Pub Date : 2024-12-01Epub Date: 2024-08-19DOI: 10.1016/j.jctube.2024.100478
Mohammad Yazdanmanesh, Keyvan Tadayon, Darya Bagherian Koshkghazi, Nader Mosavari
Non-tuberculous mycobacteria (NTM) are among the most important pathogens in wild, captive, marine, and freshwater fish species. So, it is important to consider fish as the primary source of infection for aquarium fish and humans. The present study analyzed the occurrence of NTM in aquarium fish in Ilam, west of Iran. In total, 50 samples of infected fish were collected from different aquariums. Following initial sample processing, sediment of each sample was inoculated into Lowenstein-Jensen and Herrold egg media. The positive colonies were investigated with, growth rate, pigmentation, colony morphology, niacin accumulation, nitrate reduction, catalase activity, urease activity, and arylsulfatase activity. Also, molecular identification was carried out by sequencing of heat shock protein 65 kD gene (hsp65) sequence analysis. According to our results, NTM were isolated from 13 samples (26%), comprising 6 (46.2%) rapid growing, and 7 (53.8%) slow growing mycobacteria. In addition, Mycobacterium marinum was the most common NTM isolated in ornamental fish, which is potentially dangerous for both fish and humans. In conclusion, the current study indicates that ornamental fish play a significant role as a source of NTM.
{"title":"Isolation and identification of non-tuberculous mycobacteria from aquarium fish in Ilam, Iran","authors":"Mohammad Yazdanmanesh, Keyvan Tadayon, Darya Bagherian Koshkghazi, Nader Mosavari","doi":"10.1016/j.jctube.2024.100478","DOIUrl":"10.1016/j.jctube.2024.100478","url":null,"abstract":"<div><p>Non-tuberculous mycobacteria (NTM) are among the most important pathogens in wild, captive, marine, and freshwater fish species. So, it is important to consider fish as the primary source of infection for aquarium fish and humans. The present study analyzed the occurrence of NTM in aquarium fish in Ilam, west of Iran. In total, 50 samples of infected fish were collected from different aquariums. Following initial sample processing, sediment of each sample was inoculated into Lowenstein-Jensen and Herrold egg media. The positive colonies were investigated with, growth rate, pigmentation, colony morphology, niacin accumulation, nitrate reduction, catalase activity, urease activity, and arylsulfatase activity. Also, molecular identification was carried out by sequencing of heat shock protein 65 kD gene (<em>hsp65</em>) sequence analysis. According to our results, NTM were isolated from 13 samples (26%), comprising 6 (46.2%) rapid growing, and 7 (53.8%) slow growing mycobacteria. In addition, <em>Mycobacterium marinum</em> was the most common NTM isolated in ornamental fish, which is potentially dangerous for both fish and humans. In conclusion, the current study indicates that ornamental fish play a significant role as a source of NTM.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100478"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000652/pdfft?md5=b7bc321c40a22541121e5ed4e3017488&pid=1-s2.0-S2405579424000652-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-08-14DOI: 10.1016/j.jctube.2024.100476
Xingxing Jin , Qianfang Hu , Yishi Li , Xia Zhang , Wan Tao , Houyu Zhong , Qinghai Zhao
Background/Purpose
Tuberculosis remains a leading cause of infectious death worldwide, The potential for nucleic acid residue on bronchoscopes to cause false positive results in molecular diagnostic methods and subsequently lead to tuberculosis misdiagnosis has long perplexed clinical.
Methods
We utilized Xpert MTB/RIF to analyze the liquid collected after bronchoscope washing, employed by patients either with or without active pulmonary tuberculosis, and subjected to standard reprocessing (SR) or intensive reprocessing (IR) procedures. The IR procedure included specialized training and the provision of patient information to cleaning staff before the SR procedure, and repeated washing and suction of the bronchoscope with sterilized water post SR procedure.
Results
55 participants enrolled in the study were divided into three groups: SR group (n = 28), IR group(n = 14), and the control group(n = 13). Among the 55 enrolled patients, neither Mycobacterium tuberculosis nor contamination was detected by MIGT 960 liquid culture in the washing liquid. The positive rate of MTB/RIF in the SR group (12/28) was significantly higher than that in the IR group (1/14), with a statistically significant difference observed between them (42.86 % vs. 7.14 %, P=0.018).
Conclusions
Nucleic acid residue on reusable bronchoscopes cleaned via the SR procedure was found to potentially cause false positives in MTB/RIF tests. Reprocessing bronchoscopes via the IR procedure was effective in significantly reducing nucleic acid residue, although complete elimination was not achieved.
