scholarly journals TCA cycle remodeling drives proinflammatory signaling in humans with pulmonary tuberculosis

2021 ◽  
Vol 17 (9) ◽  
pp. e1009941
Author(s):  
Jeffrey M. Collins ◽  
Dean P. Jones ◽  
Ashish Sharma ◽  
Manoj Khadka ◽  
Ken H. Liu ◽  
...  
Keyword(s):  
Arachidonic Acid ◽  
Pulmonary Tuberculosis ◽  
Metabolic Response ◽  
Tca Cycle ◽  
Multidrug Resistant ◽  
Pulmonary Tb ◽  
Metabolic Remodeling ◽  
Mdr Tb ◽  
Key Driver ◽  
Tca Cycle Intermediates

The metabolic signaling pathways that drive pathologic tissue inflammation and damage in humans with pulmonary tuberculosis (TB) are not well understood. Using combined methods in plasma high-resolution metabolomics, lipidomics and cytokine profiling from a multicohort study of humans with pulmonary TB disease, we discovered that IL-1β-mediated inflammatory signaling was closely associated with TCA cycle remodeling, characterized by accumulation of the proinflammatory metabolite succinate and decreased concentrations of the anti-inflammatory metabolite itaconate. This inflammatory metabolic response was particularly active in persons with multidrug-resistant (MDR)-TB that received at least 2 months of ineffective treatment and was only reversed after 1 year of appropriate anti-TB chemotherapy. Both succinate and IL-1β were significantly associated with proinflammatory lipid signaling, including increases in the products of phospholipase A2, increased arachidonic acid formation, and metabolism of arachidonic acid to proinflammatory eicosanoids. Together, these results indicate that decreased itaconate and accumulation of succinate and other TCA cycle intermediates is associated with IL-1β-mediated proinflammatory eicosanoid signaling in pulmonary TB disease. These findings support host metabolic remodeling as a key driver of pathologic inflammation in human TB disease.

scholarly journals TCA cycle remodeling is associated with IL-1β-mediated proinflammatory eicosanoid signaling in humans with pulmonary tuberculosis

2021 ◽  
Author(s):  
Jeffrey M. Colins ◽  
Dean P. Jones ◽  
Ashish Sharma ◽  
Manoj Khadka ◽  
Ken Liu ◽  
...  
Keyword(s):  
Arachidonic Acid ◽  
Pulmonary Tuberculosis ◽  
Pulmonary Inflammation ◽  
Tca Cycle ◽  
Multidrug Resistant ◽  
Inflammatory Signaling ◽  
Pulmonary Tb ◽  
Mdr Tb ◽  
Tca Cycle Intermediates ◽  
Cytokine Profiling

AbstractThe metabolic signaling pathways that drive pathologic tissue inflammation and damage in humans with pulmonary tuberculosis (TB) are not well understood. Using combined methods in plasma high-resolution metabolomics, lipidomics and cytokine profiling from a multicohort study of humans with pulmonary TB disease, we discovered that IL-1β-mediated inflammatory signaling was closely associated with TCA cycle remodeling, characterized by accumulation of TCA cycle intermediates such as succinate and decreases in itaconate. This inflammatory metabolic network was particularly active in persons with multidrug-resistant (MDR)-TB after receiving 2 months of ineffective treatment and was only reversed after 1 year of appropriate anti-TB chemotherapy. Both succinate and IL-1β were closely associated with increases in proinflammatory lipid signaling, including increases in the products of phospholipase A2, increased arachidonic acid formation, and metabolism of arachidonic acid to proinflammatory eicosanoids. Together, these results indicate that decreased itaconate and accumulation of succinate and other TCA cycle intermediates are important drivers of IL-1β-mediated proinflammatory eicosanoid signaling in humans with pulmonary TB disease. Host-directed therapies that mitigate such metabolic reprograming may have potential to limit excessive pulmonary inflammation and tissue damage.

scholarly journals Comparison of Chest X-Ray Findings Between Primary and Secondary Multidrug Resistant Pulmonary Tuberculosis

2021 ◽  
Vol 5 (10) ◽  
pp. 903-910
Author(s):  
Ricky Septafianty ◽  
Anita Widyoningroem ◽  
M. Yamin S. S ◽  
Rosy Setiawati ◽  
Soedarsono
Keyword(s):  
Pulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
X Rays ◽  
Pulmonary Tb ◽  
X Ray ◽  
Pleural Thickening ◽  
Significant Difference ◽  
Record Data ◽  
Mdr Tb ◽  
Chest X Ray

