scholarly journals MYCOBACTERIA AND OTHER ACID FAST ORGANISMS ASSOCIATED WITH PULMONARY DISEASE IN JOS, NIGERIA PULMONARY DISEASE AND ACID FAST ORGANISMS

2015 ◽  
Vol 3 (1) ◽  
pp. 15
Author(s):  
Ani AE ◽  
Diarra B ◽  
Dahle UR ◽  
Lekuk C ◽  
Yetunde F ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Diagnostic Procedures ◽  
Adult Patients ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Tuberculosis Complex ◽  
Nocardia Species ◽  
Genotype Assay ◽  
Prompt Diagnosis

Objective: Acid fast bacilli (AFB) for sputum smear microscopy is the affordable method used for prompt diagnosis of tuberculosis in Nigeria despite its lack of specificity and limited sensitivity. The study aims to identify Mycobacterium tuberculosis and other acid fast organisms isolated from sputum of of HIV positive adult patients with pulmonary disease in Jos, Nigeria. Methods: Acid fast organisms isolated from 80 AFB positive sputa of HIV positive adult patients suspected for tuberculosis in Jos, Nigeria were identified for members of M. tuberculosis Complex (M tuberculosis, M bovis, M africanum, M canetti M. microti and M. caprae) by use of spoligootyping, Multiplex Gen Probe, Hain genotype assay and gene sequencing for spoligotype negative isolates. Results: Seven different spoligotypes of M. tuberculosis complex were identified from 70/80 (87.5%) total number of isolates. M. kansasii (1), M. dulvalii (1) Nocardia species (1) and Tsukamurella species (2) were detected from 5/10 spoligotype negative isolates. Conclusion and Recommendation: Although M. tuberculosis is the dominant AFB associated with chronic pulmonary disease in Jos, Nigeria, other clinically relevant mycobacteria were observed in the study. This suggests that other AFB positive microorganisms associated withtuberculosis -like symptoms could be misdiagnosed and incorrectly treated as M. tuberculosis. It is therefore necessary for laboratories in TB high burden countries to step up diagnostic procedures beyond routine smear microscopy.

scholarly journals Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis

2016 ◽  
Vol 42 (3) ◽  
pp. 191-195 ◽  
Author(s):  
Abdullah Şimşek ◽  
İlhami Yapıcı ◽  
Mesiha Babalık ◽  
Zekiye Şimşek ◽  
Mustafa Kolsuz
Keyword(s):  
Fine Needle Aspiration Biopsy ◽  
Granulomatous Inflammation ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Bronchial Brushing ◽  
Endobronchial Tuberculosis ◽  
Proportional Distribution ◽  
Hiv Negative

ABSTRACT Objective: To determine the proportional distribution of endobronchial tuberculosis (EBTB) subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. Methods: This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. Results: The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both). Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%). Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%). Smear microscopy of BAL fluid (BALF) was performed in 16 patients and was positive for AFB in 10 (62.5%). Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%). Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%); bronchial brushing, in 7 (38.8%); fine-needle aspiration biopsy, in 2 (11.1%); and BAL, in 2 (11.1%). Bronchial anthracofibrosis was observed in 5 (27.7%) of the 18 cases evaluated. Conclusions: In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB.

scholarly journals X-RAY MORPHOLOGICAL SEMIOTICS OF NON-TUBERCULOUS MYCOBACTERIAL PULMONARY DISEASE

2018 ◽  
Vol 99 (4) ◽  
pp. 184-190
Author(s):  
R. B. Amansakhedov ◽  
L. N. Lepekha ◽  
L. I. Dmitrieva ◽  
I. Yu. Andrievskaya ◽  
A. T. Sigaev ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Pulmonary Disease ◽  
Photon Emission ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Emission Computed Tomography ◽  
X Ray ◽  
Radionuclide Study ◽  
Planar Mode