长期以来，支气管镜上的核酸残留可能导致分子诊断方法出现假阳性结果，进而导致结核病误诊，这一直困扰着临床医生。方法我们利用Xpert MTB/RIF分析支气管镜清洗后收集的液体，这些液体由患有或不患有活动性肺结核的患者使用，并经过标准再处理（SR）或强化再处理（IR）程序。IR程序包括在SR程序前对清洁人员进行专门培训并提供患者信息，以及在SR程序后用消毒水反复清洗和抽吸支气管镜：结果55名参与研究者被分为三组：SR组（28人）、IR组（14人）和对照组（13人）。在 55 名入选患者中，通过 MIGT 960 液体培养，均未在清洗液中检测到结核分枝杆菌或污染。SR组的MTB/RIF阳性率（12/28）明显高于IR组（1/14），两者之间的差异有统计学意义（42.86 % vs. 7.14 %，P=0.018）。通过 IR 程序重新处理支气管镜能有效地显著减少核酸残留，但并不能完全消除核酸残留。
{"title":"Intensive reprocessing of reusable bronchoscopes can reduce the false positive rate of Xpert MTB/RIF caused by nucleic acid residue","authors":"Xingxing Jin , Qianfang Hu , Yishi Li , Xia Zhang , Wan Tao , Houyu Zhong , Qinghai Zhao","doi":"10.1016/j.jctube.2024.100476","DOIUrl":"10.1016/j.jctube.2024.100476","url":null,"abstract":"<div><h3>Background/Purpose</h3><p>Tuberculosis remains a leading cause of infectious death worldwide, The potential for nucleic acid residue on bronchoscopes to cause false positive results in molecular diagnostic methods and subsequently lead to tuberculosis misdiagnosis has long perplexed clinical.</p></div><div><h3>Methods</h3><p>We utilized Xpert MTB/RIF to analyze the liquid collected after bronchoscope washing, employed by patients either with or without active pulmonary tuberculosis, and subjected to standard reprocessing (SR) or intensive reprocessing (IR) procedures. The IR procedure included specialized training and the provision of patient information to cleaning staff before the SR procedure, and repeated washing and suction of the bronchoscope with sterilized water post SR procedure.</p></div><div><h3>Results</h3><p>55 participants enrolled in the study were divided into three groups: SR group (n = 28), IR group(n = 14), and the control group(n = 13). Among the 55 enrolled patients, neither Mycobacterium tuberculosis nor contamination was detected by MIGT 960 liquid culture in the washing liquid. The positive rate of MTB/RIF in the SR group (12/28) was significantly higher than that in the IR group (1/14), with a statistically significant difference observed between them (42.86 % vs. 7.14 %, P=0.018).</p></div><div><h3>Conclusions</h3><p>Nucleic acid residue on reusable bronchoscopes cleaned via the SR procedure was found to potentially cause false positives in MTB/RIF tests. Reprocessing bronchoscopes via the IR procedure was effective in significantly reducing nucleic acid residue, although complete elimination was not achieved.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100476"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000639/pdfft?md5=3f8ddafd8f567849a17b648cc8c48070&pid=1-s2.0-S2405579424000639-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Background and Objective</h3><div>The global incidence rate of tuberculosis and related death among the elderly are 3 times and 6 times more than that of non-elderly, respectively. Therefore, the successful treatment of tuberculosis in the elderly affects all national tuberculosis control programs. Given the fact that “medication adherence” is the main key to effective treatment, it is essential to identify the factors related to medication adherence in the elderly with tuberculosis and provide appropriate interventions. Family caregivers play a pivot role in the elderly care and treatment, and their characteristics can influence the medication adherence of the elderly with tuberculosis. The objective of present study was determining the medication adherence of the elderly with tuberculosis and the factors related to their family caregivers in Iran.</div></div><div><h3>Method</h3><div>The present study was carried out through descriptive-analytical method and convenience sampling. 305 elderly patients with tuberculosis as well as their family caregivers who met the inclusion criteria were selected from those who referred to infectious diseases clinic of Masih Deneshvari Hospital in Tehran. Demographic and background data, 12-item standard general health questionnaire, Zarit Scale of Caregiver Burden questionnaire and Morisky Green Levine Medication Adherence questionnaire were used for the elderly with tuberculosis. The significance level for statistical tests was considered 0.05. Data analysis of the study was done using SPSS-25 software. Independent <em>t</em>-test, One-way ANOVA, Tukey’s test, Spearman’s correlation test and ordinal logistic regression model were also used for the analytical statistics.</div></div><div><h3>Findings</h3><div>Out of the elderly with tuberculosis, 44.92 % had low medication adherence, 27.54 % had moderate medication adherence, and 27.54 % had full medication adherence. Medication adherence of married elderly was significantly better than single, widowed or lonely elderly (p < 0.001 and F = 53.192). The medication adherence was significantly better among the elderly whose caregivers had better general health (p > 0.001 and r = 0.776) and no burden or low burden according to Zarit scale (p > 0.001 and F = 357/96). In addition, there was a significant relationship between general characteristics of the caregivers (age, gender, marital status, number of children, education, knowledge about tuberculosis, sources of information, relativity to the patient, number of caregivers, employment status, and affordability) and the medication adherence of the elderly with tuberculosis. The results of simultaneous regression test of ordinal logistic regression showed that variables predict medication adherence behavior to a very acceptable level. The coefficient of determination values obtained from McFadden (0.4), Nagelkerke (0.747) and Cox-Snell (0.714) statistics demonstrated high explanatory power of the mod
