Pub Date : 2026-01-14DOI: 10.1016/j.jctube.2026.100582
Katherine Timboe , J.Brooks Jackson , Greta L. Becker
Tuberculosis (TB), caused by Mycobacterium tuberculosis, is the leading infectious cause of death globally. Although effective treatments are available, treatment length, drug toxicity, and the emergence of drug-resistant strains have challenged TB control efforts. Current clinical trials are focused on developing shorter, safer, and more effective regimens that incorporate both new and repurposed agents for the treatment of TB. This narrative review provides an overview of current and emerging treatment options for drug-susceptible, drug-resistant, and latent TB based on recent clinical trials and WHO guidelines.
{"title":"Recent advances in tuberculosis treatment: Towards shorter, safer, and more effective therapies","authors":"Katherine Timboe , J.Brooks Jackson , Greta L. Becker","doi":"10.1016/j.jctube.2026.100582","DOIUrl":"10.1016/j.jctube.2026.100582","url":null,"abstract":"<div><div>Tuberculosis (TB), caused by Mycobacterium tuberculosis, is the leading infectious cause of death globally. Although effective treatments are available, treatment length, drug toxicity, and the emergence of drug-resistant strains have challenged TB control efforts. Current clinical trials are focused on developing shorter, safer, and more effective regimens that incorporate both new and repurposed agents for the treatment of TB. This narrative review provides an overview of current and emerging treatment options for drug-susceptible, drug-resistant, and latent TB based on recent clinical trials and WHO guidelines.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"42 ","pages":"Article 100582"},"PeriodicalIF":2.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976813","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}
Multidrug-resistant tuberculosis (MDR-TB) remains a major public health challenge in South Asia, which bears a disproportionate global burden. Comprehensive, longitudinal analyses of MDR-TB mortality trends, stratified by country and sex, with forward-looking projections are limited.
Methods
We conducted a retrospective analysis using data from the Global Burden of Disease Study 2023 to examine age-standardized mortality rates (ASMR) attributable to MDR-TB in South Asia and its countries (Bangladesh, Bhutan, India, Nepal, Pakistan) from 1990 to 2023. Trends were assessed by sex, and estimated annual percentage changes (EAPC) were calculated via log-linear regression. Seasonal Autoregressive Integrated Moving Average (SARIMA) models were employed to forecast ASMR through 2050, with 95% prediction intervals.
Results
Regional ASMR rose from 0.25 per 100,000 (95% UI: 0.03–0.88) in 1990 to a peak of 6.34 (95% UI: 2.56–13.56) in 2010, declining to 3.63 (95% UI: 0.54–9.80) by 2023, driven predominantly by India and Pakistan. Nepal exhibited consistent declines (EAPC: −2.44%; 95% CI: −3.21 to −1.66), while Pakistan showed the highest increase (EAPC: 6.16%; 95% CI: 3.21–9.19). Males consistently had higher ASMR across all settings. Forecasts suggest continued declines toward near-elimination in Bangladesh, Bhutan, and Nepal, but potential substantial rebounds in India, Pakistan, and regionally, with upper prediction intervals exceeding 20–40 per 100,000 by 2050 in high-burden scenarios.
Conclusion
Despite progress in some countries, MDR-TB mortality remains elevated in populous nations, with persistent male excess. Projections highlight risks of resurgence without intensified interventions. These findings underscore the urgent need for tailored, gender-sensitive strategies and enhanced regional collaboration to achieve End TB targets in South Asia.