Objective: to evaluate the X-ray radiological features of nontuberculous mycobacterial pulmonary disease (NTMPD) versus morphological findings.Material and methods. The investigation enrolled 37 patients, in whom the radiographic signs of dissemination were determined and various types of NTMPD were identified. The investigation was conducted on a Siemens Somatom Emotion 16 multislice computed tomography (MSCT) scanner using a high-resolution algorithm (Quick Time Virtual Reality). To clarify the activity of pathological changes in the thoracic organs, 16 (43.2%) patients underwent a radionuclide study with 99mTc-technetrile on a Nucline Spirit gamma camera in planar and single photon emission computed tomography modes.The diagnosis was verified by sputum smear microscopy and clinical laboratory and bronchologic examinations: bronchoalveolar lavage in 11 (29.7%) patients, various types of bronchial biopsies in 17 (46.0%), morphological examinations, and videoassisted thoracoscopic surgery for pulmonary resection in 9 (24.3%).Results. The dissemination foci in mycobacterial diseases were characterized by their location in the lung parenchyma with vascular and bronchial involvement and reactive changes in the pulmonary pleurae and intrathoracic lymph nodes (ITLN). In 92.7% of cases, the detected foci were predominantly centrilobular with endobronchial localization. Their contours were mixed with clear and fuzzy outlines in 98.7% of cases. In 70.3% of cases, the foci were asymmetrically localized mainly in the subpleural areas of the lung and 12.3% of cases were accompanied by reactive involvement of the visceral pleura.CT study revealed a tree-in-bud sign in 96.7% of cases, frosted glass in 10.2%, and mosaic perfusion in 13.2%. A more than 10-mm increase in ITLN was found in 11.7% of cases.In a number of cases, it was difficult to speak about the activity of the pathological process in the lung and ITLN, as shown by MSCT. In this case, a lung radionuclide study with 99mTc-technetrile was carried out in the planar mode. The degree of tracer accumulation, localization, and extent were analyzed in the planar mode.Conclusion. Thus, the CT typical signs of NTMPD are the asymmetric location of its foci with an endobronchial extension, peribronchovascular localization of foci; the presence of a CT tree-in-bud sign; and the slight involvement of the pulmonary pleurae in the process. 99mTs-technetril radionuclide study has established that the most active inflammatory process is located in the lung and the tracer accumulates in the pathologically altered lymph nodes.

scholarly journals Rapid Testing for the Diagnosis of Pulmonary Tuberculosis and Rifampicin Resistance: A Review of Cost-Effectiveness

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Anusree Subramonian ◽  
Melissa Severn
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Rapid Testing ◽  
Tuberculosis Complex ◽  
Effective Option ◽  
Data Source ◽  
Source Populations ◽  
The Cost

The evidence regarding the cost-effectiveness of the Xpert Mycobacterium tuberculosis complex and resistance to rifampicin (Xpert MTB/RIF) test compared with smear microscopy in diagnosing tuberculosis is summarized in this report. Results from the included 6 studies showed that Xpert MTB/RIF testing is a cost-effective option compared with sputum smear microscopy. However, the generalizability of the results to the Canadian setting are unclear because of the clinical data source populations, willingness-to-pay thresholds, and assumptions used in the analyses. There is a lack of evidence regarding the cost-effectiveness of Xpert MTB/RIF testing compared with mycobacterial cultures or culture-based susceptibility testing.

scholarly journals Prolongation of acid-fast bacilli sputum smear positivity in patients with multidrug-resistant pulmonary tuberculosis

2020 ◽  
Author(s):  
Sidwell Mvo ◽  
Benjamin Longo-Mbenza ◽  
Sandeep D. Vasaikar ◽  
Teke Apalata
Keyword(s):  
Conversion Rate ◽  
Cox Regression ◽  
Multidrug Resistant ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Cell Counts ◽  
Conversion Rates ◽  
Mdr Tb ◽  
Hiv Negative