{"title":"Relationship of family caregivers’ associated factors with medication adherence among elderly with tuberculosis in Iran","authors":"Somayeh Hassani , Farahnaz Mohammadi Shahboulagi , Mahshid Foroughan , Payam Tabarsi , Gholamreza Ghaedamini Harouni , Hamidreza Jamaati , Mohammad Varahram , Seyed Mohammad Seyedmehdi , Seyed Alireza Nadji","doi":"10.1016/j.jctube.2024.100488","DOIUrl":"10.1016/j.jctube.2024.100488","url":null,"abstract":"<div><h3>Background and Objective</h3><div>The global incidence rate of tuberculosis and related death among the elderly are 3 times and 6 times more than that of non-elderly, respectively. Therefore, the successful treatment of tuberculosis in the elderly affects all national tuberculosis control programs. Given the fact that “medication adherence” is the main key to effective treatment, it is essential to identify the factors related to medication adherence in the elderly with tuberculosis and provide appropriate interventions. Family caregivers play a pivot role in the elderly care and treatment, and their characteristics can influence the medication adherence of the elderly with tuberculosis. The objective of present study was determining the medication adherence of the elderly with tuberculosis and the factors related to their family caregivers in Iran.</div></div><div><h3>Method</h3><div>The present study was carried out through descriptive-analytical method and convenience sampling. 305 elderly patients with tuberculosis as well as their family caregivers who met the inclusion criteria were selected from those who referred to infectious diseases clinic of Masih Deneshvari Hospital in Tehran. Demographic and background data, 12-item standard general health questionnaire, Zarit Scale of Caregiver Burden questionnaire and Morisky Green Levine Medication Adherence questionnaire were used for the elderly with tuberculosis. The significance level for statistical tests was considered 0.05. Data analysis of the study was done using SPSS-25 software. Independent <em>t</em>-test, One-way ANOVA, Tukey’s test, Spearman’s correlation test and ordinal logistic regression model were also used for the analytical statistics.</div></div><div><h3>Findings</h3><div>Out of the elderly with tuberculosis, 44.92 % had low medication adherence, 27.54 % had moderate medication adherence, and 27.54 % had full medication adherence. Medication adherence of married elderly was significantly better than single, widowed or lonely elderly (p < 0.001 and F = 53.192). The medication adherence was significantly better among the elderly whose caregivers had better general health (p > 0.001 and r = 0.776) and no burden or low burden according to Zarit scale (p > 0.001 and F = 357/96). In addition, there was a significant relationship between general characteristics of the caregivers (age, gender, marital status, number of children, education, knowledge about tuberculosis, sources of information, relativity to the patient, number of caregivers, employment status, and affordability) and the medication adherence of the elderly with tuberculosis. The results of simultaneous regression test of ordinal logistic regression showed that variables predict medication adherence behavior to a very acceptable level. The coefficient of determination values obtained from McFadden (0.4), Nagelkerke (0.747) and Cox-Snell (0.714) statistics demonstrated high explanatory power of the mod","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100488"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuberculosis (TB) remains a significant cause of mortality globally, with India accounting for 27% of the estimated number of people with TB. Multidrug-resistant TB (MDR-TB) and isoniazid (INH) resistance pose additional challenges to effective treatment. We aimed to describe treatment outcomes of INH mono-resistant TB patients under programmatic conditions in Mumbai, India.
Methods
This retrospective cohort study was conducted at Shatabdi Hospital in Mumbai between 2019–2021.We described the clinical and demographic characteristics, treatment outcomes, and risk factors for unfavourable outcomes among patients with INH mono-resistant TB treated with rifampicin, ethambutol, pyrazinamide, and levofloxacin (LfxREZ) for a duration of 6 months.
Results
Among 3105 patients with drug-resistant TB initiated on treatment, 217 (7 %) had INH mono-resistant TB. Of these, 54 % (117/217) were female, with a median age of 26 years (interquartile range: 20–40). The majority (88 %; 191/217) presented with pulmonary TB, and most (87 %; 188/217) had favourable treatment outcomes, including treatment completion (52 %; 112/217) and cure (35 %; 76/217). Unfavourable outcomes, including treatment failure (2.3 %; 5/217), loss to follow-up (9.2 %; 20/217), or death (1.8 %; 4/217), were observed in 13 % (29/217) of patients. A total of ten (5 %) patients experienced at least one non-severe adverse drug reaction. Factors associated with unfavourable outcomes included severe thinness (p = 0.019) and male gender (p = 0.012).
