scholarly journals Pulmonary Tuberculosis Outbreak in a High School, China

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.

scholarly journals A tuberculosis school outbreak in China, 2018: reaching an often overlooked adolescent population

2019 ◽  
Vol 147 ◽  
Author(s):  
N. N. You ◽  
L. M. Zhu ◽  
G. L. Li ◽  
L. Martinez ◽  
W. Lu ◽  
...  
Keyword(s):  
High School ◽  
Skin Testing ◽  
Variable Number Tandem Repeat ◽  
Variable Number ◽  
Sputum Smear ◽  
Tuberculin Skin Testing ◽  
Age Group ◽  
School Based ◽  
Symptom Screening ◽  
Index Cases

Abstract Adolescents have been largely neglected from tuberculosis control efforts. In low- to medium burden settings much of the tuberculosis burden in this age group occurs from school outbreaks. We report on a large tuberculosis outbreak in adolescents from a boarding high school in Jiangsu Province, China. From March to June 2018, a tuberculosis outbreak occurred in a boarding high school. We conducted an outbreak investigation involving clinical diagnostic tests and molecular analysis to determine the outbreak origin. Cases were detected through symptom screening, tuberculin skin testing (TST), chest radiography, sputum smear, solid sputum culture and GeneXpert MTB/RIF. Mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) genotyping and spoligotyping methods were performed on Mycobacterium tuberculosis (M. tuberculosis) isolates to identify the outbreak origin. A total of 845 students and 131 teachers/staff attended a TST screening for tuberculosis infection. The prevalence of elevated tuberculin reactions at ≥5, ≥10 and ≥15 mm was 12.19% (119/976), 6.35% (62/976) and 3.28% (32/976), respectively. Radiographic abnormalities were present in 5.73% (56 of 976) individuals, 40 students and 16 teachers/staff. Of these, 12 students were diagnosed with confirmed tuberculosis. In total, 14 students (two index cases and 12 confirmed cases) were diagnosed and reported in the tuberculosis outbreak, an attack rate of 1.7% (14/847) among students (two index cases and 845 screened students). Results from MIRU-VNTR typing and spoligotyping analyses demonstrated that three M. tuberculosis strains belong to the Beijing family with corresponding MIRU-VNTR alleles. This school-based tuberculosis outbreak among adolescents demonstrates that transmission among individuals in this age group is common and must be prioritised. It suggests that identifying and timely diagnosis of smear-positive cases, especially in the early phase of outbreaks, is the key to preventing further spread among close contacts.

scholarly journals Can 15-Locus Mycobacterial Interspersed Repetitive Unit-Variable-Number Tandem Repeat Analysis Provide Insight into the Evolution of Mycobacterium tuberculosis?

2005 ◽  
Vol 71 (12) ◽  
pp. 8207-8213 ◽  
Author(s):  
Andrea Gibson ◽  
Timothy Brown ◽  
Lucy Baker ◽  
Francis Drobniewski
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Tandem Repeats ◽  
Variable Number Tandem Repeat ◽  
Epidemiological Studies ◽  
Variable Number ◽  
Molecular Techniques ◽  
Nucleotide Polymorphisms ◽  
East African ◽  
Phylogeny And Evolution ◽  
Phylogenetic Lineages

ABSTRACT The phylogeny and evolution of the bacterium Mycobacterium tuberculosis is still poorly understood despite the application of a variety of molecular techniques. We analyzed 469 M. tuberculosis and 49 Mycobacterium bovis isolates to evaluate if the mycobacterial interspersed repetitive units-variable-number tandem repeats (MIRU-VNTR) commonly used for epidemiological studies can define the phylogeny of the M. tuberculosis complex. This population was characterized by previously identified silent single-nucleotide polymorphisms (sSNPs) or by a macroarray based on these sSNPs that was developed in this study. MIRU-VNTR phylogenetic codes capable of differentiating between phylogenetic lineages were identified. Overall, there was 90.9% concordance between the lineages of isolates as defined by the MIRU-VNTR and sSNP analyses. The MIRU-VNTR phylogenetic code was unique to M. bovis and was not observed in any M. tuberculosis isolates. The codes were able to differentiate between different M. tuberculosis strain families such as Beijing, Delhi, and East African-Indian. Discrepant isolates with similar but not identical MIRU-VNTR codes often displayed a stepwise trend suggestive of bidirectional evolution. A lineage-specific panel of MIRU-VNTR can be used to subdivide each lineage for epidemiological purposes. MIRU-VNTR is a valuable tool for phylogenetic studies and could define an evolutionarily uncharacterized population of M. tuberculosis complex organisms.

