Evidence for boosting Mycobacterium tuberculosis-specific IFN-  responses at 6 weeks following tuberculin skin testing

ABSTRACTOld tuberculin (OT) and purified protein derivative (PPD) are widely used for tuberculin skin testing (TST) in diagnosis of tuberculosis (TB) but often yield poor specificity and anergy in reaction. Therefore, it is necessary to develop new serological methods as a possible auxiliary diagnostic method for TB. In this study, we characterized the dynamic antibody responses of 10 purified recombinant antigens, PPD, and OT in rhesus monkeys experimentally infected withMycobacterium tuberculosisand analyzed the time to antibody detection, antibody levels, and their association with the infectious doses. The antibodies were detected as early as 4 weeks after infection in response to 5 antigens (CFP10, CFP10-ESAT-6, U1, MPT64, and Ag85b). Antibodies against most of the other antigens were detected between 4 and 12 weeks after infection. The levels of antibodies were dose dependant. We further evaluated the serodiagnostic potential of these antigens by using indirect enzyme-linked immunosorbent assay in 71 TST-positive and 90 TST-negative serum samples from monkeys. For all 12 antigens, the median optical density values of TST-positive monkeys were statistically significantly higher than those of TST-negative monkeys (P< 0.001). Among those antigens, Ag85b and CFP10 showed higher diagnostic potential than others. A combination of results from Ag85b, the 38-kDa antigen (Ag38kDa), and Ag14kDa reaches a sensitivity of 95.77%, indicating that these antigens may be ideal cocktails in TB diagnosis.

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Trends in Compliance With the Guidelines for Preventing the Transmission of Mycobacterium tuberculosis Among New Jersey Hospitals, 1989 to 1996

Infection Control and Hospital Epidemiology ◽

10.1086/501627 ◽

1999 ◽

Vol 20 (05) ◽

pp. 337-340 ◽

Cited By ~ 1

Author(s):

Lilia P. Manangan ◽

Edgar R. Collazo ◽

Jerome Tokars ◽

Sindy Paul ◽

William R. Jarvis

Keyword(s):

Mycobacterium Tuberculosis ◽

New Jersey ◽

Skin Testing ◽

Multidrug Resistant ◽

Tuberculin Skin Testing ◽

Healthcare Facilities ◽

Patient Admissions ◽

Mdr Tb ◽

Respiratory Devices ◽

Attending Physicians

AbstractObjective:To determine trends in compliance with the guidelines for preventing the transmission ofMycobacterium tuberculosisin healthcare facilities among New Jersey hospitals from 1989 through 1996.Design:A voluntary questionnaire was sent to all 96 New Jersey hospitals in 1992. The 53 that responded were resurveyed in 1996.Results:Of the 96 hospitals surveyed in 1992, 53 (55%) returned a completed questionnaire; 33 (64%) were community, nonteaching hospitals. In 1991, patients with tuberculosis (TB) were admitted at 38 (72%) of 53 hospitals, and from 1989 through 1991, patients with multidrug-resistant (MDR) TB were admitted at 15 (29%) of 52 hospitals. Twenty-nine (57%) of 51 reported having rooms meeting the Centers for Disease Control and Prevention (CDC) criteria for acid-fast bacilli (AFB) isolation. A nonfltted surgical mask was used as a respiratory protective device by healthcare workers (HCWs) at 28 (55%) of 51 hospitals. Attending physicians were included in tuberculin skin-testing (TST) programs at 5 (11%) of 45 hospitals. In the 1996 resurvey, 48 (94%) of 53 surveyed hospitals returned a completed questionnaire; 34 (81%) of 42 had TB patient admissions, and 4 (9%) of 43 had MDR TB patient admissions in 1996. Forty-five (96%) of 47 reported having rooms that met CDC criteria for AFB isolation. N95 respiratory devices were used by HCWs at 45 (94%) of 48 hospitals. Attending physicians were included in the TST programs at 22 (54%) of 41 hospitals.Conclusion:New Jersey hospitals have made improvements in availability of AFB isolation rooms, use of proper respiratory protective devices, and expansion of TST programs for HCWs from 1989 through 1996.

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Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries

European Respiratory Journal ◽

10.1183/13993003.01245-2015 ◽

2015 ◽

Vol 46 (6) ◽

pp. 1563-1576 ◽

Cited By ~ 295

Author(s):

Haileyesus Getahun ◽

Alberto Matteelli ◽

Ibrahim Abubakar ◽

Mohamed Abdel Aziz ◽

Annabel Baddeley ◽

...

Keyword(s):

Mycobacterium Tuberculosis ◽

Skin Testing ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

World Health ◽

Public Health Approach ◽

People Living With Hiv ◽

Tuberculin Skin Testing ◽

Mycobacterium Tuberculosis Infection ◽

Systematic Testing

Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3–4 month isoniazid plus rifampicin; or 3–4 month rifampicin alone.

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Effect of tuberculin skin testing on a Mycobacterium tuberculosis-specific interferon- assay

European Respiratory Journal ◽

10.1183/09031936.00117506 ◽

2007 ◽

Vol 29 (6) ◽

pp. 1212-1216 ◽

Cited By ~ 54

Author(s):

E. M. S. Leyten ◽

C. Prins ◽

A. W. J. Bossink ◽

S. Thijsen ◽

T. H. M. Ottenhoff ◽

...

Keyword(s):

Mycobacterium Tuberculosis ◽

Skin Testing ◽

Tuberculin Skin Testing

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Pulmonary Tuberculosis Outbreak in a High School, China

Austin Internal Medicine ◽

10.26420/austininternmed.2021.1053 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

◽

Yang Zhou ◽

Bing Zhao ◽

Tao Li ◽

Qian Cheng ◽

...

Keyword(s):

High School ◽

Mycobacterium Tuberculosis ◽

Tandem Repeats ◽

Skin Testing ◽

Drug Susceptibility ◽

Variable Number ◽

Hunan Province ◽

Tuberculin Skin Testing ◽

Nucleotide Polymorphisms ◽

Symptom Screening

This study reports an outbreak of Tuberculosis (TB) in a high school in Hunan province, China during January 2017-April 2018. Contact investigation and TB screening were conducted through symptom screening, tuberculin skin testing, chest radiography and smear examination. Identification of positive isolates and drug susceptibility phenotype were assessed by standard method. Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR) and Whole Genome Sequencing (WGS) were performed to investigate the relationships among the positive isolates. A total of 90 students and one teacher were diagnosed active pulmonary TB among 2908 students and 188 staff, with an attack rate of 2.94%. Thirteen positive isolates were identified as drug susceptible Beijing family of Mycobacterium tuberculosis. Results of MIRU-VNTR typing and WGS revealed two clones of Mycobacterium tuberculosis circulating during outbreak. One hundred and twenty-nine Single Nucleotide Polymorphisms (SNPs) discriminated the isolates in two clusters; the maximum number of SNPs between any pair of isolates in each cluster was five or fewer. Our findings highlight the importance of early identification and isolation of the TB cases to prevent spread of TB. WGS provides better resolution than MIRU-VNTR to identify recent transmission in TB outbreak.

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