Conclusion
Treating INH mono-resistant patients with LfxREZ resulted in satisfactory outcomes and low toxicity. It is important to rule out drug resistance to INH while determining the treatment regimen.
{"title":"Treatment outcomes among patients with isoniazid mono-resistant tuberculosis in Mumbai, India: A retrospective cohort study","authors":"Sumaiya Khan , Arunima Silsarma , Raman Mahajan , Shahid Khan , Praveen Davuluri , Narendra Sutar , Aparna Iyer , Shubhangi Mankar , Vikas Oswal , Varsha Puri , Daksha Shah , Vijay Chavan , Hannah Spencer , Petros Isaakidis","doi":"10.1016/j.jctube.2024.100481","DOIUrl":"10.1016/j.jctube.2024.100481","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) remains a significant cause of mortality globally, with India accounting for 27% of the estimated number of people with TB. Multidrug-resistant TB (MDR-TB) and isoniazid (INH) resistance pose additional challenges to effective treatment. We aimed to describe treatment outcomes of INH mono-resistant TB patients under programmatic conditions in Mumbai, India.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted at Shatabdi Hospital in Mumbai between 2019–2021.We described the clinical and demographic characteristics, treatment outcomes, and risk factors for unfavourable outcomes among patients with INH mono-resistant TB treated with rifampicin, ethambutol, pyrazinamide, and levofloxacin (LfxREZ) for a duration of 6 months.</div></div><div><h3>Results</h3><div>Among 3105 patients with drug-resistant TB initiated on treatment, 217 (7 %) had INH mono-resistant TB. Of these, 54 % (117/217) were female, with a median age of 26 years (interquartile range: 20–40). The majority (88 %; 191/217) presented with pulmonary TB, and most (87 %; 188/217) had favourable treatment outcomes, including treatment completion (52 %; 112/217) and cure (35 %; 76/217). Unfavourable outcomes, including treatment failure (2.3 %; 5/217), loss to follow-up (9.2 %; 20/217), or death (1.8 %; 4/217), were observed in 13 % (29/217) of patients. A total of ten (5 %) patients experienced at least one non-severe adverse drug reaction. Factors associated with unfavourable outcomes included severe thinness (p = 0.019) and male gender (p = 0.012).</div></div><div><h3>Conclusion</h3><div>Treating INH mono-resistant patients with LfxREZ resulted in satisfactory outcomes and low toxicity. It is important to rule out drug resistance to INH while determining the treatment regimen.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100481"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-10-31DOI: 10.1016/j.jctube.2024.100493
Anda Viksna , Darja Sadovska , Vija Riekstina , Anda Nodieva , Ilva Pole , Renate Ranka , Iveta Ozere
Background
The recurrence of tuberculosis (TB) continues to place a significant burden on patients and TB programs worldwide. Repeated TB episodes can develop either due to endogenous reactivation of previously treated TB or exogenous reinfection with a distinct strain of Mycobacterium tuberculosis (Mtb). Determining the precise cause of the recurrent TB episodes and identifying reasons for endogenous reactivation of previously successfully treated patients is crucial for introducing effective TB control measures.
Methods
Here, we aimed to provide a retrospective individual analysis of the clinical data of pulmonary TB patients with assumed endogenous infection reactivation based on WGS results to identify the reasons for reactivation. Patient medical files were reviewed to describe the provoking factors for endogenous reactivation.
Results
In total, 25 patients with assumed endogenous TB reactivation were included in the study group, and 30 patients with one TB episode during the study period were included in the control group. There were no statistically significant differences identified between studied patient groups in patients age (t(53) = −1.53, p = 0.13), body mass index (t(53) = 0.82, p = 0.42), area of residency (χ2(1;55) = 0.015, p = 0.9), employment status (χ2(1;55) = 0.076, p = 0.78) and presence of comorbidities (χ2(1;55) = 3.67, p = 0.78). Study group patients had statistically significantly more frequently positive sputum smear microscopy results (χ2(1;55) = 8.72, p = 0.0031), longer time to sputum smear (t(31) = −2.2, p = 0.036) and sputum culture conversion (W (55) = 198.5, p = 0.0029). Smoking was statistically significantly (χ2(1;55) = 5.77, p = 0.016) more frequently represented among study group patients. The median treatment duration for drug susceptible TB was 6 months in both in the control group (IQR 6–6) and among study group patients (IQR 6–7.75). The median treatment duration for multidrug-resistant TB was 20 months (IQR 17–23) in the control group and 19 months (IQR 16–19) in the study group patients.
Conclusion
Positive SSM for acid-fast bacteria, delayed time to sputum smear and sputum culture conversion, smoking, and incomplete therapy in the study group patients with multidrug-resistant TB should be considered as potential reasons for reactivation in recurrent TB patient group in our study.