Introduction: Radiological imaging has a key role in multidrug-resistant (MDR) pulmonary tuberculosis (TB) screening and diagnosis. However, new cases of MDR pulmonary TB are often overlooked; therefore, its transmission might continue before its diagnosis. The most widely used and affordable radiological modality is a chest radiograph. This study aims to describe the characteristics of primary and secondary MDR pulmonary TB chest x-ray findings for differential diagnosis. Methods: This study was an analytic observational study with a retrospective design. Researchers evaluated medical record data of primary and secondary MDR pulmonary TB patients who underwent chest x-ray examinations. The patient's chest x-rays were then evaluated. Evaluated variables were lung, pleural, and mediastinal abnormalities and severity category. Results: The most common chest x-ray finding in primary MDR pulmonary TB was consolidation (96.2%), which was mostly unilateral (52.0%), accompanied by cavities (71.2%), most of which were multiple (83.8%) with a moderate category of severity. The most common chest x-ray finding in secondary MDR pulmonary TB was consolidation (100%), which was mostly bilateral (60.4%), accompanied by cavities (80.2%), most of which were multiple (90.1%) with severe category of severity. Pleural thickening (47.5%) was also found. Conclusion: There was a significant difference between primary and secondary MDR pulmonary TB in terms of mild severity category, and pleural thickening. Mild severity category is mostly found in primary MDR-TB and pleural thickening is mostly found in secondary TB.

scholarly journals Comparison of Chest X-Ray Findings Between Primary and Secondary Multidrug Resistant Pulmonary Tuberculosis

2021 ◽  
Vol 5 (4) ◽  
pp. 855-862
Author(s):  
Ricky Septafianty ◽  
Anita Widyoningroem ◽  
M. Yamin S. S ◽  
Rosy Setiawati ◽  
Soedarsono
Keyword(s):  
Pulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
X Rays ◽  
Pulmonary Tb ◽  
X Ray ◽  
Pleural Thickening ◽  
Significant Difference ◽  
Record Data ◽  
Mdr Tb ◽  
Chest X Ray

Introduction: Radiological imaging has a key role in multidrug-resistant (MDR) pulmonary tuberculosis (TB) screening and diagnosis. However, new cases of MDR pulmonary TB are often overlooked; therefore, its transmission might continue before its diagnosis. The most widely used and affordable radiological modality is a chest radiograph. This study aims to describe the characteristics of primary and secondary MDR pulmonary TB chest x-ray findings for differential diagnosis. Methods: This study was an analytic observational study with a retrospective design. Researchers evaluated medical record data of primary and secondary MDR pulmonary TB patients who underwent chest x-ray examinations. The patient's chest x-rays were then evaluated. Evaluated variables were lung, pleural, and mediastinal abnormalities and severity category. Results: The most common chest x-ray finding in primary MDR pulmonary TB was consolidation (96.2%), which was mostly unilateral (52.0%), accompanied by cavities (71.2%), most of which were multiple (83.8%) with a moderate category of severity. The most common chest x-ray finding in secondary MDR pulmonary TB was consolidation (100%), which was mostly bilateral (60.4%), accompanied by cavities (80.2%), most of which were multiple (90.1%) with severe category of severity. Pleural thickening (47.5%) was also found. Conclusion: There was a significant difference between primary and secondary MDR pulmonary TB in terms of mild severity category, and pleural thickening. Mild severity category is mostly found in primary MDR-TB and pleural thickening is mostly found in secondary TB.

scholarly journals Genetic Diversity of IFγ, IL1β, TLR2, and TLR8 Loci in Pulmonary Tuberculosis in Kazakhstan

2014 ◽  
Vol 3 ◽  
Author(s):  
Dauren Yerezhepov ◽  
Axat Zhabagin ◽  
Ayken Askapuli ◽  
Saule Rakhimova ◽  
Zhannur Nurkina ◽  
...  
Keyword(s):  
Epidemiological Data ◽  
Multidrug Resistant ◽  
Taqman Assay ◽  
World Population ◽  
Protection Mechanism ◽  
Pulmonary Tb ◽  
Increased Risk ◽  
Mdr Tb ◽  
Latent Tb ◽  
Genotype A