{"title":"Epidemiologic trajectories and burden of multidrug-resistant tuberculosis (MDR-TB) mortality across South Asia: An analysis of Global Burden of Disease data (1990–2023) with machine learning forecasting to 2050","authors":"Ibrahim Khalil , Sakib Abrar , I.M. Khalid Reza , Md. Imran Hossain , Mst. Mahmuda Akter , Farhana Sultana","doi":"10.1016/j.jctube.2026.100580","DOIUrl":"10.1016/j.jctube.2026.100580","url":null,"abstract":"<div><h3>Background</h3><div>Multidrug-resistant tuberculosis (MDR-TB) remains a major public health challenge in South Asia, which bears a disproportionate global burden. Comprehensive, longitudinal analyses of MDR-TB mortality trends, stratified by country and sex, with forward-looking projections are limited.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis using data from the Global Burden of Disease Study 2023 to examine age-standardized mortality rates (ASMR) attributable to MDR-TB in South Asia and its countries (Bangladesh, Bhutan, India, Nepal, Pakistan) from 1990 to 2023. Trends were assessed by sex, and estimated annual percentage changes (EAPC) were calculated via log-linear regression. Seasonal Autoregressive Integrated Moving Average (SARIMA) models were employed to forecast ASMR through 2050, with 95% prediction intervals.</div></div><div><h3>Results</h3><div>Regional ASMR rose from 0.25 per 100,000 (95% UI: 0.03–0.88) in 1990 to a peak of 6.34 (95% UI: 2.56–13.56) in 2010, declining to 3.63 (95% UI: 0.54–9.80) by 2023, driven predominantly by India and Pakistan. Nepal exhibited consistent declines (EAPC: −2.44%; 95% CI: −3.21 to −1.66), while Pakistan showed the highest increase (EAPC: 6.16%; 95% CI: 3.21–9.19). Males consistently had higher ASMR across all settings. Forecasts suggest continued declines toward near-elimination in Bangladesh, Bhutan, and Nepal, but potential substantial rebounds in India, Pakistan, and regionally, with upper prediction intervals exceeding 20–40 per 100,000 by 2050 in high-burden scenarios.</div></div><div><h3>Conclusion</h3><div>Despite progress in some countries, MDR-TB mortality remains elevated in populous nations, with persistent male excess. Projections highlight risks of resurgence without intensified interventions. These findings underscore the urgent need for tailored, gender-sensitive strategies and enhanced regional collaboration to achieve End TB targets in South Asia.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"42 ","pages":"Article 100580"},"PeriodicalIF":2.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976811","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}
{"title":"Comments on “Tuberculosis infection control in MDR-TB designated hospitals in Jiangsu Province, China”","authors":"Sushma Narsing Katkuri , Varshini Vadhithala , Arun Kumar , Sushma Verma , Dhanya Dedeepya","doi":"10.1016/j.jctube.2026.100581","DOIUrl":"10.1016/j.jctube.2026.100581","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"42 ","pages":"Article 100581"},"PeriodicalIF":2.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938857","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}
We report a case of disseminated Mycobacterium triviale infection in a 61-year-old male with no significant comorbidities. Definitive pathogen identification was provided by nucleotide matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF-MS) analysis. The results of a literature review underscore the critical role of MALDI-TOF MS in increasing the accuracy in detecting the pathogen. A regimen combining rifampin, fluoroquinolone, macrolide, and ethambutol appears to be a viable treatment option.
{"title":"Disseminated Mycobacterium triviale infection: A rare case report and literature review","authors":"Li-qing Liang , Fei Xiao , Xin-yi Zhuo , Xiao-fan Wu , Xiu-yu Qin , Ye Qiu","doi":"10.1016/j.jctube.2026.100579","DOIUrl":"10.1016/j.jctube.2026.100579","url":null,"abstract":"<div><div>We report a case of disseminated <em>Mycobacterium triviale</em> infection in a 61-year-old male with no significant comorbidities. Definitive pathogen identification was provided by nucleotide matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF-MS) analysis. The results of a literature review underscore the critical role of MALDI-TOF MS in increasing the accuracy in detecting the pathogen. A regimen combining rifampin, fluoroquinolone, macrolide, and ethambutol appears to be a viable treatment option.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"42 ","pages":"Article 100579"},"PeriodicalIF":2.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976812","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}
Pub Date : 2025-12-04DOI: 10.1016/j.jctube.2025.100576
Xiaomeng Hu, Changhao Cheng, Qian Jin, Wu Jin, Qiaoyan Dong, Fan Wu, Fen Hu, Ying Li, Lei Wang, Lu Lu, Qing Xu, Juan Du
Background
Multidrug-resistant tuberculosis (MDR-TB) complicated by extrapulmonary TB (EPTB) poses significant therapeutic challenges. While delamanid (DLM) demonstrates extensive tissue penetration, clinical evidence supporting its use specifically for MDR-TB with EPTB remain limited. This report evaluates an all-oral DLM-containing regimen for this complex presentation.
