International Journal of Mycobacteriology最新文献

A 29-year-old previously healthy man with a month-long dry cough presented with hematemesis after mild chest trauma. Endoscopy showed a blood-filled stomach, but bleeding originated from the trachea. Bronchoscopy revealed an aspergilloma in the left upper lung lobe, confirmed histologically and by fungal culture. Imaging showed an apical cavity with pleural thickening. The patient had no history of tuberculosis, diabetes, or immunosuppression, and tested negative for human immunodeficiency virus. Hemorrhage resolved with conservative measures, and a 3-month course of voriconazole led to successful recovery without recurrence at 6 months. This case highlights hematemesis as a rare presentation of pulmonary aspergillosis, emphasizing the need to consider it in differential diagnoses of unexplained hematemesis, especially after trauma. Early bronchoscopy, histology, and imaging are key to diagnosis, enabling timely antifungal treatment and favorable outcomes.

Background: The resistance of Mycobacterium tuberculosis (Mtb) on first- and second-line anti-tuberculosis (TB) drugs is an issue for TB control; therefore, developing new anti-TB drugs is a priority in TB research. In this sense, the Ca2+ P-type ATPase plasma membrane transporter CtpF is an interesting anti-TB drug target.

Methods: In this work, the activity of 4C-substituted pyrrolo[1,2-a]quinoxalinic compounds on Mtb viability and Ca2+ ATPase activity mediated by the plasma membrane transporter, CtpF, was assessed. The pyrrolo[1,2-a]quinoxalines compounds were initially in silico and analyzed as potential inhibitors of the CtpF transporter. Molecular docking analyses showed that 4-(3,4-methylenedioxyphenyl) pyrrolo[1,2-a]quinoxaline (4b) and 4-(2-chlorophenyl) pyrrolo[1,2-a]quinoxaline (4c) compounds are potential CtpF inhibitors. These compounds were synthesized by green chemistry using deep eutectic solvent under environmentally friendly processes.

Results: Even though both compounds, 4b and 4c, inhibit the plasma membrane Ca2+ ATPase activity mediated by the CtpF transporter (IC50 of 8.05 ± 0.04 µM and 9.15 ± 0.03 µM for 4b and 4c, respectively), only the 4b compound was active on Mtb cells (MIC = 25 µg/mL). Interestingly, compound 4b also showed low toxicity on VERO cells (19.65 ± 0.51%) and hemolytic activity (1.45 ± 0.20%) in human O Rh (+) erythrocytes.

Conclusions: 4-(3,4-methylenedioxyphenyl) pyrrolo[1,2-a]quinoxalinic core-derived compounds could be useful for developing alternative anti-TB compounds.

Whats new: Multiple brain infarcts are very rare in patients with extrapulmonary TB. Patients with disseminated TB with specific involvement of CNS have a high incidence of mortality and morbidity patients.

Background: Assessment of treatment response to pulmonary tuberculosis (TB) is currently done by follow-up cultures since smear microscopy cannot distinguish viable from nonviable bacilli. This delays the therapeutic decision and increases the work load on the TB laboratories. This study evaluated the utility of fluorescein diacetate (FDA) viability staining against culture as a modality to assess treatment response in patients receiving anti tubercular treatment.

Methods: In a cross-sectional study conducted for 2 years at a tertiary care hospital, around 110 follow-up sputum samples from patients with initial smear positivity were collected. After being processed for light-emitting diode fluorescence (FL) microscopy and liquid culture by MGIT 960, the samples were subjected to FDA viability staining as an additional step. FDA staining and FL microscopy results were compared to culture to determine its diagnostic accuracy in predicting bacterial viability.

Results: The positivity rates for FL microscopy, FDA microscopy, and culture were 17%, 10%, and 8.18%, respectively. Culture results correlated with FL microscopy in 83.6% of cases and with FDA staining in 94.5%. FDA staining outperformed FL microscopy in terms of sensitivity, specificity, positive predictive value (PPV), and NPV, with values of 77.7%, 96.04%, 63.6%, and 97.9%, respectively. Among FL microscopy positive samples, FDA staining demonstrated 100% sensitivity and NPV, but poor specificity and PPV (57.14% and 45.45%, respectively) owing to false positive results in some cases.

Conclusion: FDA viability staining proved to be a better predictor of bacteriological clearance during follow-up examinations of patients on antitubercular therapy and may be explored in future research.

Background: India has one of the highest prevalence of tuberculosis (TB) incidence, and Vitamin D deficiency is potentially a risk factor. Latent TB infection is the main reservoir of the global burden of TB. Detecting Mycobacterium tuberculosis infection and identifying the risk factors are the first steps toward improving TB control, preventive therapy, and treatment completion.

Methods: The present study explores the relationship between latent TB prevalence by QuantiFERON-TB Gold PLUS using interferon-gamma release assay (IGRA) and Vitamin D levels by enzyme immunoassay in 46 young healthy adults.