Genotyping and drug susceptibility patterns of M. tuberculosis isolated from HIV seropositive patients in Tehran Iran

2021 ◽  
Vol 19 ◽  
Author(s):  
Seifu Gizaw Feyisa ◽  
Mehrnaz Rasoolinejad ◽  
Maliheh Hasan-nejad ◽  
Siroos Amini ◽  
Gholamreza Hamzelou ◽  
...  
Keyword(s):  
Tandem Repeats ◽  
Transmission Rate ◽  
Blot Hybridization ◽  
Drug Susceptibility ◽  
Variable Number ◽  
Drug Resistant ◽  
Recent Transmission ◽  
Tehran Province ◽  
Drug Resistant Strains ◽  
Hiv Seropositive

Aim: To investigate the prevalence and drug-resistance M. tuberculosis isolated from HIV seropositive individuals in Tehran, Iran. Background: Human immunodeficiency virus (HIV) is one of the most important risk factors for developing active tuberculosis (TB). Objective: To determine the rate of transmission and drug resistant M. tuberculosis (MTB) strains isolated from HIV seropositive patients in Tehran province, Iran. Methods: This study consecutively enrolled 217 TB/HIV coinfected patients from April 2018 to August 2019 at Emam Khomeini referral hospital and 5 other health centers in Tehran province. The isolates were genotyped using 15 loci Mycobacterial interspersed repetitive unit-variable number tandem repeats (MIRU-VNTR). Minimum inhibitory concentration (MIC) was determined for 6 drugs. In addition, mutations were assessed in rpoB, katG, inhA, and ahpC genes using Reverse Blot Hybridization Assay System. Results: A 20 (9.2%) patients were culture-positive for M. tuberculosis and typed by MIRU-VNTR, 13 (65%) strains formed 5 clusters, but 6 (30%) isolates had a unique pattern. The total Hunter–Gaston discrimination index (HGDI) for all 15 loci was 0.846, and the cluster size was 2 to 4 patients. The estimated proportion of recent transmission was 45%. The mutation was identified in 1 isolate, lost inhAW1 and mutation in MT1 loci, which was resistant to isoniazid (INH). Moreover, 1 (5%) and 3 (15%) isolates were resistant to INH and ethambutol (EMB), respectively, of which 1 was resistant to INH and EMB. Conclusion: The transmission rate of TB in HIV patients was relatively high; however, the prevalence of drug-resistant strains and TB infection in females was insignificant in this study (p < 0.05); none of the isolates was MDR strains.

scholarly journals Population structure of drug-resistant Mycobacterium tuberculosis in Central Asia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anna Engström ◽  
Uladzimir Antonenka ◽  
Abdylat Kadyrov ◽  
Gulmira Kalmambetova ◽  
Katharina Kranzer ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Population Structure ◽  
Central Asia ◽  
Tandem Repeats ◽  
Relative Size ◽  
Multidrug Resistant ◽  
Variable Number ◽  
Health Concern ◽  
Drug Resistant ◽  
Recent Emergence

Abstract Background Drug-resistant tuberculosis (TB) is a major public health concern threathing the success of TB control efforts, and this is particularily problematic in Central Asia. Here, we present the first analysis of the population structure of Mycobacterium tuberculosis complex isolates in the Central Asian republics Uzbekistan, Tajikistan, and Kyrgyzstan. Methods The study set consisted of 607 isolates with 235 from Uzbekistan, 206 from Tajikistan, and 166 from Kyrgyzstan. 24-loci MIRU-VNTR (Mycobacterial Interspersed Repetitive Units - Variable Number of Tandem Repeats) typing and spoligotyping were combined for genotyping. In addition, phenotypic drug suceptibility was performed. Results The population structure mainly comprises strains of the Beijing lineage (411/607). 349 of the 411 Beijing isolates formed clusters, compared to only 33 of the 196 isolates from other clades. Beijing 94–32 (n = 145) and 100–32 (n = 70) formed the largest clusters. Beijing isolates were more frequently multidrug-resistant, pre-extensively resistant (pre-XDR)- or XDR-TB than other genotypes. Conclusions Beijing clusters 94–32 and 100–32 are the dominant MTB genotypes in Central Asia. The relative size of 100–32 compared to previous studies in Kazakhstan and its unequal geographic distribution support the hypothesis of its more recent emergence in Central Asia. The data also demonstrate that clonal spread of resistant TB strains, particularly of the Beijing lineage, is a root of the so far uncontroled MDR-TB epidemic in Central Asia.

scholarly journals Determining Mycobacterium tuberculosis Infection among BCG-Immunised Ugandan Children by T-SPOT.TB and Tuberculin Skin Testing

PLoS ONE ◽  
2012 ◽  
Vol 7 (10) ◽  
pp. e47340 ◽  
Author(s):  
Gyaviira Nkurunungi ◽  
Jimreeves E. Lutangira ◽  
Swaib A. Lule ◽  
Hellen Akurut ◽  
Robert Kizindo ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Skin Testing ◽  
Tuberculosis Infection ◽  
Tuberculin Skin Testing ◽  
Mycobacterium Tuberculosis Infection

scholarly journals Mycobacterium tuberculosis Population Structure Determines the Outcome of Genetics-Based Second-Line Drug Resistance Testing