{"title":"Endogenous reactivation cases identified by whole genome sequencing of Mycobacterium tuberculosis: Exploration of possible causes in Latvian tuberculosis patients","authors":"Anda Viksna , Darja Sadovska , Vija Riekstina , Anda Nodieva , Ilva Pole , Renate Ranka , Iveta Ozere","doi":"10.1016/j.jctube.2024.100493","DOIUrl":"10.1016/j.jctube.2024.100493","url":null,"abstract":"<div><h3>Background</h3><div>The recurrence of tuberculosis (TB) continues to place a significant burden on patients and TB programs worldwide. Repeated TB episodes can develop either due to endogenous reactivation of previously treated TB or exogenous reinfection with a distinct strain of <em>Mycobacterium tuberculosis</em> (Mtb). Determining the precise cause of the recurrent TB episodes and identifying reasons for endogenous reactivation of previously successfully treated patients is crucial for introducing effective TB control measures.</div></div><div><h3>Methods</h3><div>Here, we aimed to provide a retrospective individual analysis of the clinical data of pulmonary TB patients with assumed endogenous infection reactivation based on WGS results to identify the reasons for reactivation. Patient medical files were reviewed to describe the provoking factors for endogenous reactivation.</div></div><div><h3>Results</h3><div>In total, 25 patients with assumed endogenous TB reactivation were included in the study group, and 30 patients with one TB episode during the study period were included in the control group. There were no statistically significant differences identified between studied patient groups in patients age (t<sub>(53)</sub> = −1.53, p = 0.13), body mass index (t<sub>(53)</sub> = 0.82, p = 0.42), area of residency (χ<sup>2</sup><sub>(1;55)</sub> = 0.015, p = 0.9), employment status (χ<sup>2</sup><sub>(1;55) =</sub> 0.076, p = 0.78) and presence of comorbidities (χ<sup>2</sup><sub>(1;55)</sub> = 3.67, p = 0.78). Study group patients had statistically significantly more frequently positive sputum smear microscopy results (χ<sup>2</sup><sub>(1;55)</sub> = 8.72, p = 0.0031), longer time to sputum smear (t<sub>(31)</sub> = −2.2, p = 0.036) and sputum culture conversion (W <sub>(55)</sub> = 198.5, p = 0.0029). Smoking was statistically significantly (χ<sup>2</sup><sub>(1;55)</sub> = 5.77, p = 0.016) more frequently represented among study group patients. The median treatment duration for drug susceptible TB was 6 months in both in the control group (IQR 6–6) and among study group patients (IQR 6–7.75). The median treatment duration for multidrug-resistant TB was 20 months (IQR 17–23) in the control group and 19 months (IQR 16–19) in the study group patients.</div></div><div><h3>Conclusion</h3><div>Positive SSM for acid-fast bacteria, delayed time to sputum smear and sputum culture conversion, smoking, and incomplete therapy in the study group patients with multidrug-resistant TB should be considered as potential reasons for reactivation in recurrent TB patient group in our study.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100493"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-08-02DOI: 10.1016/j.jctube.2024.100466
Albert Okumu , James Orwa , Ruth Sitati , Isaiah Omondi , Ben Odhiambo , Jeremiah Ogoro , George Oballa , Benjamin Ochieng , Steve Wandiga , Collins Ouma
Multidrug-resistant tuberculosis (MDR-TB) is caused by M. tuberculosis (Mtb) with resistance to the first-line anti-TB medicines isoniazid (INH) and rifampicin (RIF). In Western Kenya, there is reported low prevalence of drug resistant strains among HIV tuberculosis patients, creating a need to determine factors associated with drug resistance patterns among presumptive MDR-TB patients. To determine factors associated with drug resistance patterns among presumptive MDR-TB patients in western Kenya. Three hundred and ninety (3 9 0) sputum sample isolates from among presumptive multidrug TB patients, were analyzed for TB drug resistance as per Ministry of Health (MoH) TB program diagnostic algorithm. Frequency and percentages were used to summarize categorical data while median and interquartile range (IQR) were used for continuous data. Multivariable logistic regression was carried out to identify factors associated with TB drug resistance. Out of 390 participants enrolled, 302/390 (77.4 %) were males, with a median age of 34 years. The HIV-infected were 118/390 (30.3 %). Samples included 322 (82.6 %) from presumptive patients, while 68/390 (17.4 %) were either lost to follow-up patients, failures to first-line treatment or newly diagnosed cases. A total of 64/390 (16.4 %) of the isolates had at least some form of drug resistance. Out of 390, 14/390 (3.6 %) had MDR, 12 (3.1 %) were RIF mono-resistance, 34 (8.7 %) had INH, while 4 (1 %) had ethambutol resistance. The category of previously treated patients (those who received or are currently on TB treatment) had a 70 % reduced likelihood of resistance (aOR: 0.30; 95 % CI: 0.13–0.70). In contrast, older age was associated with an increased likelihood of resistance to INH and RIF, with an adjusted odds ratio of 1.04 per year (95 % CI: 1.00–1.08). Prompt MDR-TB diagnosis is essential for appropriate patient care, management, and disease prevention and control. We recommend active surveillance on drug resistant TB in these regions to detect drug resistance patterns for rapid disease management.
