Study of spectrum of fungal isolates in the sputum of newly diagnosed pulmonary tuberculosis patients

2021 ◽  
pp. 004947552110546
Author(s):  
Abdul Raouf Wani ◽  
Lokender Kumar ◽  
Ritu Singhal ◽  
Amartya Chakraborti ◽  
Sagar Mohanrao Khot

Tuberculosis is a state of immunosupression which exposes the patients to further opportunistic pathogens like fungus. Methods: 102 newly diagnosed sputum positive pulmonary tuberculosis cases were enrolled. Significant fungal isolates were seen in 31/102 (30.4%) patients. Aspergillus spp. were isolated in 13/31(41.9%) of the positive fungal cultures while Candida spp. were isolated in 15/31 (48.4%). Low body mass index, duration of symptoms, haemoptysis, severity of radiological features and IgG Aspergillus antibodies were independent risk factors for positive fungal culture. Significant proportion of patients with PTB have fungal colonisation of their airways which can lead to poor clinical outcomes. Few easily ascertained clinical parameters can help the clinician to determine patients who are at a higher risk of fungal colonisation.

2021 ◽  
Vol 1 (2) ◽  
pp. 50-58
Author(s):  
Richard K.D. Ephraim

Background: Diabetes mellitus is an important risk factor associated with tuberculosis (TB). This study investigated the prevalence and determinants of hyperglycemia among newly diagnosed pulmonary tuberculosis patients in the Agona Swedru Municipality. Method: A hospital-based cross-sectional study was conducted from December 2015 to April 2016. One hundred (100) newly diagnosed pulmonary tuberculosis patients at the Agona Swedru Municipal Hospital (ASMH) were enrolled for the study. Socio-demographic, clinical and anthropometric measurements were collected and fasting blood glucose (FBG) measured using standard protocols. Data was analyzed using Statistical Package for Social Sciences (SPSS) software version 20.0. Result: Of the 100 participants, 26% had hyperglycemia. The significant factors associated with increased risk of hyperglycemia among participants were history of diabetes mellitus (OR = 8.17, p= 0.004), severity of infection (OR = 23.64, p < 0.001) and duration of symptoms (OR= 2.63, p= 0.042). Conclusion: Hyperglycemia was common among newly diagnosed pulmonary tuberculosis patients. History of diabetes mellitus, severity of infection, and duration of symptoms were the determinants of hyperglycemia in pulmonary tuberculosis. Regular screening of hyperglycemia is essential in the management of tuberculosis. Finally, further studies should be conducted on glucose levels among pulmonary tuberculosis patients using higher sample size to increase the understanding of the subject.


2020 ◽  
Vol 65 (7-8) ◽  
pp. 31-36
Author(s):  
N. M. Krasnova ◽  
N. E. Evdokimova ◽  
A. A. Egorova ◽  
O. I. Filippova ◽  
E. A. Alekseeva ◽  
...  

Introduction. Liver damage can be a dangerous side effect of using isoniazid. Individual susceptibility to isoniazid in humans is dependent on the presence of N-acetyltransferase 2 allelic variants in genome. It was imperative to assess the effect of genetically determined isoniazid acetylation rate in terms of risk of developing isoniazid-induced hepatotoxicity, as well as prevention of potential hepatopathy, and improvement of tuberculosis chemotherapy safety. Aim. To study the effect of acetylation type on the incidence of isoniazid hepatotoxicity in residents of the Sakha Republic (Yakutia) with newly diagnosed pulmonary tuberculosis. Methods. The study included 112 patients with newly diagnosed pulmonary tuberculosis. Genotyping was performed using real-time polymerase chain reaction. The following single nucleotide polymorphisms were studied: rs1801280, rs1799930, rs1799931, rs1799929, rs1208, rs1041983. Hepatotoxicity was determined based on the results of clinical laboratory monitoring and using the criteria developed by the European Association for the Study of the Liver (2019). Results. Hepatotoxic reactions developed more often in slow acetylators (43.2%), compared to fast acetylators (20.7%) and intermediate acetylators (10.9%); p=0.002. Serum alanine aminotransferase activity was 5 or more times above the upper limit of normal activity in 37.8% of slow acetylators, and in 8.7% of intermediate acetylators; p=0.001. Clinical manifestations of isoniazid hepatotoxicity were observed more often in slow acetylators (29.7%), than in fast acetylators (3.4%); p=0.000. Conclusion. Slow acetylation type ought to be considered an important risk factor for developing isoniazid hepatotoxicity in patients with pulmonary tuberculosis.


Respirology ◽  
2007 ◽  
Vol 12 (4) ◽  
pp. 594-598 ◽  
Author(s):  
Jae-Hee OH ◽  
Chul-Su YANG ◽  
Yeon-Kyeong NOH ◽  
Yu-Mi KWEON ◽  
Sung-Soo JUNG ◽  
...  

2020 ◽  
pp. 35-42
Author(s):  
M.M. Kuzhko ◽  
T.V. Tlustova ◽  
D.O. Butov ◽  
M.I. Gumeniuk ◽  
L.M. Protsyk ◽  
...  