Abstract Background The study sought to determine factors associated with prolonged smear positivity in multidrug-resistant tuberculosis (MDR-TB) patients following an appropriate management.Methods Newly diagnosed patients [(100 MDR-TB and 100 drug-susceptible TB (DS-TB)] were enrolled between June 2017 and May 2018. Clinical and radiological findings were recorded. Sputum samples were collected for Xpert® MTB/RIF and line probe assays (LiPA). Microscopic tests, including smear grading, were performed at baseline, 4, 8 and 12 weeks post anti-TB therapy. Kaplan-Meier and Cox regression analyses were performed using SPSS v23 with ρ set at ≤ 0.05.Results Of the 200 patients (median age of 34.8 years), 114 (57%) were HIV positive. After 12 weeks of treatment, there was a significant microscopy conversion rate among DS-TB patients [43/45 (95.6%)] as compared to MDR-TB patients [54/69 (78.3%)] (ρ = 0.009), all co-infected with HIV. Similarly, among HIV negative patients, a significant microscopy conversion rate was noted among DS-TB patients [48/55(69.6%)] as compared to MDR-TB patients [21/31(30.4%)] (ρ = 0.03). Time to microscopy conversion was 4.58 ± 2.97 weeks and 5.69 ± 3.25 weeks for HIV positive patients aged ≥35 years and <35 years, respectively whilst among HIV negative patients, time to conversion was 5.00 ± 2.83 weeks and 6.86± 3.59 weeks for those aged ≥35 years and <35 years, respectively (ρ = 0.003). There was a significant association between CD4+ T cell counts at initiation of TB treatment and smear microscopy conversion rates after 12 weeks (ρ = 0.010). At 8 weeks of anti-TB therapy, all MDR-TB patients whose baseline smear microscopy score ranged from scanty to 1+ converted negative whilst 25% of patients with score ≥2+ at baseline remained positive at the end of 12 weeks of treatment (ρ = 0.014). Multivariate Cox regression showed that only baseline smear microscopy grade was independently associated with prolonged smear positivity in MDR-TB patients at 12 weeks (ρ = 0.014).Conclusion Baseline microscopy score ≥2+ is key determinant for prolonged MDR-TB smear positivity beyond 12 weeks of anti-TB therapy. This indicator, though less sensitive than culture, can be used in poor resource settings.

scholarly journals Molecular Detection of Mycobacterium tuberculosis in Oral Mucosa from Patients with Presumptive Tuberculosis

2020 ◽  
Vol 9 (12) ◽  
pp. 4124
Author(s):  
Barbara Molina-Moya ◽  
Nelly Ciobanu ◽  
Marta Hernandez ◽  
Cristina Prat-Aymerich ◽  
Valeriu Crudu ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Oral Mucosa ◽  
The Elderly ◽  
Storage Conditions ◽  
Molecular Diagnostic ◽  
Smear Microscopy ◽  
X Rays ◽  
Rt Pcr ◽  
Tuberculosis Complex ◽  
Tb 34

Tuberculosis (TB) diagnosis is increasingly based on the detection of Mycobacterium tuberculosis complex (MTBC) DNA in sputum using molecular diagnostic tests as the first test for diagnosis. However, sputum can be difficult to obtain in children, patients without productive cough, and the elderly and approaches testing non-sputum samples are needed. We evaluated whether TB can be detected from the oral mucosa of patients with TB. Adults with presumptive TB were examined using culture, Xpert MTB/RIF, smear microscopy and X-Rays. Oral mucosa swabs collected on PrimeStore-MTM, stored at room temperature if tested within 30 days or at −20 °C if examined at a later time. RT-PCR was performed to detect M. tuberculosis DNA. Eighty patients had bacteriologically-confirmed TB, 34 had bacteriologically-negative TB (negative tests but abnormal X-rays) and 152 were considered not to have TB (not TB). Oral swabs RT-PCR were positive in 29/80 (36.3%) bacteriologically-confirmed, 9/34 (26.5%) bacteriologically-negative and 29/152 (19.1%) not TB. The yield varied among samples stored for less and more than 30 days (p = 0.013) from 61% (11/18) and 29% (18/62) among bacteriologically confirmed, and 30.8% (4/13) and 23.8% (5/21) among bacteriologically-negative participants. Among not TB patients, the specificity was 80.9% (123/152), being 78.3% (18/23) among samples stored less than 30 days and 81.4% (105/129) among samples stored for more than 30 days (p = 0.46). The detection of M. tuberculosis in oral mucosa samples is feasible, but storage conditions may affect the yield.

scholarly journals A Retrospective Cross-Sectional Study of the Utility of Cartridge-Based Nucleic Acid Amplification Test in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in People Living with HIV in Second Highest HIV Prevalent State in India