{"title":"Factors associated with tuberculosis drug resistance among presumptive multidrug resistance tuberculosis patients identified in a DRTB surveillance study in western Kenya","authors":"Albert Okumu , James Orwa , Ruth Sitati , Isaiah Omondi , Ben Odhiambo , Jeremiah Ogoro , George Oballa , Benjamin Ochieng , Steve Wandiga , Collins Ouma","doi":"10.1016/j.jctube.2024.100466","DOIUrl":"10.1016/j.jctube.2024.100466","url":null,"abstract":"<div><p>Multidrug-resistant tuberculosis (MDR-TB) is caused by <em>M. tuberculosis</em> (<em>Mtb</em>) with resistance to the first-line anti-TB medicines isoniazid (INH) and rifampicin (RIF). In Western Kenya, there is reported low prevalence of drug resistant strains among HIV tuberculosis patients, creating a need to determine factors associated with drug resistance patterns among presumptive MDR-TB patients. To determine factors associated with drug resistance patterns among presumptive MDR-TB patients in western Kenya. Three hundred and ninety (3<!--> <!-->9<!--> <!-->0) sputum sample isolates from among presumptive multidrug TB patients, were analyzed for TB drug resistance as per Ministry of Health (MoH) TB program diagnostic algorithm. Frequency and percentages were used to summarize categorical data while median and interquartile range (IQR) were used for continuous data. Multivariable logistic regression was carried out to identify factors associated with TB drug resistance. Out of 390 participants enrolled, 302/390 (77.4 %) were males, with a median age of 34 years. The HIV-infected were 118/390 (30.3 %). Samples included 322 (82.6 %) from presumptive patients, while 68/390 (17.4 %) were either lost to follow-up patients, failures to first-line treatment or newly diagnosed cases. A total of 64/390 (16.4 %) of the isolates had at least some form of drug resistance. Out of 390, 14/390 (3.6 %) had MDR, 12 (3.1 %) were RIF mono-resistance, 34 (8.7 %) had INH, while 4 (1 %) had ethambutol resistance. The category of previously treated patients (those who received or are currently on TB treatment) had a 70 % reduced likelihood of resistance (aOR: 0.30; 95 % CI: 0.13–0.70). In contrast, older age was associated with an increased likelihood of resistance to INH and RIF, with an adjusted odds ratio of 1.04 per year (95 % CI: 1.00–1.08). Prompt MDR-TB diagnosis is essential for appropriate patient care, management, and disease prevention and control. We recommend active surveillance on drug resistant TB in these regions to detect drug resistance patterns for rapid disease management.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100466"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000536/pdfft?md5=7b2b02de9f953b8195ed23b9e43f47c3&pid=1-s2.0-S2405579424000536-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-11-26DOI: 10.1016/j.jctube.2024.100498
Dorte Bek Folkvardsen , Victor Naestholt Dahl , Christian Wejse , Erik Svensson , Troels Lillebaek
Patients with pulmonary tuberculosis (PTB) may face challenges in providing sputum specimens for diagnosis. Mycobacterium tuberculosis (Mtb) is potentially present in the stool due to swallowed sputum. Therefore easy-to-obtain stool could be used as an alternative to sputum sampling. However, the evidence for using stool specimens for PTB diagnosis is sparse, especially in resource-rich settings.
In this study, spanning two years, the results of 562 stool specimens were evaluated alongside those of respiratory specimens sent to the International Reference Laboratory of Mycobacteriology in Denmark.
Despite the potential advantages of stool culture, only five out of 19 patients with PTB had Mtb culture-positive stool, all of whom also had positive respiratory specimens. Conversely, relying solely on stool specimens could lead to missed diagnoses of PTB.
While stool analysis may offer additional value in specific settings or populations, such as those unable to produce sputum, this study discourages its general use for PTB testing in resource-rich, TB low-incidence settings like Denmark. Instead, we advocate for prospective trials in specific subpopulations to elucidate the role of stool as a complementary diagnostic tool for PTB. The study underscores the importance of tailoring diagnostic approaches based on the setting and patient characteristics.
