scholarly journals Viable Mycobacterium tuberculosis in sputum after pulmonary tuberculosis cure

2019 ◽  
Author(s):  
Atiqa Ambreen ◽  
Muhammad Jamil ◽  
Muhammad Aqeelur Rahman ◽  
Tehmina Mustafa
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Sputum Smear ◽  
Care Hospital ◽  
Continuation Phase ◽  
Pulmonary Tb ◽  
Direct Smear ◽  
Smear Examination ◽  
End Of Treatment ◽  
Performing Culture

Abstract Background Pulmonary tuberculosis (TB) with detectable Mycobacterium tuberculosis in the sputum is a major source of transmission. In resource limited TB endemic settings, cure is declared by sputum smear examination for acid fast bacilli without performing culture. This may lead to erroneous treatment outcomes as viable bacteria may be missed by low sensitivity of direct smear method of acid fast staining. The aim of this study was to investigate if sterilizing cure is achieved among the new pulmonary TB cases declared cured by sputum smear conversion and the impact of addition of ethambutol in the continuation phase in achieving sterilizing cure. Methods New sputum smear positive pulmonary TB patients registered at a tertiary care hospital in Pakistan were followed under standard Directly Observed Treatment Short Course strategy for six months. Half of these patients received ethambutol in addition to isoniazid and rifampicin in continuation phase. Sputum specimens were examined on microscopy at 2 months and end of treatment. Sputa of patients with negative direct smear examination at the end of treatment were cultured on solid medium. Results Total of 533 newly diagnosed sputum smear positive pulmonary TB patients were registered from November 2013 to March 2014. Among these 504 converted sputum negative at 2 months and 348 converted at the end of six months of treatment and declared cured. Sputa of 204/348 patients were cultured, and 12/204 (6%) were culture positive. Culture positivity at 6 month was not associated with bacterial load, smoking, diabetes, presence of cavities, history of contact with TB, age, gender, socioeconomic status, or addition of ethambutol in the continuation phase of treatment. Conclusion Six month treatment does not provide sterilizing cure in all pulmonary TB leading to risk for relapse. Direct smear examination is not enough to declare cure in TB patients. Addition of ethambutol in the continuation phase did not result in better sterilizing cure. These findings emphasize the importance of performing culture and follow-up of patients to monitor relapse in routine TB care. More studies are needed to find the optimal duration of treatment for individual or carefully selected groups of patients.

scholarly journals Viable Mycobacterium tuberculosis in sputum after pulmonary tuberculosis cure

2019 ◽  
Author(s):  
Atiqa Ambreen ◽  
Muhammad Jamil ◽  
Muhammad Aqeelur Rahman ◽  
Tehmina Mustafa
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Sputum Smear ◽  
Care Hospital ◽  
Continuation Phase ◽  
Pulmonary Tb ◽  
Direct Smear ◽  
Smear Examination ◽  
End Of Treatment ◽  
The Impact

Abstract Background Pulmonary tuberculosis (TB) with detectable Mycobacterium tuberculosis in the sputum is a major source of transmission. In resource limited TB endemic settings, cure is declared through sputum smear examination for acid fast bacilli without performing culture. This may lead to erroneous treatment outcomes as viable bacteria may be missed due to the low sensitivity of direct smear method. The aim of this study was to investigate if sterilizing cure is achieved among the new pulmonary TB cases declared cured by sputum smear conversion and to evaluate the impact of addition of ethambutol in the continuation phase in achieving it. Methods New sputum smear-positive pulmonary TB patients registered at a tertiary care hospital in Pakistan from November 2013 to March 2014 were followed under standard Directly Observed Treatment Short Course strategy for six months. Half of these patients received ethambutol in addition to isoniazid and rifampicin in the continuation phase. Sputum specimens were examined on microscopy at 2 months and at the end of treatment. Sputa of patients with negative direct smear examination at the end of treatment were cultured. Results Among 5746 TB suspects, 1595 were new sputum smear positive pulmonary TB cases, and 533 were registered at our hospital. Among these, 504 converted sputum negative at 2 months and 348 converted at the end of six months of treatment and were declared cured. Sputa of 204/348 patients were cultured, and 12/204 (6%) were culture-positive. Culture positivity at 6 months was not associated with bacterial load, smoking, diabetes, presence of cavities, history of contact with TB patients, age, sex, socioeconomic status, or addition of ethambutol in the continuation phase. Conclusion Viable cultivable bacilli were detected in 6% of cured patients, which would have significant impact on the control of TB. This highlights the need for an inexpensive and accurate surrogate marker for culture as it is not feasible to perform culture in routine for monitoring treatment response in the low-resource settings. The treatment outcome did not improve by addition of ethambutol emphasizing the need to find the optimal duration of treatment for individual or carefully selected groups of patients.