2012 ◽  
Vol 56 (5) ◽  
pp. 2420-2427 ◽  
Author(s):  
E. M. Streicher ◽  
I. Bergval ◽  
K. Dheda ◽  
E. C. Böttger ◽  
N. C. Gey van Pittius ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Population Structure ◽  
Drug Susceptibility ◽  
Resistance Testing ◽  
Second Line ◽  
Nucleotide Polymorphisms ◽  
Content Type ◽  
Phenotypic Resistance ◽  
Resistant Tuberculosis ◽  
Emergence Of Resistance

ABSTRACTThe global emergence of multidrug-resistant tuberculosis has highlighted the need for the development of rapid tests to identify resistance to second-line antituberculosis drugs. Resistance to fluoroquinolones and aminoglycosides develops through nonsynonymous single nucleotide polymorphisms in thegyrAandgyrBgenes and therrsgene, respectively. Using DNA sequencing as the gold standard for the detection of mutations conferring resistance, in conjunction with spoligotyping, we demonstrated heteroresistance in 25% and 16.3% ofMycobacterium tuberculosisisolates resistant to ofloxacin and amikacin, respectively. Characterization of follow-up isolates from the same patients showed that the population structure of clones may change during treatment, suggesting different phases in the emergence of resistance. The presence of underlying mutant clones was identified in isolates which failed to show a correlation between phenotypic resistance and mutation in thegyrAorrrsgene. These clones harbored previously described mutations in either thegyrAorrrsgene, suggesting that rare mutations conferring resistance to ofloxacin or amikacin may not be as important as was previously thought. We concluded that the absence of a correlation between genotypic and phenotypic resistance implies an early phase in the emergence of resistance within the patient. Thus, the diagnostic utility of genetics-based drug susceptibility tests will depend on the proportion of patients whose bacilli are in the process of acquiring resistance in the study setting. These data have implications for the interpretation of molecular and microbiological diagnostic tests for patients with drug-susceptible and drug-resistant tuberculosis who fail to respond to treatment and for those with discordant results.

Molecular epidemiology of Mycobacterium tuberculosis in adult Filipino TB-HIV co-infected patients

2021 ◽  
Vol 25 (4) ◽  
pp. 285-291
Author(s):  
J. C. M. Malabad ◽  
C. F. Ang ◽  
F. A. R. Palabrica ◽  
M. A. M. Cajucom ◽  
N. G. Gloriani ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Mycobacterium Tuberculosis ◽  
Molecular Epidemiology ◽  
Disease Transmission ◽  
Tandem Repeats ◽  
The Philippines ◽  
Variable Number ◽  
People Living With Hiv ◽  
East African ◽  
Living With Hiv

BACKGROUND: TB is the leading cause of death from a single infectious disease, particularly among people living with HIV (PLHIV). Molecular epidemiology provides information on prevalent genotypes of Mycobacterium tuberculosis and disease transmission dynamics, which aid in TB control. Identification of mutations that confer drug resistance is essential for the rapid diagnosis of drug-resistant TB, especially in high TB burden settings, like the Philippines.METHODS: This study aimed to determine mutations in M. tuberculosis drug resistance-conferring genes and circulating genotypes in PLHIV. MIRU-VNTR (mycobacterial interspersed repetitive unit-variable number of tandem repeats) typing using a set of 24-loci and sequencing of drug resistance-conferring genes were performed in 22 M. tuberculosis isolates from TB-HIV co-infected patients.RESULTS: The prevalence of resistance to any drug was 31.8%, 18.2% for isoniazid monoresistance, 4.5% for streptomycin monoresistance and 9.1% for multidrug resistance. The identified mutations in the katG, rpoB, pncA, rpsL and gyrA genes have been reported in the literature; none was found in the inhA and embB genes. All isolates belonged to the EAI2-Manila family and were grouped into four clusters based on their phenotypic drug resistance and mutation profiles.CONCLUSION: The use of 24-loci set may be used as a more discriminatory MIRU-VNTR typing in settings where the East African-Indian lineage is predominant, like the Philippines.

scholarly journals Serum Antibody Responses to 10 Mycobacterium tuberculosis Proteins, Purified Protein Derivative, and Old Tuberculin in Natural and Experimental Tuberculosis in Rhesus Monkeys

2011 ◽  
Vol 18 (12) ◽  
pp. 2154-2160 ◽  
Author(s):  
Fangui Min ◽  
Yu Zhang ◽  
Ren Huang ◽  
Wende Li ◽  
Yu'e Wu ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Rhesus Monkeys ◽  
Skin Testing ◽  
Serum Antibody ◽  
Antibody Responses ◽  
Antibody Detection ◽  
Enzyme Linked Immunosorbent Assay ◽  
Tuberculin Skin Testing ◽  
Purified Protein Derivative ◽  
Diagnostic Potential

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.

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

1999 ◽  
Vol 20 (05) ◽  
pp. 337-340 ◽  
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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