support (B = 0.380, P < 0.001), resilience (B = 0.210, P < 0.001), and temporal discounting (B = 0.364, 0 < 0.001) and negatively associated with stigma (B = -0.317, P < 0.001). Temporal discounting made a higher significant contribution (B = 0.343, P < 0.001) in predicting adherence than social support (B = 0.187, P = 0.005), resilience (B = 0.175, P = 0.002) and stigma (B = -0.317, P < 0.001).

Conclusion: Patient-centred interventions that promote social support, resilience, and temporal discounting are urgently needed to enhance adherence among PwDR-TB. Stigma reduction strategies are required at all levels.

Mycobacterium haemophilum is a nontuberculous mycobacterium that predominantly causes disease in immunocompromised patients. Due to some similarities, especially in terms of skin manifestations to Mycobacterium leprae, disease caused by these two agents may be commonly confused with each other. Here, we describe an immunocompromised adult patient with disseminated skin lesions, prolonged cough, and progressive ocular symptoms with the initial diagnosis of leprosy but a final diagnosis of M. haemophilum infection. Clinical clues such as the pattern of skin lesions, detailed neurological examination, and concurrent involvement of other organs, combined with molecular techniques could eventually lead to the correct diagnosis.