Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

英文中文

Patient’s features, clinical patterns and outcomes of non-tuberculous mycobacteria infections: A 10-year retrospective analysis from a third level university hospital 非结核分枝杆菌感染的患者特征、临床模式和预后：来自某三级大学医院的10年回顾性分析

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

Pub Date : 2026-02-01 DOI: 10.1016/j.jctube.2026.100584

Maria Mazzitelli , Anna Ferrari , Giacomo Berti , Davide Leoni , Francesco Colombo , Samuele Gardin , Vincenzo Scaglione , Daniele Mengato , Fausto Braccioni , Umberto Semenzato , Paolo Spagnolo , Mariaenrica Tinè , Andrea Vianello , Annamaria Cattelan , Andrea Sattin

Background

Non-tuberculous mycobacteria (NTM) increasingly recognized as clinically relevant pathogens, particularly in immunocompromised individuals and patients with structural lung disease. Despite their growing clinical impact, real-world data on NTM infections in Europe remain limited.

Methods

We conducted a retrospective cohort study in adults diagnosed with NTM infections at a 1700-bed tertiary care hospital in Italy between 2015 and 2024. Data were collected on demographics, comorbidities, radiological and microbiological findings, treatment regimens, and outcomes. Multivariable Cox regression analyses were performed to identify factors associated with treatment failure, overall mortality, and NTM-attributable mortality.

Results

Among 149 treated patients (median age: 68 years; 60.4% female), the most prevalent species were Mycobacterium avium (38.9%), M. intracellulare (29.5%), and M. kansasii (8.7%). Pulmonary disease was observed in 87.9%, with radiologic findings commonly including nodules (67.8%) and bronchiectasis (64.6%). Clinical cure was achieved in 52.3%, while 47.7% experienced treatment failure. The relapse rate was 9.4%. All-cause and NTM-attributable mortality were 14.8% and 4.7%, respectively. Treatment failure was significantly associated with cavitary disease. Attributable mortality was independently associated with older age, , previous tuberculosis, cancer, autoimmune disorders, and use of nebulized amikacin.

Conclusions

NTM infections remain challenging to manage, particularly among patients with comorbidities and immunosuppression. Our findings highlight the need for individualized care strategies, multidisciplinary approach, improved diagnostics, and enhanced surveillance of NTM infections in Europe.

背景：非结核分枝杆菌（NTM）越来越被认为是临床相关的病原体，特别是在免疫功能低下的个体和患有结构性肺病的患者中。尽管它们的临床影响越来越大，但欧洲NTM感染的实际数据仍然有限。方法：我们对意大利一家拥有1700个床位的三级医院2015年至2024年间诊断为NTM感染的成人进行了回顾性队列研究。收集了人口统计学、合并症、放射学和微生物学发现、治疗方案和结果的数据。进行多变量Cox回归分析以确定与治疗失败、总死亡率和ntm归因死亡率相关的因素。结果149例患者（中位年龄68岁，女性60.4%）中，以鸟分枝杆菌（38.9%）、胞内分枝杆菌（29.5%）和堪萨斯分枝杆菌（8.7%）最为常见。肺部疾病占87.9%，影像学表现通常包括结节（67.8%）和支气管扩张（64.6%）。临床治愈率为52.3%，治疗失败率为47.7%。复发率为9.4%。全因死亡率和ntm归因死亡率分别为14.8%和4.7%。治疗失败与空洞病显著相关。归因死亡率与年龄、既往结核病、癌症、自身免疫性疾病和雾化阿米卡星的使用独立相关。结论sntm感染仍然具有挑战性，特别是在有合并症和免疫抑制的患者中。我们的研究结果强调了欧洲需要个性化护理策略、多学科方法、改进诊断和加强对NTM感染的监测。

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引用次数: 0

The diagnostic efficacy of bronchoscopy guided by hand-drawn mapping in the diagnosis of initial treatment for sputum-smear negative peripheral pulmonary tuberculosis 手工绘图引导支气管镜在痰涂片阴性周围性肺结核初治中的诊断效果

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

Pub Date : 2026-01-24 DOI: 10.1016/j.jctube.2025.100578

Yukun Tao , Xiuyan Liu , Yaning Liu , Yiming Ma , Yi Liu , Ming Ding

Background

This study aims to evaluate the clinical value and safety of hand–drawn mapping for bronchoscopic navigation combined with radial probe endobronchial ultrasound (RP–EBUS) in the diagnosis of primary peripheral sputum smear–negative pulmonary tuberculosis (SNPTB).