Case Presentation
Four patients (aged 35, 24, 47, 4 years; 3 females, 1 child) with molecularly confirmed MDR pulmonary TB (MDR-PTB) and concurrent EPTB (spinal, central nervous system, breast, lymph node) received individualized all-oral regimens. Regimens combined DLM with bedaquiline (BDQ), linezolid (LZD), fluoroquinolones, and companion drugs for ≥ 15 months. Follow-up imaging demonstrated significant lesion resolution in all cases, including the pediatric lymph node involvement (first reported in China). Twenty-four adverse events occurred (15 Grade 1, 6 Grade 2, 3 Grade 3), primarily corrected QT interval prolongation (5 events, one > 500 ms). Most events (21/24, 87.5 %) resolved following dose adjustments or supportive care. No serious adverse events or deaths occurred.
Conclusion
In this small case series of patients with MDR-TB and diverse extrapulmonary manifestations, an all-oral DLM-containing regimen was associated with significant lesion regression and demonstrated a manageable safety profile. QT prolongation was the primary adverse event, reversible with intervention. These findings—representing China’s first systematic report of this regimen for multisite EPTB, including the pediatric case—align with WHO guidance and suggest DLM’s potential utility based on its extensive tissue penetration. Further validation in larger multicenter studies is warranted.
{"title":"Efficacy and safety of an all-oral delamanid-containing regimen in the treatment of multidrug-resistant pulmonary tuberculosis complicated by extrapulmonary tuberculosis: Four case reports and review of the literature","authors":"Xiaomeng Hu, Changhao Cheng, Qian Jin, Wu Jin, Qiaoyan Dong, Fan Wu, Fen Hu, Ying Li, Lei Wang, Lu Lu, Qing Xu, Juan Du","doi":"10.1016/j.jctube.2025.100576","DOIUrl":"10.1016/j.jctube.2025.100576","url":null,"abstract":"<div><h3>Background</h3><div>Multidrug-resistant tuberculosis (MDR-TB) complicated by extrapulmonary TB (EPTB) poses significant therapeutic challenges. While delamanid (DLM) demonstrates extensive tissue penetration, clinical evidence supporting its use specifically for MDR-TB with EPTB remain limited. This report evaluates an all-oral DLM-containing regimen for this complex presentation.</div></div><div><h3>Case Presentation</h3><div>Four patients (aged 35, 24, 47, 4 years; 3 females, 1 child) with molecularly confirmed MDR pulmonary TB (MDR-PTB) and concurrent EPTB (spinal, central nervous system, breast, lymph node) received individualized all-oral regimens. Regimens combined DLM with bedaquiline (BDQ), linezolid (LZD), fluoroquinolones, and companion drugs for ≥ 15 months. Follow-up imaging demonstrated significant lesion resolution in all cases, including the pediatric lymph node involvement (first reported in China). Twenty-four adverse events occurred (15 Grade 1, 6 Grade 2, 3 Grade 3), primarily corrected QT interval prolongation (5 events, one > 500 ms). Most events (21/24, 87.5 %) resolved following dose adjustments or supportive care. No serious adverse events or deaths occurred.</div></div><div><h3>Conclusion</h3><div>In this small case series of patients with MDR-TB and diverse extrapulmonary manifestations, an all-oral DLM-containing regimen was associated with significant lesion regression and demonstrated a manageable safety profile. QT prolongation was the primary adverse event, reversible with intervention. These findings—representing China’s first systematic report of this regimen for multisite EPTB, including the pediatric case—align with WHO guidance and suggest DLM’s potential utility based on its extensive tissue penetration. Further validation in larger multicenter studies is warranted.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"42 ","pages":"Article 100576"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797342","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}
Pub Date : 2025-12-02DOI: 10.1016/j.jctube.2025.100577
Parth Aphale, Shashank Dokania, Himanshu Shekhar
The study by Song et al. [1] detailing the significant improvements in Tuberculosis Infection Control (TBIC) implementation rates across designated hospitals in Jiangsu Province, China, provides valuable data on the feasibility of programmatic interventions in high-burden settings. The demonstrated rise in compliance for Administrative Controls (AC), Environmental Controls (EC), and Respiratory Protection (RP) is commendable. However, as scholars focused on global TB elimination, we must constructively appraise whether measuring implementation rates adequately captures the desired public health impact, particularly in facilities designated for multi-drug resistant tuberculosis (MDR-TB).