2021 ◽  
Author(s):  
Tade Bagbi ◽  
Ningthoukhongjam Reema ◽  
S. Bhagyabati Devi ◽  
Thangjam Gautam Singh ◽  
Mohammad Jaleel ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative

Abstract Introduction Tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV) is difficult to diagnose due to fewer organisms in sputum and extrapulmonary samples. Sputum culture takes 4 to 8 weeks for growth of the mycobacteria. Delayed treatment for TB in PLHIV leads to increased mortality. This study evaluated cartridge-based nucleic acid amplification test (CBNAAT) as a diagnostic tool for diagnosis of pulmonary TB (PTB) and extrapulmonary TB (EPTB) in PLHIV in the second most HIV prevalent state in India and for comparing its efficacy between Ziehl–Neelsen (ZN) staining sputum smear–positive and sputum smear–negative TB. Methods This cross-sectional study was conducted in RIMS, Imphal, with 167 PLHIV patients, age 15 years or older, having signs and symptoms of TB. Appropriate samples for sputum microscopy and CBNAAT were sent. Conclusion The overall sensitivity of sputum smear for acid-fast bacillus (AFB) was found to be 30.71% and that of CBNAAT was 38.57%. Sensitivity of CBNAAT for sputum smear–positive and sputum smear–negative TB was 100 and 11.3%, respectively. Sensitivity of ZN smear for AFB of EPTB sample was 48.1% and that of CBNAAT was 59.25%. In both PTB and EPTB, CBNAAT showed an increase in diagnosis of microbiologically confirmed PTB cases by 7.8 and 11.1%, respectively, over and above the cases diagnosed by ZN smear microscopy. Rifampicin resistance was detected in five patients. We conclude that CBNAAT is a rapid test with better sensitivity in diagnosis of PTB and EPTB in PLHIV, compared with ZN smear microscopy. It detects rifampicin resistance for multidrug-resistant TB and helps in early treatment intervention.

scholarly journals Characterization of Drug-Resistant Lipid-Dependent Differentially Detectable Mycobacterium tuberculosis

2021 ◽  
Vol 10 (15) ◽  
pp. 3249
Author(s):  
Annelies W. Mesman ◽  
Seung-Hun Baek ◽  
Chuan-Chin Huang ◽  
Young-Mi Kim ◽  
Sang-Nae Cho ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Culture Media ◽  
Multidrug Resistant ◽  
Culture Conditions ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Solid Culture ◽  
Lowenstein Jensen ◽  
Genetic Mechanisms ◽  
Lipid Resuscitation

An estimated 15–20% of patients who are treated for pulmonary tuberculosis (TB) are culture-negative at the time of diagnosis. Recent work has focused on the existence of differentially detectable Mycobacterium tuberculosis (Mtb) bacilli that do not grow under routine solid culture conditions without the addition of supplementary stimuli. We identified a cohort of TB patients in Lima, Peru, in whom acid-fast bacilli could be detected by sputum smear microscopy, but from whom Mtb could not be grown in standard solid culture media. When we attempted to re-grow Mtb from the frozen sputum samples of these patients, we found that 10 out of 15 could be grown in a glycerol-poor/lipid-rich medium. These fell into the following two groups: a subset that could be regrown in glycerol after “lipid-resuscitation”, and a group that displayed a heritable glycerol-sensitive phenotype that were unable to grow in the presence of this carbon source. Notably, all of the glycerol-sensitive strains were found to be multidrug resistant. Although whole-genome sequencing of the lipid-resuscitated strains identified 20 unique mutations compared to closely related strains, no single genetic lesion could be associated with this phenotype. In summary, we found that lipid-based media effectively fostered the growth of Mtb from a series of sputum smear-positive samples that were not culturable in glycerol-based Lowenstein–Jensen or 7H9 media, which is consistent with Mtb’s known preference for non-glycolytic sources during infection. Analysis of the recovered strains demonstrated that both genetic and non-genetic mechanisms contribute to the observed differential capturability, and suggested that this phenotype may be associated with drug resistance.

scholarly journals Impact of Xpert MTB/RIF on Antiretroviral Therapy-Associated Tuberculosis and Mortality: A Pragmatic Randomized Controlled Trial