Results: Among the 46 young adults tested, 14 (30.43%) were IGRA positive, 32 (69.56%) were IGRA negative, and 1 (2.17%) had indeterminate results. Among all, Vitamin D deficiency was found to be in 23.91% of individuals (n = 11). The optimal value of Vitamin D was found in 33 individuals (71.73%) and an overdose of Vitamin D was found in 2 individuals (4.34%). We found 23.19% of individuals as IGRA negative but had Vitamin D deficiency (mean = 12 ng/ml) and 4% of individuals as IGRA positive and Vitamin D deficient. The 45.66% of individuals with an optimal range of Vitamin D (mean = 40.77 ng/ml) were IGRA negative. We also observed that 42.85% of IGRA-positive individuals were taking Vitamin D supplements.

Conclusion: Although we did not find any significant correlation between Vitamin D deficiency and IGRA-positive individuals, Vitamin D supplements may be helpful in maintaining a healthy state in latent TB individuals.

Background: Algeria and North Africa have limited data on tuberculosis (TB) risk factors. In addition, pretreatment assessments often do not include fasting blood glucose or renal function tests. These biological tests are only carried out if the interview and the results of the biochemical analysis of the urine make it possible to identify a patient at risk. This study aimed to identify the main risk factors for pulmonary TB (PT) in people aged 15 years and over in Blida and to specify the unrecognised rates of diabetes and chronic renal failure in conjunction with TB.

Methods: We conducted a matched case-control study in Blida, involving 223 PT cases and 446 controls matched by age, sex, and location. Data collection included a structured questionnaire, with renal and fasting glucose tests for all participants. Bivariate and multivariate logistic regression analyses identified independent predictors of TB.

Results: Contact with TB was the strongest predictor (odds ratio [OR]: 23.60, 95% confidence interval [CI]: 10.69-52.14) of PT. Other significant associations included corticosteroid use >7 days (OR: 9.97, 95% CI: 3.38-29.39), diabetes (OR: 4.20, 95% CI: 2.53-6.96), low body weight (OR: 6.38, 95% CI: 2.93-13.89), unemployment (OR: 2.55, 95% CI: 1.43-4.56), smoking (OR: 2.20, 95% CI: 1.41-3.43), and overcrowding (OR: 1.50, 95% CI: 1.03-2.38). Fasting glucose screening revealed undiagnosed diabetes in 5.4% of cases.

Conclusions: The study highlights the need to include metabolic screening in the systematic management of TB and emphasizes the importance of close contact with TB patients.

Background: Pulmonary tuberculosis (TB) is a major global health issue, with Mycobacterium tuberculosis as its primary cause. However, secondary infections like those from Aspergillus spp. can mimic TB symptoms, complicating diagnosis and treatment. This study examines polymerase chain reaction (PCR) as a rapid, sensitive tool for detecting Aspergillus spp. in patients with TB-like clinical presentations.

Methods: This study analyzed 110 sputum samples from patients exhibiting pulmonary TB symptoms at Wahidin Sudirohusodo General Hospital and Hasanuddin University Hospital, Makassar, Indonesia. Samples were examined using PCR with Aspergillus spp., specific primers, ASAP1 and ASAP2. Culture examination was conducted for result confirmation.

Results: Out of 110 samples, PCR detected Aspergillus spp. in 25 (22.7%) samples, while culture identified only 8 (7.2%) samples as positive. Among the PCR-positive samples, eight were also culture-positive, and 17 were culture-negative. Patients primarily fell within the productive age group (18-50 years, 49.1%), with a slight male predominance (58.1%) and notable comorbidity presence (52.7%).

Conclusion: PCR significantly improves the detection of Aspergillus spp. in TB patients compared to culture, facilitating timely and accurate diagnosis of fungal coinfections. Improved diagnostic accuracy may enhance clinical management and treatment outcomes for TB patients.

Background: Tuberculosis (TB) remains a major public health issue globally, presenting in pulmonary tuberculosis(PTB) and extra PTB(EPTB) forms. Acid-Fast Bacilli (AFB) testing is crucial for detecting Mycobacterium tuberculosis. Understanding TB epidemiology, including positivity rates, demographic patterns, and comorbidities, is essential for effective control. This study analyses AFB testing trends for TB over 5 years, focusing on PTB and EPTB cases, gender and age distribution, and associated comorbidities to inform public health and clinical practices.

Methods: This retrospective study analyzed AFB, Mantoux, and polymerase chain reaction (PCR) testing data from 2019 to 2023. Trends in positivity rates, PTB/EPTB ratios, demographics, and comorbidities were assessed, with statistical analyses and comparisons to prior studies to contextualize findings.

Results: AFB testing volume rose from 2440 samples in 2019-2518 in 2023. PTB positivity declined from 3.7% to 2.5%, whereas EPTB cases peaked in 2020. Males predominated PTB cases, peaking at 84.62% in 2020. PTB to EPTB ratios were 12.82:1 (AFB) and 3.47:1 (PCR). Mantoux positivity rose significantly from 2019 to 2022 (χ² =18.64, P < 0.001), with higher rates in males and older adults. An increase in rifampicin-resistant TB was noted in 2022-2023. Common TB comorbidities included diabetes, hypertension, and chronic lung disease, complicating treatment.

Conclusion: This study highlights dynamic TB trends, stressing the need for age- and gender-specific control strategies. Rising EPTB cases, drug resistance, and comorbidities underscore the importance of targeted interventions, preventive measures, and socioeconomic research to optimize TB management.