{"title":"The critical link between TB infection control process and clinical impact: need for efficacy data and MDR-TB specificity","authors":"Parth Aphale, Shashank Dokania, Himanshu Shekhar","doi":"10.1016/j.jctube.2025.100577","DOIUrl":"10.1016/j.jctube.2025.100577","url":null,"abstract":"<div><div>The study by Song et al. [1] detailing the significant improvements in Tuberculosis Infection Control (TBIC) implementation rates across designated hospitals in Jiangsu Province, China, provides valuable data on the feasibility of programmatic interventions in high-burden settings. The demonstrated rise in compliance for Administrative Controls (AC), Environmental Controls (EC), and Respiratory Protection (RP) is commendable. However, as scholars focused on global TB elimination, we must constructively appraise whether measuring implementation rates adequately captures the desired public health impact, particularly in facilities designated for multi-drug resistant tuberculosis (MDR-TB).</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"42 ","pages":"Article 100577"},"PeriodicalIF":2.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692201","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}
Pub Date : 2025-11-27DOI: 10.1016/j.jctube.2025.100575
Jonathan Izudi , Saidi Appeli , Francis Bajunirwe
Rationale
Food insecurity (FI), hazardous alcohol consumption (HAC), and poor mental health are common among people with tuberculosis (TB), yet empirical evidence on their interrelationships remains limited.
Objective
We evaluated the effect of FI on HAC and psychological well-being among people with pulmonary TB in Kampala, Uganda.
Methods
We collected data across five TB clinics and constructed a quasi-experimental design. FI was the exposure, measured using the FI Experience Scale (FIES). FIES scores range between 0 and 8, and individuals were classified as food insecure if they scored ≥ 4. The primary outcome was HAC, assessed using the Alcohol Use Disorders Identification Test (AUDIT) tool. Participants with AUDIT scores ≥ 16, indicating high-risk drinking or possible alcohol dependence, were categorized as having HAC. The secondary outcome was psychological well-being measured using the World Health Organization’s Five Well-Being Index, with a total score of <15 indicating poor psychological well-being. We used doubly robust estimation to report causal risk ratios (RR) and 95 % confidence intervals (CI).
Results
Of 818 participants, 475 (58.1 %) were from food-insecure households, 153 (18.7 %) had HAC, and 316 (38.6 %) had poor psychological well-being. FI was independently associated with HAC (RR 1.43, 95 % CI: 1.21–1.69), but not poor psychological well-being (RR 1.06, 95 % CI: 0.81–1.37).
Conclusion
FI is associated with a higher likelihood of HAC but not psychological well-being among people with TB in Kampala, Uganda. Given their high prevalence, there is a need to address food insecurity, HAC, and poor psychological well-being within TB control programs.