scholarly journals Viable Mycobacterium tuberculosis in sputum after pulmonary tuberculosis cure

2019 ◽  
Author(s):  
Atiqa Ambreen ◽  
Muhammad Jamil ◽  
Muhammad Aqeelur Rahman ◽  
Tehmina Mustafa
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Sputum Smear ◽  
Care Hospital ◽  
Continuation Phase ◽  
Pulmonary Tb ◽  
Direct Smear ◽  
Smear Examination ◽  
End Of Treatment ◽  
The Impact

Abstract Background Pulmonary tuberculosis (TB) with detectable Mycobacterium tuberculosis in the sputum is a major source of transmission. In resource limited TB endemic settings, cure is declared through sputum smear examination for acid fast bacilli without performing culture. This may lead to erroneous treatment outcomes as viable bacteria may be missed due to the low sensitivity of direct smear method. The aim of this study was to investigate if sterilizing cure is achieved among the new pulmonary TB cases declared cured by sputum smear conversion and to evaluate the impact of addition of ethambutol in the continuation phase in achieving it. Methods New sputum smear-positive pulmonary TB patients registered at a tertiary care hospital in Pakistan from November 2013 to March 2014 were followed under standard Directly Observed Treatment Short Course strategy for six months. Half of these patients received ethambutol in addition to isoniazid and rifampicin in the continuation phase. Sputum specimens were examined on microscopy at 2 months and at the end of treatment. Sputa of patients with negative direct smear examination at the end of treatment were cultured. Results Among 5746 TB suspects, 1595 were new sputum smear positive pulmonary TB cases, and 533 were registered at our hospital. Among these, 504 converted sputum negative at 2 months and 348 converted at the end of six months of treatment and were declared cured. Sputa of 204/348 patients were cultured, and 12/204 (6%) were culture-positive. Culture positivity at 6 months was not associated with bacterial load, smoking, diabetes, presence of cavities, history of contact with TB patients, age, sex, socioeconomic status, or addition of ethambutol in the continuation phase. Conclusion Viable cultivable bacilli were detected in 6% of cured patients, which would have significant impact on the control of TB. This highlights the need for an inexpensive and accurate surrogate marker for culture as it is not feasible to perform culture in routine for monitoring treatment response in the low-resource settings. The treatment outcome did not improve by addition of ethambutol emphasizing the need to find the optimal duration of treatment for individual or carefully selected groups of patients.

scholarly journals Viable Mycobacterium tuberculosis in sputum after pulmonary tuberculosis cure

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Atiqa Ambreen ◽  
Muhammad Jamil ◽  
Mohammad Aqeel ur Rahman ◽  
Tehmina Mustafa
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Sputum Smear ◽  
Care Hospital ◽  
Continuation Phase ◽  
Pulmonary Tb ◽  
Direct Smear ◽  
Smear Examination ◽  
End Of Treatment ◽  
The Impact