{"title":"Culturing stool specimens has no added value in diagnosing pulmonary tuberculosis","authors":"Dorte Bek Folkvardsen , Victor Naestholt Dahl , Christian Wejse , Erik Svensson , Troels Lillebaek","doi":"10.1016/j.jctube.2024.100498","DOIUrl":"10.1016/j.jctube.2024.100498","url":null,"abstract":"<div><div>Patients with pulmonary tuberculosis (PTB) may face challenges in providing sputum specimens for diagnosis. Mycobacterium tuberculosis (Mtb) is potentially present in the stool due to swallowed sputum. Therefore easy-to-obtain stool could be used as an alternative to sputum sampling. However, the evidence for using stool specimens for PTB diagnosis is sparse, especially in resource-rich settings.</div><div>In this study, spanning two years, the results of 562 stool specimens were evaluated alongside those of respiratory specimens sent to the International Reference Laboratory of Mycobacteriology in Denmark.</div><div>Despite the potential advantages of stool culture, only five out of 19 patients with PTB had Mtb culture-positive stool, all of whom also had positive respiratory specimens. Conversely, relying solely on stool specimens could lead to missed diagnoses of PTB.</div><div>While stool analysis may offer additional value in specific settings or populations, such as those unable to produce sputum, this study discourages its general use for PTB testing in resource-rich, TB low-incidence settings like Denmark. Instead, we advocate for prospective trials in specific subpopulations to elucidate the role of stool as a complementary diagnostic tool for PTB. The study underscores the importance of tailoring diagnostic approaches based on the setting and patient characteristics.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100498"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-07-26DOI: 10.1016/j.jctube.2024.100471
Aneesha Raj , Nabiha S. Khakoo , Alex A. Ashkin , Mary T. Green , Rene R. Tresgallo
Objectives
To determine if integrating VDOT into TB therapy demonstrated non-inferiority to direct observation, and if VDOT utilization increased across Florida after the onset of Covid-19.
Methods
A statewide programmatic review was conducted of all patients in Florida who initiated tuberculosis treatment between January 2018 – December 2018 and January 2020 – December 2021, as documented by the Florida Department of Health.
Results
1361 patients received treatment within the analysis timeframe. Therapy completion was 97.2% in those utilizing VDOT compared to 92.3% utilizing only DOT (p=<.001). Average duration of therapy was 220.5 days in the DOT-only cohort compared to 211.1 days with VDOT integration (p=.027). A 176.35% increase in VDOT utilization was seen across Florida during Covid-19.
Conclusions
This is the first and largest state-wide study evaluating the efficacy of integrating VDOT into TB therapy, finding statistically significant improvements in completion and duration of therapy. Despite increased VDOT utilization since the onset of Covid-19, we suspect that multiple barriers may be hindering further integration. VDOT should be recommended as a cost effective, non-inferior alternative to DOT in monitoring the treatment of tuberculosis.
{"title":"Investigating the efficacy of integrating video-directly observed therapy (VDOT) in the treatment of tuberculosis (TB): A statewide analysis from Florida","authors":"Aneesha Raj , Nabiha S. Khakoo , Alex A. Ashkin , Mary T. Green , Rene R. Tresgallo","doi":"10.1016/j.jctube.2024.100471","DOIUrl":"10.1016/j.jctube.2024.100471","url":null,"abstract":"<div><h3>Objectives</h3><p>To determine if integrating VDOT into TB therapy demonstrated non-inferiority to direct observation, and if VDOT utilization increased across Florida after the onset of Covid-19.</p></div><div><h3>Methods</h3><p>A statewide programmatic review was conducted of all patients in Florida who initiated tuberculosis treatment between January 2018 – December 2018 and January 2020 – December 2021, as documented by the Florida Department of Health.</p></div><div><h3>Results</h3><p>1361 patients received treatment within the analysis timeframe. Therapy completion was 97.2% in those utilizing VDOT compared to 92.3% utilizing only DOT (<em>p=<.001</em>). Average duration of therapy was 220.5 days in the DOT-only cohort compared to 211.1 days with VDOT integration (<em>p=.027</em>). A 176.35% increase in VDOT utilization was seen across Florida during Covid-19.</p></div><div><h3>Conclusions</h3><p>This is the first and largest state-wide study evaluating the efficacy of integrating VDOT into TB therapy, finding statistically significant improvements in completion and duration of therapy. Despite increased VDOT utilization since the onset of Covid-19, we suspect that multiple barriers may be hindering further integration. VDOT should be recommended as a cost effective, non-inferior alternative to DOT in monitoring the treatment of tuberculosis.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100471"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000585/pdfft?md5=53a81a011b7f7bc2a5244b626b2d383d&pid=1-s2.0-S2405579424000585-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-07-26DOI: 10.1016/j.jctube.2024.100465
Bernardo Castro-Rodriguez , Greta Franco-Sotomayor , Solón Alberto Orlando , Miguel Ángel Garcia-Bereguiain
Tuberculosis (TB) is one of the three leading causes of death from a single infectious agent, Mycobacterium tuberculosis (MTB), together with COVID-19 and HIV/AIDS. This disease places a heavy burden on countries with low socio-economic development and aggravates existing inequalities. For the year 2021, estimations for Ecuador were 8500 TB cases, of which 370 were associated to multiple drug resistance (TB-MDR), and 1160 deaths. In the same year, Ecuador notified 5973 total cases, 401 of them were TB-MDR, pointing out an under diagnosis problem. The few molecular epidemiology studies available conclude that L4 is the most prevalent MTB lineage in Ecuador (with LAM as the main L4 sublineage), but L2-Beijing family is also present at low prevalence. Nevertheless, with less than 1 % MTB isolates genetically characterized by either MIRU-VNTR, spolygotyping or WGS to date, molecular epidemiology research must me improved to assist the TB surveillance and control program in Ecuador.