Introduction. Tuberculosis (TB) is caused by bacterium Mycobacterium tuberculosis (MTB), and according to the WHO, up to 30% of world population is infected with latent TB. Pathogenesis of TB is multifactorial, and its development depends on environmental, social, microbial, and genetic factors of both the bacterium and the host. The number of TB cases in Kazakhstan has decreased in the past decade, but multidrug-resistant (MDR) TB cases are dramatically increasing. Polymorphisms in genes responsible for immune response have been associated with TB susceptibility. The objective of this study was to investigate the risk of developing pulmonary TB (PTB) associated with polymorphisms in several inflammatory pathway genes among Kazakhstani population.Methods. 703 participants from 3 regions of Kazakhstan were recruited for a case-control study. 251 participants had pulmonary TB (PTB), and 452 were healthy controls (HC). Males and females represented 42.39% and 57.61%, respectively. Of all participants, 67.4% were Kazakhs, 22.8% Russians, 3.4% Ukrainians, and 6.4% were of other origins. Clinical and epidemiological data were collected from medical records, interviews, and questionnaires. DNA samples were genotyped using TaqMan assay on 4 polymorphisms: IFNγ (rs2430561) and IL1β (rs16944), TLR2 (rs5743708) and TLR8 (rs3764880). Statistical data was analyzed using SPSS 19.Results. Genotyping by IFγ, IL1β, TLR2 showed no significant association with PTB susceptibility (p > 0.05). TLR8 genotype A/G was significantly higher in females (F/M – 41.5%/1.3%) and G/G in males (M/F – 49%/20.7%) (χ2=161.43, p < 0.001). A significantly increased risk of PTB development was observed for TLR A/G with an adjusted OR of 1.48 (95%, CI: 0.96 - 2.28), and a protective feature was revealed for TLR8 G/G genotype (OR: 0.81, 95%, CI: 0.56 - 1.16, p = 0.024). Additional grouping by gender revealed that TLR8 G/G contributes as protective genotype (OR: 1.83, 95%, CI: 1.18 - 2.83, p = 0.036) in males of the control group.Conclusion. Results indicate that heterozygous genotype A/G of TLR8 increases the risk of PTB development, while G/G genotype may serve as protection mechanism. A/A genotype is strongly associated with susceptibility to PTB. To clarify the role of other polymorphisms in susceptibility to PTB in Kazakhstani population, further investigations are needed. 

scholarly journals KAMI-PMO TB (EDUKASI DAN PENDAMPINGAN PENGAWAS MENELAN OBAT TB) DALAM PENGENDALIAN MDR TB

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Mareta Dea Rosaline ◽  
Santi Herlina
Keyword(s):  
Multidrug Resistant ◽  
T Test ◽  
P Value ◽  
Test Analysis ◽  
Pulmonary Tb ◽  
Drug Ingestion ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Paired T Test