Abstract Background Pulmonary tuberculosis (TB) with detectable Mycobacterium tuberculosis in the sputum is a major source of transmission. In resource limited TB endemic settings, cure is declared through sputum smear examination for acid fast bacilli without performing culture. This may lead to erroneous treatment outcomes as viable bacteria may be missed due to the low sensitivity of direct smear method. The aim of this study was to investigate if sterilizing cure is achieved among the new pulmonary TB cases declared cured by sputum smear conversion and to evaluate the impact of addition of ethambutol in the continuation phase in achieving it. Methods New sputum smear-positive pulmonary TB patients registered at a tertiary care hospital in Pakistan from November 2013 to March 2014 were followed under standard Directly Observed Treatment Short Course strategy for 6 months. Half of these patients received ethambutol in addition to isoniazid and rifampicin in the continuation phase. Sputum specimens were examined on microscopy at 2 months and at the end of treatment. Sputa of patients with negative direct smear examination at the end of treatment were cultured. Results Among 5746 TB suspects, 1595 were new sputum smear positive pulmonary TB cases, and 533 were registered at our hospital. Among these, 504 converted sputum negative at 2 months and 348 converted at the end of 6 months of treatment and were declared cured. Sputa of 204/348 patients were cultured, and 12/204 (6%) were culture-positive. Culture positivity at 6 months was not associated with bacterial load, smoking, diabetes, presence of cavities, history of contact with TB patients, age, sex, socioeconomic status, or addition of ethambutol in the continuation phase. Conclusion Viable cultivable bacilli were detected in 6% of cured patients, which would have significant impact on the control of TB. This highlights the need for an inexpensive and accurate surrogate marker for culture as it is not feasible to perform culture in routine for monitoring treatment response in the low-resource settings. The treatment outcome did not improve by addition of ethambutol emphasizing the need to find the optimal duration of treatment for individual or carefully selected groups of patients.

scholarly journals Should Sputum Smear Examination Be Carried Out at the End of the Intensive Phase and End of Treatment in Sputum Smear Negative Pulmonary TB Patients?

PLoS ONE ◽  
2012 ◽  
Vol 7 (11) ◽  
pp. e49238 ◽  
Author(s):  
Sumit Malhotra ◽  
Sanjay P. Zodpey ◽  
Shivani Chandra ◽  
Ram Pal Vashist ◽  
Srinath Satyanaryana ◽  
...  
Keyword(s):  
Sputum Smear ◽  
Intensive Phase ◽  
Pulmonary Tb ◽  
Smear Examination ◽  
End Of Treatment ◽  
Smear Negative ◽  
Sputum Smear Examination

scholarly journals Mantoux test results and BCG vaccination status in TB-exposed children

2015 ◽  
Vol 55 (1) ◽  
pp. 7
Author(s):  
Fadilah Harahap ◽  
Ridwan M. Daulay ◽  
Muhammad Ali ◽  
Wisman Dalimunthe ◽  
Rini Savitri Daulay
Keyword(s):  
Pulmonary Tuberculosis ◽  
Nutritional Status ◽  
Household Contact ◽  
Mantoux Test ◽  
Skin Tests ◽  
Sputum Smear ◽  
Test Results ◽  
Time Duration ◽  
Pulmonary Tb ◽  
Bcg Vaccination

Background Tuberculosis (TB) infection is highly prevalent in Indonesia. The source of transmission of TB to a child is usually via an adult with sputum smear-positive pulmonary tuberculosis. The Mantoux test is a diagnostic tool for tuberculosis infection. The BCG vaccine has been used for the prevention of TB, but its efficacy is still debated. Objective To assess for an association between Mantoux test results and BCG vaccination in children who had contact with adult pulmonary tuberculosis and to assess for differences in Mantoux test induration with regards to nutritional status, age, type of TB contact, and time duration since BCG vaccination in BCG-vaccinated and BCG-unvaccinated children. Methods A cross-sectional study was conducted in FebruaryMarch 2011 on infants and children (aged 3 months to five years), who had household contact with adult pulmonary TB. We performed tuberculin (Mantoux) skin tests to detect TB infection in the children. Subjects were consisted of two groups: BCG-vaccinated and BCG-unvaccinated. Results Subjects were 100 children (50 BCG-vaccinated and 50 BCG-unvaccinated subjects). Positive Mantoux test results were observed in 9 vaccinated subjects and 33 unvaccinated subjects. The mean diameters of induration in the vaccinated and unvaccinated groups were 7.6 mm and 9.6 mm, respectively (95%CI of difference -4.25 to 0.20; P=0.074). In children who had household contact with sputum smear-positive adult pulmonary TB, BCG vaccination was a protective factor against TB infection, with an odds ratio (OR) of 0.113 (95%CI 0.045 to 0.286; P=0.0001). There were no significant differences in Mantoux test induration associated with nutritional status, age, type of TB contact, and duration since BCG vaccination, between the two groups. Conclusion BCG vaccination has a protective effect on TBexposed children, based on Mantoux test results. However, there are no differences in Mantoux test induration associated with nutritional status, age, type of TB contact, or duration since BCG vaccination, between the BCG-vaccinated and BCGunvaccinated groups.