{"title":"Molecular epidemiology of Mycobacterium tuberculosis in Ecuador: Recent advances and future challenges","authors":"Bernardo Castro-Rodriguez , Greta Franco-Sotomayor , Solón Alberto Orlando , Miguel Ángel Garcia-Bereguiain","doi":"10.1016/j.jctube.2024.100465","DOIUrl":"10.1016/j.jctube.2024.100465","url":null,"abstract":"<div><p>Tuberculosis (TB) is one of the three leading causes of death from a single infectious agent, <em>Mycobacterium tuberculosis</em> (MTB), together with COVID-19 and HIV/AIDS. This disease places a heavy burden on countries with low socio-economic development and aggravates existing inequalities. For the year 2021, estimations for Ecuador were 8500 TB cases, of which 370 were associated to multiple drug resistance (TB-MDR), and 1160 deaths. In the same year, Ecuador notified 5973 total cases, 401 of them were TB-MDR, pointing out an under diagnosis problem. The few molecular epidemiology studies available conclude that L4 is the most prevalent MTB lineage in Ecuador (with LAM as the main L4 sublineage), but L2-Beijing family is also present at low prevalence. Nevertheless, with less than 1 % MTB isolates genetically characterized by either MIRU-VNTR, spolygotyping or WGS to date, molecular epidemiology research must me improved to assist the TB surveillance and control program in Ecuador.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100465"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000524/pdfft?md5=523e158b4dc2231d00ccc23469b658a7&pid=1-s2.0-S2405579424000524-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-11-26DOI: 10.1016/j.jctube.2024.100502
Hatice Polat , Gulcan Bahcecioglu Turan , Mehtap Tan
Background & Aim
It is aimed to analyze the relationship between stigmatization levels and social support perceptions of tuberculosis patients.
Methods & Materials
Research data are collected using socio-demographic information form, Stigmatization Scale in Patients with Tuberculosis and Multidimensional Social Support Scale.
Results
85.5 % of the patients have said that there are no other tuberculosis patients in their families. 83.9 % of the patients have stated that they did not tell anyone that they had tuberculosis. The results of the study show that patients with tuberculosis faced stigmatization, that their score from the scale is at a moderate level [mean:88.0 ± 10.33], and they got a moderate score [mean:54.19 ± 14.07] on the social support perception scale. It is determined that there is a negative relationship between social support perception and stigmatization. It is determined that tuberculosis patients experienced medium level of stigmatization. It is determined that their social support perception is at a medium level.
Conclusion
Stigmatization level is found to be significantly higher in individuals whose support from family, friends and a significant other in their life decreased. In order to reduce stigmatization in patients with tuberculosis, it may be recommended to increase the awareness of the society about the disease.
{"title":"Determining the relationship between stigmatization and social support in tuberculosis patients","authors":"Hatice Polat , Gulcan Bahcecioglu Turan , Mehtap Tan","doi":"10.1016/j.jctube.2024.100502","DOIUrl":"10.1016/j.jctube.2024.100502","url":null,"abstract":"<div><h3>Background & Aim</h3><div>It is aimed to analyze the relationship between stigmatization levels and social support perceptions of tuberculosis patients.</div></div><div><h3>Methods & Materials</h3><div>Research data are collected using socio-demographic information form, Stigmatization Scale in Patients with Tuberculosis and Multidimensional Social Support Scale.</div></div><div><h3>Results</h3><div>85.5 % of the patients have said that there are no other tuberculosis patients in their families. 83.9 % of the patients have stated that they did not tell anyone that they had tuberculosis. The results of the study show that patients with tuberculosis faced stigmatization, that their score from the scale is at a moderate level [mean:88.0 ± 10.33], and they got a moderate score [mean:54.19 ± 14.07] on the social support perception scale. It is determined that there is a negative relationship between social support perception and stigmatization. It is determined that tuberculosis patients experienced medium level of stigmatization. It is determined that their social support perception is at a medium level.</div></div><div><h3>Conclusion</h3><div>Stigmatization level is found to be significantly higher in individuals whose support from family, friends and a significant other in their life decreased. In order to reduce stigmatization in patients with tuberculosis, it may be recommended to increase the awareness of the society about the disease.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100502"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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