Methods

Patients suspected of having peripheral–type primary SNPTB, who were admitted to Southeast University Zhongda Hospital from 2021 to 2024, were retrospectively analyzed. Patients were divided into two groups. The sensitivity, specificity, diagnostic accuracy rate, and area under the receiver–operating characteristic (ROC) curve were evaluated with different diagnostic methods.

Results

A total of 212 patients were enrolled, including 149 in the SNPTB group and 63 in the non–SNPTB group. The success rate of ultrasound bronchoscopy exploration is 90.6 %. The sensitivity, specificity, diagnostic accuracy, and AUC value of bronchoscopy guided by hand-drawn mapping were 92.6 %, 95.2 %, 93.4 %, and 0.939, respectively, which were superior to those of T-SPOT detection (P < 0.05). Among the various sampling methods, EBUS–guided bronchoalveolar lavage fluid metagenomic next–generation sequencing (EBUS–BALF mNGS) demonstrated the highest sensitivity (86.6 %), positive predictive value (89.6 %), and AUC (0.917).

Conclusions

For peripheral SNPTB, the combination of hand–drawn navigation and RP–EBUS is both safe and effective. EBUS–BALF mNGS demonstrated the highest diagnostic efficiency. When radial ultrasound detects hypoechoic areas of the lesion, it is recommended to perform BALF mNGS. Conversely, in solid lesions, the negative rate of BALF mNGS is relatively high, and combining mNGS with biopsy is recommended to further improve diagnostic efficiency.

本研究旨在评价支气管镜导航手绘定位联合桡骨探头支气管内超声（RP-EBUS）诊断原发性外周痰涂片阴性肺结核（SNPTB）的临床价值和安全性。方法回顾性分析东南大学中大医院2021 ~ 2024年收治的疑似外周型原发性SNPTB患者。患者分为两组。采用不同的诊断方法评价其敏感性、特异性、诊断准确率及ROC曲线下面积。结果共纳入212例患者，其中SNPTB组149例，非SNPTB组63例。超声支气管镜探查成功率为90.6%。手工绘制支气管镜的敏感性、特异性、诊断准确性和AUC值分别为92.6%、95.2%、93.4%和0.939，均优于T-SPOT检测（P < 0.05）。在各种采样方法中，ebus引导的支气管肺泡灌洗液宏基因组新一代测序（EBUS-BALF mNGS）灵敏度最高（86.6%），阳性预测值最高（89.6%），AUC最高（0.917）。结论手绘导航与RP-EBUS联合治疗外周性SNPTB安全有效。ebus - half mNGS的诊断效率最高。当径向超声检测到病变的低回声区域时，建议行半空超声。相反，在实性病变中，BALF mNGS的阴性率较高，建议将mNGS与活检相结合，以进一步提高诊断效率。

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引用次数: 0

Recent advances in tuberculosis treatment: Towards shorter, safer, and more effective therapies 结核病治疗的最新进展：迈向更短、更安全、更有效的治疗

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

Pub Date : 2026-01-14 DOI: 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.