{"title":"Effect of food insecurity on hazardous alcohol consumption and psychological well-being among people with tuberculosis in Kampala, Uganda","authors":"Jonathan Izudi , Saidi Appeli , Francis Bajunirwe","doi":"10.1016/j.jctube.2025.100575","DOIUrl":"10.1016/j.jctube.2025.100575","url":null,"abstract":"<div><h3>Rationale</h3><div>Food insecurity (FI), hazardous alcohol consumption (HAC), and poor mental health are common among people with tuberculosis (TB), yet empirical evidence on their interrelationships remains limited.</div></div><div><h3>Objective</h3><div>We evaluated the effect of FI on HAC and psychological well-being among people with pulmonary TB in Kampala, Uganda.</div></div><div><h3>Methods</h3><div>We collected data across five TB clinics and constructed a quasi-experimental design. FI was the exposure, measured using the FI Experience Scale (FIES). FIES scores range between 0 and 8, and individuals were classified as food insecure if they scored ≥ 4. The primary outcome was HAC, assessed using the Alcohol Use Disorders Identification Test (AUDIT) tool. Participants with AUDIT scores ≥ 16, indicating high-risk drinking or possible alcohol dependence, were categorized as having HAC. The secondary outcome was psychological well-being measured using the World Health Organization’s Five Well-Being Index, with a total score of <15 indicating poor psychological well-being. We used doubly robust estimation to report causal risk ratios (RR) and 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Of 818 participants, 475 (58.1 %) were from food-insecure households, 153 (18.7 %) had HAC, and 316 (38.6 %) had poor psychological well-being. FI was independently associated with HAC (RR 1.43, 95 % CI: 1.21–1.69), but not poor psychological well-being (RR 1.06, 95 % CI: 0.81–1.37).</div></div><div><h3>Conclusion</h3><div>FI is associated with a higher likelihood of HAC but not psychological well-being among people with TB in Kampala, Uganda. Given their high prevalence, there is a need to address food insecurity, HAC, and poor psychological well-being within TB control programs.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"42 ","pages":"Article 100575"},"PeriodicalIF":2.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624911","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}
Pub Date : 2025-11-27DOI: 10.1016/j.jctube.2025.100574
Kaley Parchinski , Lisa Pascopella , Pennan Barry
Background
Central nervous system (CNS) tuberculosis (TB) is rare and causes substantial morbidity and mortality. We quantified the frequency, characteristics, outcomes, and risks associated with CNS TB.
Methods
We performed a retrospective analysis of culture-confirmed TB in adults reported to the California TB Registry during 2010–2022 to compare individuals with CNS TB vs. non-CNS TB. We used a causal diagram and modified Poisson model with robust variance to estimate the adjusted relative risk of CNS TB vs. non-CNS TB among people with TB caused by Mycobacterium bovis vs. non-M. bovis M. tuberculosis complex. We also identified risk factors for death with CNS TB.
Results
There were 21,117 TB cases reported; 382 (1.8 %) involved the CNS. Compared to those without CNS TB, those with CNS TB were more likely younger, of Hispanic ethnicity, born in Mexico, infected with M. bovis, co-infected with HIV, immunosuppressed, and to have had normal chest radiography. The adjusted relative risk of M. bovis (vs. non-M. bovis) causing CNS TB was 2.86 (95 % CI 2.04–4.02). A large number of CNS TB patients died, 108 (28.3 %). Among people with CNS TB, death was associated with older age, end-stage renal disease, and immune suppression.
Conclusion
More than one quarter of patients with CNS TB died. People with TB caused by M. bovis, were more likely to have CNS TB than people with TB caused by non-M. bovis forms of the M. tuberculosis complex. Further efforts to prevent, rapidly diagnose, and effectively treat CNS TB is warranted.