Tuberculosis control in Indonesia is still not optimal. The problem of MDR TB (Multidrug-Resistant Tuberculosis) is an obstacle to controlling TB in Indonesia. MDR TB is caused by no response from TB germs to treatment isoniazid and rifampicin, anti-tuberculosis drugs. TB incidence rate in Serang district ranks second in Banten Province after Tangerang. The number of pulmonary TB cases is due to the lack of public knowledge and awareness about pulmonary TB disease. To reduce the adverse effects of MDR TB requires the involvement of cadres or family members who controlling drug ingestion (PMO). The form of activities carried out through the formation of cadres to care for TB through the KAMI-PMO TB (Education and Assistance for TB Medication Supervisors) in Desa Baros, Kabupaten Serang. The purpose is to increase the commitment, ability, and knowledge of cadres as coordinator of PMO (Drug Swallow Supervisor) to control MDR TB. The method of implementing activities is counseling, demonstrations, and assistance to cadres. The media used were PPT, WE-PMO TB Booklet, and educational videos. The result of the training was an increase in the ability of cadres in providing PMO counseling by 87%. The Paired T-Test analysis results showed a p-value of 0.000, which means that the training conducted affected cadres' knowledge of PMO TB. In conclusion, education and assistance to cadres have a good influence in increasing knowledge and abilities. The expected result is TB care cadres can provide aid and become the coordinator of TB PMO (Drug Ingestion Supervisor).  ABSTRAK:Pengendalian Tuberculosi di Indonesia masih belum optimal.Permasalahan MDR TB (Multidrug Resistant Tuberculosis) merupakan hambatan pengendalian TB di Indonesia. MDR TB disebabkan tidak ada respon kuman TB terhadap pengobatan isoniazid dan rifampizin yang merupakan obat anti tuberculosis. Angka kejadian TB di kabupaten Serang menempati urutan kedua di Provinsi Banten setelah Tangerang, dan banyaknya kasus TB Paru dikarenakan pengetahuan dan kesadaran masyarakat tentang penyakit TB Paru masih kurang. Untuk mengurangi dampak buruk MDR TB dibutuhkan keterlibatan peran serta kader peduli TB atau anggota keluarga yang berperan dalam pengawasan menelan obat (PMO). Bentuk kegiatan yang dilakukan sebagai bentuk pemberdayaan masyarakat melalui pembentukan kader peduli TB  melalui KAMI-PMO TB (Edukasi dan Pendampinga Pengawas Menelan Obat TB) di Desa Baros Kabupaten Serang. Tujuan dari pengabdian masyarakat adalah meningkatkan komitmen, kemampuan dan pengetahuan kader sebagai koordinator PMO (Pengawas Menelan Obat) dalam upaya pengendalian MDR TB. Metode pelaksanaan kegiatan adalah penyuluhan, demontrasi, dan pendampingan kader. Media yang digunakan yaitu PPT, Booklet KAMI-PMO TB , dan video edukasi. Hasil dari kegiatan adalah meningkatnya kemampuan kader dalam memberikan penyuluhan PMO cukup tinggi sebesar 87%. Hasil analisis uji Paired T- Test didapatkan nilai p value 0,000 yang artinya ada pengaruh pelatihan yang dilakukan terhadap pengetahuan kader tentang PMO TB. Kesimpulannya edukasi dan pendampingan kepada kader memiliki pengaruh yang baik  dalam meningkatkan pengetahuan dan kemampuan, sehingga hasil yang diharapkan kader peduli TB dapat melakukan pendampingan pada pasien TB dan menjadi koordinator PMO (Pengawas Menelan Obat) TB dalam upaya pengendalian MDR TB

scholarly journals Rifampicin and isoniazid drug resistance among patients diagnosed with pulmonary tuberculosis in southwestern Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0259221
Author(s):  
Lisa Nkatha Micheni ◽  
Kennedy Kassaza ◽  
Hellen Kinyi ◽  
Ibrahim Ntulume ◽  
Joel Bazira
Keyword(s):  
Drug Resistance ◽  
Pulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
Bivariate Analysis ◽  
Newly Diagnosed ◽  
High Resolution Melt ◽  
Significant Control ◽  
Mdr Tb ◽  
Previously Treated ◽  
Southwestern Uganda

Multidrug-resistant tuberculosis (MDR-TB) has become a major threat to the control of tuberculosis globally. Uganda is among the countries with a relatively high prevalence of tuberculosis despite significant control efforts. In this study, the drug resistance of Mycobacterium tuberculosis to rifampicin (RIF) and isoniazid (INH) was investigated among patients diagnosed with pulmonary tuberculosis in Southwestern Uganda. A total of 283 sputum samples (266 from newly diagnosed and 17 from previously treated patients), collected between May 2018 and April 2019 at four different TB diagnostic centres, were assessed for RIF and INH resistance using high-resolution melt curve analysis. The overall prevalence of monoresistance to INH and RIF was 8.5% and 11% respectively, while the prevalence of MDR-TB was 6.7%. Bivariate analysis showed that patients aged 25 to 44 years were at a higher risk of developing MDR-TB (cOR 0.253). Furthermore, among the newly diagnosed patients, the prevalence of monoresistance to INH, RIF and MDR-TB was 8.6%, 10.2% and 6.4% respectively; while among the previously treated cases, these prevalence rates were 5.9%, 23.5% and 11.8%. These rates are higher than those reported previously indicating a rise in MTB drug resistance and may call for measures used to prevent a further rise in drug resistance. There is also a need to conduct frequent drug resistance surveys, to monitor and curtail the development and spread of drug-resistant TB.

scholarly journals Clinical profile of pulmonary tuberculosis and MDR TB in children at tertiary medical institute