scholarly journals Acid fast bacilli detected in the oral swab sample of a pulmonary tuberculosis patient

2018 ◽  
Vol 51 (2) ◽  
pp. 91
Author(s):  
Reiska Kumala Bakti ◽  
Ni Made Mertaniasih ◽  
Diah Savitri Ernawati ◽  
Bagus Soebadi ◽  
Priyo Hadi
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Buccal Mucosa ◽  
Symptom Assessment ◽  
Tuberculosis Patient ◽  
Rapid Screening ◽  
Pulmonary Tb ◽  
Acid Fast Bacilli ◽  
Dental Practitioners ◽  
Treatment Procedures

Background: Tuberculosis (TB) is an infectious disease that persists as a health problem worldwide. Mycobacterium tuberculosis, as an etiological agent, is transmitted from infected to uninfected individuals via airborne droplet nuclei. Oral health care workers or dental practitioners may be at high risk of TB infection because of their close proximity to infected individuals during treatment procedures. Simple and rapid screening of mycobacterium tuberculosis in the oral cavity is necessary in order to prevent transmission of infection. Purpose: To investigate the presence of acid-fast bacilli in the buccal mucosa of pulmonary TB patients. Methods: Nineteen pulmonary TB patients of both sexes, ranging in age from 19 to 74 years old participated in this study. The diagnosis of tuberculosis was performed by clinical symptom assessment and supporting examination, including acid-fast bacilli on sputum examination. Two buccal mucosa swabs taken from pulmonary TB patients were collected for acid fast bacilli direct smear by Ziehl Neelsen staining. Results: With regard to mycobacterium tuberculosis, acid-fast bacilli presented in 10.5% of the oral buccal mucosa swabs of subjects, whereas in the sputum specimens, bacilli were found in 52.6% of subjects. Conclusion: Acid-fast bacilli can be found in the buccal epithelial mucosa of pulmonary tuberculosis patients, although its presence was very limited.

scholarly journals Sex and age differences inMycobacterium tuberculosisinfection in Brazil

2018 ◽  
Vol 146 (12) ◽  
pp. 1503-1510 ◽  
Author(s):  
P. Fernandes ◽  
Y. Ma ◽  
M. Gaeddert ◽  
T. Tsacogianis ◽  
P. Marques-Rodrigues ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Tuberculin Skin Test ◽  
Age Differences ◽  
Host Susceptibility ◽  
Sputum Smear ◽  
Pulmonary Tb ◽  
Household Contacts ◽  
Exposure Data ◽  
Multivariable Modelling ◽  
Sex And Age Differences

AbstractGlobally, the prevalence of tuberculosis (TB) disease is higher in males. This study examined the effect of sex and age onMycobacterium tuberculosis(Mtb) infection. Demographic and exposure data were collected on household contacts of sputum smear-positive pulmonary TB patients in Brazil. Contacts with tuberculin skin test induration ⩾10 mm at baseline or 12 weeks were considered Mtb infected. The study enrolled 917 household contacts from 160 households; 508 (55.4%) were female, median age was 21.0 years (range 0.30–87.0) and 609 (66.4%) had Mtb infection. The proportion infected increased with age from 63.3% in girls <5 years to 75.4% in women ⩾40 years and from 44.9% in boys <5 years to 73.6% in men ⩾40 years. Multivariable modelling showed the odds of infection increased between age 5 and 14 years among female contacts (OR 1.5 per 5-year age increase; 95% CI 1.1–2.2;P= 0.02) and between ages 0–4 and 15–39 years among male contacts (OR 2.7, 95% CI 0.83–8.9 and 1.1, 95% CI 0.99–1.3 per 5-year age increase;P= 0.10, 0.07, respectively). The study suggests that the age at which Mtb infection increases most is different in females compared with males. Studies are needed to explore whether these findings are due to differences in host susceptibility, exposure outside the household or other factors.

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