背景：中枢神经系统（CNS）结核（TB）是一种罕见的疾病，发病率和死亡率都很高。我们量化了与中枢神经系统结核相关的频率、特征、结局和风险。方法：我们对2010-2022年加州结核病登记处报告的成人培养确诊结核病患者进行回顾性分析，比较中枢神经系统结核病和非中枢神经系统结核病患者。我们使用因果图和修正的泊松模型来估计由牛分枝杆菌和非结核分枝杆菌引起的结核病患者中CNS结核与非CNS结核的校正相对风险。牛结核分枝杆菌复合体。我们还确定了中枢神经系统结核死亡的危险因素。结果共报告结核病例21,117例 ；382例（1.8 %）涉及中枢神经系统。与没有中枢神经系统结核病的患者相比，中枢神经系统结核病患者更可能年轻，西班牙裔，出生在墨西哥，感染牛分枝杆菌，合并感染艾滋病毒，免疫抑制，胸部x线检查正常。调整后的牛分枝杆菌相对危险度（相对于非牛分枝杆菌）。CNS TB的发生率为2.86（95 % CI 2.04-4.02）。大量CNS结核患者死亡，108例（28.3 %）。在中枢神经系统结核患者中，死亡与年龄、终末期肾病和免疫抑制有关。结论超过1 / 4的CNS结核患者死亡。由牛分枝杆菌引起的结核病患者比非结核分枝杆菌引起的结核病患者更容易患中枢神经系统结核病。牛形式的结核分枝杆菌复合体。进一步努力预防、快速诊断和有效治疗中枢神经系统结核病是必要的。
{"title":"Central nervous system tuberculosis: characteristics, risks, and outcomes in California adults, 2010–2022","authors":"Kaley Parchinski , Lisa Pascopella , Pennan Barry","doi":"10.1016/j.jctube.2025.100574","DOIUrl":"10.1016/j.jctube.2025.100574","url":null,"abstract":"<div><h3>Background</h3><div>Central nervous system (CNS) tuberculosis (TB) is rare and causes substantial morbidity and mortality. We quantified the frequency, characteristics, outcomes, and risks associated with CNS TB.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of culture-confirmed TB in adults reported to the California TB Registry during 2010–2022 to compare individuals with CNS TB vs. non-CNS TB. We used a causal diagram and modified Poisson model with robust variance to estimate the adjusted relative risk of CNS TB vs. non-CNS TB among people with TB caused by <em>Mycobacterium bovis</em> vs. non-<em>M. bovis M. tuberculosis</em> complex. We also identified risk factors for death with CNS TB.</div></div><div><h3>Results</h3><div>There were 21,117 TB cases reported; 382 (1.8 %) involved the CNS. Compared to those without CNS TB, those with CNS TB were more likely younger, of Hispanic ethnicity, born in Mexico, infected with <em>M. bovis</em>, co-infected with HIV, immunosuppressed, and to have had normal chest radiography. The adjusted relative risk of <em>M. bovis</em> (vs. non-<em>M. bovis</em>) causing CNS TB was 2.86 (95 % CI 2.04–4.02). A large number of CNS TB patients died, 108 (28.3 %). Among people with CNS TB, death was associated with older age, end-stage renal disease, and immune suppression.</div></div><div><h3>Conclusion</h3><div>More than one quarter of patients with CNS TB died. People with TB caused by <em>M. bovis</em>, were more likely to have CNS TB than people with TB caused by non-<em>M. bovi</em>s forms of the <em>M. tuberculosis</em> complex. Further efforts to prevent, rapidly diagnose, and effectively treat CNS TB is warranted.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"42 ","pages":"Article 100574"},"PeriodicalIF":2.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692202","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}
Pub Date : 2025-11-25DOI: 10.1016/j.jctube.2025.100573
Liangzi Yang , Houming Liu , Senlin Zhan , Hongjuan Qin , Peize Zhang
Background
Mycobacteria are rare causes of blood stream infections (BSI). Mycobacterial BSI is associated with a significantly increased risk of early death compared with other bacterial blood infectious diseases. Clinical characteristics and mortality rate of different Mycobacteria BSI remain unclear.
Methods
A retrospective study of patients with positive mycobacterial blood cultures hospitalized between January 1, 2019, and June 30, 2023, at Shenzhen Third People’s Hospital, a 1500-bed tertiary university-affiliated hospital in southern China, was performed. Clinical characteristics and mortality rate of patients with different Mycobacteria BSI were reviewed and analyzed.
Results
Forty-one hospitalized patients with positive mycobacterium blood cultures were identified. Of the 41 participants, 37 (90.2 %) were newly diagnosed with HIV/AIDS. 7 (17.1 %) BSI was caused by M. tuberculosis and 34 (82.9 %) was by non-tuberculosis mycobacteria. Twelve patients died, with an overall mortality rate of 29.3 %. The median day from admission to death is 24 days. More than 70 % (30/41) of patients were treated with three or more antibiotics for mycobacterial BSI. The mortality rate was higher in the TB-BSI group compared to the NTM-BSI group (57.1 % vs. 23.5 %, p = 0.110). The median time from hospital admission to death was similar for both groups (NTM-BSI: 27.5 days; TB-BSI: 19 days).
Conclusion
The mortality rate of patients with mycobacterial BSI is high. Mycobacterial BSI occur mostly in severely ill patients with HIV/AIDS. TB-BSI was associated with a higher mortality rate compared to NTM-BSI.