2019 ◽  
Vol 6 (6) ◽  
pp. 2571
Author(s):  
Anupama Vinayak Mauskar ◽  
Amrit Gopan
Keyword(s):  
Risk Factor ◽  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Admission Rate ◽  
P Value ◽  
Chi Square ◽  
Pulmonary Tb ◽  
Medical College ◽  
Mdr Tb ◽  
Chi Square Test

Background: India is the country with highest burden of TB. There is paucity of data as far as Pediatric TB is concern. TB in children directly reflects intensity of on-going transmission of TB in a given community. This study was done including indoor cases of Pediatric pulmonary TB in a medical college hospital, a tertiary care institute in the city of Mumbai. The aim and objectives of this study the clinical profile and outcome of Pediatric pulmonary tuberculosis/MDR TB in an indoor setting of a tertiary care center. It was a clinical observational study in a setting of medical college hospital.Methods: All admitted children with newly diagnosed pulmonary TB were included in study. A detailed clinical analysis was done. Statistical Analysis Association between two qualitative data was assessed by Chi-Square test, Fisher's exact test for all 2 X 2 tables where Chi-Square test was not valid due to small counts. Comparison of quantitative data measured between two outcomes was done using unpaired t-test. PSPP version 0.8.5 was used for statistical analysis.Results: Total of 41 patients with pulmonary TB were included in the study, making admission rate of 0.7% of total admission. Three out of 41 children had MDRTB making incidence 7% of total TB patients. Severe acute malnutrition was a major risk factor for dissemination of disease and mortality (p value 0.031and 0.0017).Conclusions: The study estimates 0.7% admission rate and 7% as incidence of MDRTB in indoor patients. Severe malnutrition was found to be risk factor for dissemination of disease [p value 0.031].

scholarly journals Gambaran Darah Tepi, Rasio Neutrofil-Limfosit, dan Rasio Trombosit-Limfosit pada Pasien Tuberkulosis Paru dengan Depresi

2019 ◽  
Vol 6 (2) ◽  
pp. 82
Author(s):  
Hamzah Shatri ◽  
Reinaldo Alexander ◽  
Rudi Putranto ◽  
Ikhwan Rinaldi ◽  
Cleopas Martin Rumende
Keyword(s):  
Pulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
Blood Cell Count ◽  
Statistical Manual ◽  
Pulmonary Tb ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Diagnostic And Statistical Manual ◽  
Dsm V ◽  
Severity Of Depression

Pendahuluan.  Pasien dengan tuberkulosis (TB) paru memiliki peningkatan risiko untuk mengalami depresi sampai 1,53 kali dari sebuah studi kohort besar. Studi – studi menemukan adanya peningkatan rasio neutrofil – limfosit (RNL) pada berbagai gangguan mood termasuk depresi, juga rasio trombosit – limfosit (RTL) terkait dengan depresi berat yang disertai dengan gejala psikotik. Penelitian ini dilakukan untuk mengetahui karakteristik gambaran darah tepi, RNL, dan RTL pada pasien TB paru yang mengalami depresi.Metode. Studi dengan desain potong lintang dilakukan terhadap 106 pasien TB paru tidak resisten obat yang berobat jalan di poliklinik paru RS Cipto Mangunkusumo, Jakarta dari bulan Agustus hingga Oktober 2018. Diagnosis depresi ditegakkan dengan wawancara menurut kriteria diagnosis dari Diagnostic and Statistical Manual of Mental Disorder-V (DSM-V) dan derajat depresi ditentukan menggunakan kuesioner Beck Depression Inventory-II (BDI-II). Pemeriksaan laboratorium dilakukan untuk mendapatkan hasil darah perifer lengkap, RNL, dan RTL. Uji statistik parametrik digunakan untuk variabel-variabel numerik dengan sebaran merata, sementara uji nonparametrik digunakan bila sebaran tidak merata.Hasil. Dari 106 pasien TB paru tidak resisten obat yang menjadi subjek penelitian, didapatkan proporsi depresi sebesar 32%. Didapatkan nilai leukosit lebih rendah pada pasien TB paru dengan depresi (p=0,024), dan juga nilai limfosit absolut yang lebih rendah pada pasien TB paru dengan depresi (p=0,004) bila dibandingkan dengan subjek tanpa depresi. Rasio neutrofil – limfosit (RNL) dan RTL tidak berhubungan signifikan secara statistik (p>0,05) dengan beratnya derajat depresi. Simpulan. Nilai hitung leukosit dan limfosit pada pasien TB paru dengan depresi lebih rendah dibandingkan pasien tanpa depresi. Nilai RNL dan RTL pada pasien depresi dengan TB paru lebih tinggi walaupun tidak signifikan secara statistik. Kata Kunci: Depresi, Gambaran darah tepi, Rasio neutrofil – limfosit, Rasio trombosit – limfosit, Tuberkulosis paruPeripheral Blood Count Characteristics, Neutrophil-Lymphocyte Ratio, and Platelet-Lymphocyte Ratio Pulmonary Tuberculosis Patients with DepressionIntroduction. Patients with pulmonary tuberculosis (TB) had an increased risk for depression up to 1.53 times from a large cohort study. Studies have found an increase in the neutrophil - lymphocyte ratio (NLR) in various mood disorders including depression, also the value of the platelet-lymphocyte ratio (PLR) associated with major depression accompanied by psychotic symptoms. This study aimed to describe the peripheral blood characteristics, NLR,  and PLR in pulmonary TB patients with depression.  Methods. A cross-sectional study of 106 non-multidrug-resistant pulmonary TB patients was done at outpatient department of Cipto Mangunkusumo General Hospital, Jakarta from August to October 2018. The diagnosis of depression was made by interview according to Diagnostic and Statistical Manual of Mental Disorder-V (DSM-V) criteria, and severity of depression is determined using Beck Depression Inventory-II (BDI-II). The laboratory tests were done to obtain complete peripheral blood results, NLR, and TLR. Parametric test was used for numeric variables with even distribution, and nonparametric test for variables with uneven distribution.Results. From 106 patients with non-multidrug-resistant pulmonary TB, the proportion of depression was 32%. White blood cell count (p=0.024), and absolute lymphocte count (p=0.004) is lower in depressed TB patients compared to nondepressed TB patients. There were no significant relationship between NLR and TLR and the severity of depression in depressed pulmonary TB patients (p>0.05). Conclusion. White blood cell count and absolute lymphocyte count are lower in depressed pulmonary TB patients. Meanwhile, RNL and PLR are higher in depressed pulmonary TB patients eventhough not statistically significant.