由结核分枝杆菌引起的结核病是全球导致死亡的主要传染性原因。虽然有有效的治疗方法，但治疗时间、药物毒性和耐药菌株的出现给结核病控制工作带来了挑战。目前的临床试验侧重于开发更短、更安全、更有效的方案，其中包括用于治疗结核病的新药物和重新利用的药物。这篇叙述性综述根据最近的临床试验和世卫组织指南，概述了目前和新出现的药物敏感、耐药和潜伏性结核病的治疗方案。

引用次数: 0

Pathogenesis of tubercular retinal vasculitis: An ongoing quest 结核性视网膜血管炎的发病机制：一个正在进行的探索

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

Pub Date : 2026-01-14 DOI: 10.1016/j.jctube.2026.100583

Ikhwanuliman Putera , Rina La Distia Nora , Saskia M. Rombach , P. Martin van Hagen , Willem A. Dik

引用次数: 0

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 南亚地区耐多药结核病（MDR-TB）死亡率的流行病学轨迹和负担：全球疾病负担数据分析（1990-2023），机器学习预测到2050年

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

Pub Date : 2026-01-07 DOI: 10.1016/j.jctube.2026.100580

Ibrahim Khalil , Sakib Abrar , I.M. Khalid Reza , Md. Imran Hossain , Mst. Mahmuda Akter , Farhana Sultana

Background

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.

背景耐多药结核病（MDR-TB）仍然是南亚的一个主要公共卫生挑战，它承担着不成比例的全球负担。按国家和性别分层的耐多药结核病死亡率趋势的综合纵向分析以及前瞻性预测是有限的。方法我们使用来自2023年全球疾病负担研究的数据进行回顾性分析，以检查1990年至2023年南亚及其国家（孟加拉国、不丹、印度、尼泊尔、巴基斯坦）耐多药结核病的年龄标准化死亡率（ASMR）。按性别评估趋势，并通过对数线性回归计算估计的年百分比变化（EAPC）。采用季节自回归综合移动平均（SARIMA）模型预测到2050年的ASMR，预测区间为95%。结果区域ASMR从1990年的0.25 / 10万（95% UI: 0.03 ~ 0.88）上升到2010年的峰值6.34 / 10万（95% UI: 2.56 ~ 13.56），到2023年下降到3.63 / 10万（95% UI: 0.54 ~ 9.80），主要受印度和巴基斯坦的驱动。尼泊尔表现出持续的下降（EAPC: - 2.44%; 95% CI: - 3.21至- 1.66），而巴基斯坦表现出最高的增长（EAPC: 6.16%; 95% CI: 3.21 - 9.19）。在所有情况下，男性的ASMR始终较高。预测表明，孟加拉国、不丹和尼泊尔的人口将继续下降，接近消失，但印度、巴基斯坦和本地区可能出现大幅反弹，在高负担情景下，到2050年，预测区间的上限将超过每10万人20-40人。结论：尽管在一些国家取得了进展，但在人口众多的国家，耐多药结核病死亡率仍然居高不下，男性死亡率持续偏高。预测强调，如果不加强干预，疫情有卷土重来的风险。这些发现强调，迫切需要制定有针对性的、对性别问题敏感的战略并加强区域合作，以实现南亚的终止结核病目标。

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引用次数: 0

Comments on “Tuberculosis infection control in MDR-TB designated hospitals in Jiangsu Province, China” 对“江苏省耐多药结核病定点医院结核感染控制情况”的评价

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

Pub Date : 2026-01-07 DOI: 10.1016/j.jctube.2026.100581

Sushma Narsing Katkuri , Varshini Vadhithala , Arun Kumar , Sushma Verma , Dhanya Dedeepya

引用次数: 0

Disseminated Mycobacterium triviale infection: A rare case report and literature review 播散性分枝杆菌感染1例报告及文献复习

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

Pub Date : 2026-01-07 DOI: 10.1016/j.jctube.2026.100579

Li-qing Liang , Fei Xiao , Xin-yi Zhuo , Xiao-fan Wu , Xiu-yu Qin , Ye Qiu

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.

我们报告一例弥散性分枝杆菌感染在61岁的男性没有明显的合并症。采用核苷酸基质辅助激光解吸电离飞行时间质谱法（MALDI-TOF-MS）对病原菌进行了鉴定。一篇文献综述的结果强调了MALDI-TOF质谱在提高检测病原体准确性方面的关键作用。利福平、氟喹诺酮、大环内酯和乙胺丁醇联合治疗方案似乎是一种可行的治疗方案。

引用次数: 0

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 含德拉玛尼全口服方案治疗耐多药肺结核合并肺外结核的疗效和安全性：4例报告和文献综述

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

Pub Date : 2025-12-04 DOI: 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.