{"title":"Treatment outcomes among patients with mycobacterial blood stream infection in a tertiary hospital:a retrospective study form 2019 to 2023","authors":"Liangzi Yang , Houming Liu , Senlin Zhan , Hongjuan Qin , Peize Zhang","doi":"10.1016/j.jctube.2025.100573","DOIUrl":"10.1016/j.jctube.2025.100573","url":null,"abstract":"<div><h3>Background</h3><div>Mycobacteria are rare causes of blood stream infections (BSI). Mycobacterial BSI is associated with a significantly increased risk of early death compared with other bacterial blood infectious diseases. Clinical characteristics and mortality rate of different Mycobacteria BSI remain unclear.</div></div><div><h3>Methods</h3><div>A retrospective study of patients with positive mycobacterial blood cultures hospitalized between January 1, 2019, and June 30, 2023, at Shenzhen Third People’s Hospital, a 1500-bed tertiary university-affiliated hospital in southern China, was performed. Clinical characteristics and mortality rate of patients with different Mycobacteria BSI were reviewed and analyzed.</div></div><div><h3>Results</h3><div>Forty-one hospitalized patients with positive mycobacterium blood cultures were identified. Of the 41 participants, 37 (90.2 %) were newly diagnosed with HIV/AIDS. 7 (17.1 %) BSI was caused by <em>M. tuberculosis</em> and 34 (82.9 %) was by non-tuberculosis mycobacteria. Twelve patients died, with an overall mortality rate of 29.3 %. The median day from admission to death is 24 days. More than 70 % (30/41) of patients were treated with three or more antibiotics for mycobacterial BSI. The mortality rate was higher in the TB-BSI group compared to the NTM-BSI group (57.1 % vs. 23.5 %, p = 0.110). The median time from hospital admission to death was similar for both groups (NTM-BSI: 27.5 days; TB-BSI: 19 days).</div></div><div><h3>Conclusion</h3><div>The mortality rate of patients with mycobacterial BSI is high. Mycobacterial BSI occur mostly in severely ill patients with HIV/AIDS. TB-BSI was associated with a higher mortality rate compared to NTM-BSI.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"42 ","pages":"Article 100573"},"PeriodicalIF":2.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692203","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}
Pub Date : 2025-11-15DOI: 10.1016/j.jctube.2025.100572
Lilian Tran , Anand Shah , Eugene J. Kim , Sofia Lopiano , Isabella N. Blanchard , Alan Nguyen , David Rutenberg , Berk Madendere , Amee Patrawalla
Background
Chronic liver disease (CLD) increases latent tuberculosis infection (LTBI) reactivation risk, yet treatment is complicated by drug-induced liver injury (DILI) and limited guidance. We compared DILI incidence, treatment completion, and adverse events between cirrhotic and non-cirrhotic patients undergoing LTBI therapy.
Methods
This single-center retrospective study included CLD patients who initiated LTBI treatment (2016–2024). Demographics, comorbidities, treatment regimens, and outcomes were collected by chart review. LTBI was diagnosed by physician documentation or positive Interferon-Gamma Release Assays (IGRAs). CLD etiologies included NAFLD, alcohol-associated liver disease, chronic hepatitis B, chronic hepatitis C, and autoimmune hepatitis. DILI was defined by the U.S DILI Network criteria or treatment alteration.
Results
Among 70 patients with CLD, 24 (34.3 %) had cirrhosis. Overall, 67.1 % completed LTBI treatment with lower rates in cirrhotics (50.0 % vs. 76.1 %, p = 0.035). Adverse effects occurred in 38.6 %, including DILI in 20.0 %. CKD ≥ 3 was associated with more adverse events (p = 0.029). Cirrhosis trended toward higher adverse events (p = 0.0528) but was not predictive of DILI (p = 0.1661). Use of isoniazid for 6 months was associated with a higher DILI risk than rifampin for 4 months (OR 7.21, 95 % CI 1.39–37.31, p = 0.019).
Conclusions
LTBI treatment in patients with CLD is achievable and generally well tolerated despite significant comorbidities. While cirrhosis was associated with lower treatment completion, it did not independently increase DILI risk. Shorter rifamycin-based regimens were safer and better tolerated compared to longer isoniazid-based regimens. Individualized regimen selection and close monitoring are essential to optimizing LTBI treatment outcomes in this high-risk population.