scholarly journals Prediction of multiple drug resistant pulmonary tuberculosis against drug sensitive pulmonary tuberculosis by CT nodular consolidation sign

2019 ◽  
Author(s):  
Xi-Ling Huang ◽  
Aliaksandr Skrahin ◽  
Pu-Xuan Lu ◽  
Sofia Alexandru ◽  
Valeriu Crudu ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Diagnostic Testing ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Pulmonary Tb ◽  
Injectable Drugs ◽  
Resistant Tuberculosis ◽  
Multiple Drug Resistant ◽  
Previously Treated Patients

AbstractMultidrug-resistant tuberculosis (mdrtb) refers to TB infection resistant to at least two most powerful anti-TB drugs, isoniazid and rifampincin. It has been estimated that globally 3.5% (which can be much higher in some regions) of newly diagnosed TB patients, and 20.5% of previously treated patients had mdrtb. Extensively drug-resistant TB (xdrtb) has resistance to rifampin and isoniazid, as well as to any member of the quinolone family and at least one of the second line injectable drugs: kanamycin, amikacin and capreomycin. xdrtb accounts for 4-20% of mdrtb. Early detection and targeted treatment are priorities for mdrtb/xdrtb control. The suspicion of mdr/xdr -pulmonary TB (mdrptb or xdrptb) by chest imaging shall suggest intensive diagnostic testing for mdrptb/xdrptb. We hypothesize that multiple nodular consolidation (NC) may serve one of the differentiators for separating dsptb vs mdrptb/xdrptb cases. For this study, mdrptb cases (n=310) and XDR-PTB cases (⋂=I58) were from the NIAID TB Portals Program (TBPP) <https://tbportals.niaid.nih.gov>. Drug sensitive pulmonary TB (dsptb) cases were from the TBPP collection (n=112) as well as the Shenzhen Center for Chronic Disease Control (n=111), Shenzhen, China, and we excluded patients with HIV(+) status. Our study shows NC, particularly multiple NCs, is more common in mdrptb than in dsptb, and more common in xdrptb than in mdrptb. For example, 2.24% of dsptb patients, 13.23% of mdrptb patients, and 20.89% of xdrptb patients, respectively, have NCs with diameter >= 10mm equal or more than 2 in number.

Sign in / Sign up

Export Citation Format

Share Document