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
L. Mupfumi ◽  
B. Makamure ◽  
M. Chirehwa ◽  
T. Sagonda ◽  
S. Zinyowera ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Limited Resource ◽  
Hiv Treatment ◽  
Treatment Programs ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Pragmatic Randomized Controlled Trial ◽  
Randomized Controlled ◽  
Art Initiation

Abstract Introduction.  GeneXpert® MTB/RIF (Xpert) is now widely distributed in high human immunodeficiency virus (HIV)/tuberculosis (TB)-burden countries. Yet, whether the test improves patient-important outcomes within HIV treatment programs in limited resource settings is unknown. Methods.  To investigate whether use of Xpert for TB screening prior to initiation of antiretroviral treatment (ART) improves patient-important outcomes, in a pragmatic randomized controlled trial we assigned 424 patients to Xpert or fluorescence sputum smear microscopy (FM) at ART initiation. The primary endpoint was a composite of 3-month mortality and ART-associated TB. Results.  There was no difference in overall TB diagnosis at ART initiation (20% [n = 43] Xpert vs 21% [n = 45] FM; P = .80), with most patients in both groups treated empirically. There was no difference in time to TB treatment initiation {5 days (interquartile range [IQR], 3–13) vs 8 days [IQR, 3–23; P = .26]} or loss to follow-up (32 [15%] vs 38 [18%]; P = 0.38). Although a nonsignificant reduction in mortality occurred in the Xpert group (11 [6%] vs 17 [10%]; 95% CI, −9% to 2%; P = .19), there was no difference in the composite outcome (9% [n = 17] Xpert vs 12% [n = 21] FM; difference −3%; 95% CI, −9% to 4%). Conclusions.  Among HIV-infected initiating ART, centralized TB screening with Xpert did not reduce the rate of ART-associated TB and mortality, compared with fluorescence microscopy.

Characteristics and outcomes of acute COVID-19 infection in paediatric and young adult patients with underlying cardiac disease

2021 ◽  
pp. 1-7
Author(s):  
Joshua M. Fisher ◽  
Sarah Badran ◽  
John T. Li ◽  
Jodie K. Votava-Smith ◽  
Patrick M. Sullivan
Keyword(s):  
Risk Factors ◽  
Young Adult ◽  
Pulmonary Disease ◽  
Cardiac Disease ◽  
Single Ventricle ◽  
Cardiac Risk ◽  
Adult Patients ◽  
Chronic Pulmonary Disease ◽  
Cardiac Risk Factors ◽  
Increased Risk

Abstract Objective To describe outcomes of acute coronavirus disease 2019 in paediatric and young adult patients with underlying cardiac disease and evaluate the association between cardiac risk factors and hospitalisation. Study design We conducted a retrospective single-institution review of patients with known cardiac disease and positive severe acute respiratory syndrome coronavirus 2 RT-PCR from 1 March, 2020 to 30 November, 2020. Extracardiac comorbidities and cardiac risk factors were compared between those admitted for coronavirus disease 2019 illness and the rest of the cohort using univariate analysis. Results Forty-two patients with a mean age of 7.7 ± 6.7 years were identified. Six were 18 years of age or more with the oldest being 22 years of age. Seventy-six percent were Hispanic. The most common cardiac diagnoses were repaired cyanotic (n = 7, 16.6%) and palliated single ventricle (n = 7, 16.6%) congenital heart disease. Fourteen patients (33.3%) had underlying syndromes or chromosomal anomalies, nine (21%) had chronic pulmonary disease and eight (19%) were immunosuppressed. Nineteen patients (47.6%) reported no symptoms. Sixteen (38.1%) reported only mild symptoms. Six patients (14.3%) were admitted to the hospital for acute coronavirus disease 2019 illness. Noncardiac comorbidities were associated with an increased risk of hospitalisation (p = 0.02), particularly chronic pulmonary disease (p = 0.01) and baseline supplemental oxygen requirement (p = 0.007). None of the single ventricle patients who tested positive required admission. Conclusions Hospitalisations for coronavirus disease 2019 were rare among children and young adults with underlying cardiac disease. Extracardiac comorbidities like pulmonary disease were associated with increased risk of hospitalisation while cardiac risk factors were not.

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