背景：慢性肝病（CLD）增加潜伏性结核感染（LTBI）再激活的风险，但药物性肝损伤（DILI）使治疗复杂化，且指导有限。我们比较了接受LTBI治疗的肝硬化和非肝硬化患者DILI发生率、治疗完成度和不良事件。方法本单中心回顾性研究纳入了2016-2024年接受LTBI治疗的CLD患者。统计数据、合并症、治疗方案和结果通过图表回顾收集。LTBI是通过医生记录或干扰素释放试验（IGRAs）阳性诊断的。CLD的病因包括NAFLD、酒精相关肝病、慢性乙型肝炎、慢性丙型肝炎和自身免疫性肝炎。DILI由美国DILI网络标准或治疗改变来定义。结果70例CLD患者中有24例（34.3%）合并肝硬化。总体而言，67.1%的患者完成了LTBI治疗，肝硬化患者的比例较低（50.0% vs 76.1%, p = 0.035）。不良反应发生率为38.6%，包括DILI发生率为20.0%。CKD≥3与更多不良事件相关（p = 0.029）。肝硬化倾向于更高的不良事件（p = 0.0528），但不能预测DILI （p = 0.1661）。使用异烟肼6个月的DILI风险高于使用利福平4个月（OR 7.21, 95% CI 1.39-37.31, p = 0.019）。结论sltbi治疗CLD患者是可以实现的，尽管存在明显的合并症，但总体耐受性良好。虽然肝硬化与较低的治疗完成度相关，但它不会单独增加DILI风险。较短的利福霉素治疗方案比较长的异烟肼治疗方案更安全，耐受性更好。个体化方案选择和密切监测对于优化高危人群的LTBI治疗结果至关重要。
{"title":"Latent TB treatment outcomes in patients with chronic liver disease: A retrospective cohort study","authors":"Lilian Tran , Anand Shah , Eugene J. Kim , Sofia Lopiano , Isabella N. Blanchard , Alan Nguyen , David Rutenberg , Berk Madendere , Amee Patrawalla","doi":"10.1016/j.jctube.2025.100572","DOIUrl":"10.1016/j.jctube.2025.100572","url":null,"abstract":"<div><h3>Background</h3><div>Chronic liver disease (CLD) increases latent tuberculosis infection (LTBI) reactivation risk, yet treatment is complicated by drug-induced liver injury (DILI) and limited guidance. We compared DILI incidence, treatment completion, and adverse events between cirrhotic and non-cirrhotic patients undergoing LTBI therapy.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included CLD patients who initiated LTBI treatment (2016–2024). Demographics, comorbidities, treatment regimens, and outcomes were collected by chart review. LTBI was diagnosed by physician documentation or positive Interferon-Gamma Release Assays (IGRAs). CLD etiologies included NAFLD, alcohol-associated liver disease, chronic hepatitis B, chronic hepatitis C, and autoimmune hepatitis. DILI was defined by the U.S DILI Network criteria or treatment alteration.</div></div><div><h3>Results</h3><div>Among 70 patients with CLD, 24 (34.3 %) had cirrhosis. Overall, 67.1 % completed LTBI treatment with lower rates in cirrhotics (50.0 % vs. 76.1 %, p = 0.035). Adverse effects occurred in 38.6 %, including DILI in 20.0 %. CKD ≥ 3 was associated with more adverse events (p = 0.029). Cirrhosis trended toward higher adverse events (p = 0.0528) but was not predictive of DILI (p = 0.1661). Use of isoniazid for 6 months was associated with a higher DILI risk than rifampin for 4 months (OR 7.21, 95 % CI 1.39–37.31, p = 0.019).</div></div><div><h3>Conclusions</h3><div>LTBI treatment in patients with CLD is achievable and generally well tolerated despite significant comorbidities. While cirrhosis was associated with lower treatment completion, it did not independently increase DILI risk. Shorter rifamycin-based regimens were safer and better tolerated compared to longer isoniazid-based regimens. Individualized regimen selection and close monitoring are essential to optimizing LTBI treatment outcomes in this high-risk population.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"41 ","pages":"Article 100572"},"PeriodicalIF":2.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578820","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}
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