ABSTRACT. The paper summarizes the results of studies regarding the most significant causes of ineffective treatment of patients with newly diagnosed pulmonary tuberculosis. It is proven that the effectiveness of treatment depends from the maximum concentration of antituberculosis drugs in blood serum, tissues and foci of affected lungs, depending on the method of administration of drugs and the presence of concomitant pathology from hepatobiliary and gastrointestinal system tract. Recommendations are given regarding the prevention of ineffective treatment of patients with pulmonary tuberculosis by improving diagnosis and developing new treatment regimens.


2021 ◽  
Vol 8 ◽  
Author(s):  
Marjan Wouthuyzen-Bakker ◽  
Noam Shohat ◽  
Javad Parvizi ◽  
Alex Soriano

The most preferred treatment for acute periprosthetic joint infection (PJI) is surgical debridement, antibiotics and retention of the implant (DAIR). The reported success of DAIR varies greatly and depends on a complex interplay of several host-related factors, duration of symptoms, the microorganism(s) causing the infection, its susceptibility to antibiotics and many others. Thus, there is a great clinical need to predict failure of the “classical” DAIR procedure so that this surgical option is offered to those most likely to succeed, but also to identify those patients who may benefit from more intensified antibiotic treatment regimens or new and innovative treatment strategies. In this review article, the current recommendations for DAIR will be discussed, a summary of independent risk factors for DAIR failure will be provided and the advantages and limitations of the clinical use of preoperative risk scores in early acute (post-surgical) and late acute (hematogenous) PJIs will be presented. In addition, the potential of implementing machine learning (artificial intelligence) in identifying patients who are at highest risk for failure of DAIR will be addressed. The ultimate goal is to maximally tailor and individualize treatment strategies and to avoid treatment generalization.


2019 ◽  
Author(s):  
Mehran Ghazalibina ◽  
Ali Shakerimoghaddam ◽  
Azad Khaledi

Abstract Background Diagnosis of fungal co-infections in patients with pulmonary tuberculosis has critical importance. In this review, we aimed to determine the prevalence of candida coinfection in patients with pulmonary tuberculosis.Methods The present systematic review of cross-sectional studies was conducted based on the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) Protocol. Studies published online in English from January 2001 to March 2019 were assessed. Literature search was performed in Web of Science, MEDLINE/PubMed, and Scopus databases using keywords combinations of “pulmonary fungal”, “pulmonary coinfection”, OR “pulmonary mycosis”, “pulmonary fungal infections/agents”, OR “polymicrobial infection”, OR “secondary infection”, OR “mixed infections”, “pulmonary candidiasis”, “fungi coinfection”, “fungal co-colonization”, AND “pulmonary tuberculosis”, OR “pulmonary TB”. Data was analyzed using Comprehensive Meta-Analysis software. Heterogeneity between studies was evaluated by Cochran's Q, and I 2 tests.Results The pooled global prevalence of candida coinfection among patients with pulmonary tuberculosis was 25.7% (95% CI: 23.7-27.9). C. albicans was the most prevalent Candida spp. with a pooled prevalence of 65.8% (95% CI: 54.3-75.7). Risk factors of candida coinfection included smoking, diabetes, advanced age, and low body mass index.Conclusion The present review showed the high rate of candida coinfection among patients suffering from pulmonary tuberculosis. Adequate measures are necessary to early diagnose and treat these infections.


2008 ◽  
pp. 64-66
Author(s):  
J. T. Isakova ◽  
Z. K. Goncharova ◽  
A. A. Aldashev

The aim of the study was to estimate spread of primary and secondary multiple drug resistant Mycobacterium tuberculosis (MBT) and to characterize rpoB, katG, inhA, and ahpC gene mutations of rifampicin (RIF) and isoniazid (INH) resistant MBT strains isolated from tuberculosis patients in Kyrgyz. We obtained 493 specimens from patients with pulmonary tuberculosis which were diagnosed based on clinical, X-ray, and bacteriological examination. Among them, newly diagnosed pulmonary tuberculosis was in 445 patients (90.2 %), and 48 of the patients (9.8 %) have already been treated for tuberculosis. Mutations of rpoB, KatG, inhA, and ahpC genes associated with RIF and INH resistance were detected by biological chip test. Sensitive MBT strains were detected in 47 % and resistant strains were in 53 % of the newly diagnosed patients. Single-drug resistance to RIF only was detected in 3 % of cases; resistance to INH was found in 20 %, resistance to both the drugs was detected in 30 % of the patients. In pre-treated patients single-drug resistance to RIF was defined in 4 % of cases, resistance to INH was in 8 %, resistance to both the drugs was estimated in 75 % of the patients. Therefore, we suppose that there is a high prevalence of multi-drug resistant MBT in Kyrgyz Republic: 30 % among newly diagnosed patients and 75 % among pre-treated patients. The main cause of RIF-resistance of MBT is Ser531→Leu mutation of rpoB gene, and the main cause of INHresistance is Ser315→Thr mutation of katG gene.


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