背景耐多药结核病（MDR-TB）合并肺外结核（EPTB）带来了重大的治疗挑战。虽然delamanid （DLM）显示出广泛的组织渗透，但支持其专门用于耐多药结核病伴EPTB的临床证据仍然有限。本报告评估了一种含dlm的全口服治疗方案。4例分子确诊耐多药肺结核（MDR- ptb）并发EPTB（脊柱、中枢神经系统、乳腺、淋巴结）患者（年龄分别为35岁、24岁、47岁、4岁；3名女性、1名儿童）接受个体化全口服治疗。DLM联合贝达喹啉（BDQ）、利奈唑胺（LZD）、氟喹诺酮类药物及伴用药≥15个月。随访影像显示所有病例的病变明显消退，包括儿童淋巴结受累（在中国首次报道）。发生了24个不良事件（15个1级，6个2级，3个3级），主要纠正QT间期延长（5个事件，1个>； 500 ms）。大多数事件（21/ 24,87.5%）在剂量调整或支持性治疗后解决。未发生严重不良事件或死亡。结论：在这个具有多种肺外表现的耐多药结核病小病例系列中，全口服含dlm的方案与显著的病变消退相关，并显示出可控的安全性。QT间期延长是主要不良事件，干预后可逆转。这些发现代表了中国首个关于该方案治疗多位点EPTB（包括儿科病例）的系统报告，与世卫组织指南一致，并表明DLM基于其广泛的组织渗透的潜在效用。有必要在更大的多中心研究中进一步验证。

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引用次数: 0

The critical link between TB infection control process and clinical impact: need for efficacy data and MDR-TB specificity 结核病感染控制过程与临床影响之间的关键联系：对疗效数据和耐多药结核病特异性的需求

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

Pub Date : 2025-12-02 DOI: 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).

Song等人的研究详细介绍了中国江苏省指定医院结核病感染控制（TBIC）执行率的显著改善，为高负担环境中规划干预的可行性提供了宝贵的数据。行政控制（AC）、环境控制（EC）和呼吸保护（RP）的合规性的提高值得称赞。然而，随着学者们关注全球结核病消除，我们必须建设性地评估衡量执行率是否充分反映了期望的公共卫生影响，特别是在指定用于耐多药结核病（MDR-TB）的设施中。

引用次数: 0

Effect of food insecurity on hazardous alcohol consumption and psychological well-being among people with tuberculosis in Kampala, Uganda 粮食不安全对乌干达坎帕拉结核病患者危险酒精消费和心理健康的影响

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

Pub Date : 2025-11-27 DOI: 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.

食物不安全（FI）、危险饮酒（HAC）和精神健康状况不佳在结核病患者中很常见，但关于它们之间相互关系的经验证据仍然有限。目的评价FI对乌干达坎帕拉肺结核患者HAC和心理健康的影响。方法收集5家结核病诊所的数据，构建准实验设计。FI是暴露，使用FI体验量表（FIES）测量。FIES得分范围在0到8之间，如果得分≥4，则被归类为粮食不安全。主要终点是HAC，使用酒精使用障碍鉴定测试（AUDIT）工具进行评估。审计评分≥16分的参与者，表明高危饮酒或可能的酒精依赖，被归类为HAC。次要结果是心理健康，使用世界卫生组织的五种幸福指数来衡量，总分为15表示心理健康状况不佳。我们使用双稳健估计来报告因果风险比（RR）和95%置信区间（CI）。结果818名参与者中，475名（58.1%）来自粮食不安全家庭，153名（18.7%）患有HAC， 316名（38.6%）心理健康状况不佳。FI与HAC独立相关（RR 1.43, 95% CI: 1.21-1.69），但与不良心理健康无关（RR 1.06, 95% CI: 0.81-1.37）。结论：在乌干达坎帕拉的结核病患者中，fi与HAC的高可能性相关，但与心理健康无关。鉴于其高流行率，有必要在结核病控制规划中解决粮食不安全、HAC和心理健康不良问题。

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