101
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Lamagni TL, Charlett A, Phin N, Zambon M, Chand M. Invasive Mycobacterium chimaera Infections and Heater-Cooler Devices in Cardiac Surgery. Emerg Infect Dis 2020; 26:632. [PMID: 32096464 PMCID: PMC7045823 DOI: 10.3201/eid2603.180452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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102
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Homolka S, Paulowski L, Andres S, Hillemann D, Jou R, Günther G, Claassens M, Kuhns M, Niemann S, Maurer FP. Two Pandemics, One Challenge-Leveraging Molecular Test Capacity of Tuberculosis Laboratories for Rapid COVID-19 Case-Finding. Emerg Infect Dis 2020; 26:2549-2554. [PMID: 32956612 PMCID: PMC7588527 DOI: 10.3201/eid2611.202602] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
In many settings, the ongoing coronavirus disease (COVID-19) pandemic coincides with other major public health threats, in particular tuberculosis. Using tuberculosis (TB) molecular diagnostic infrastructure, which has substantially expanded worldwide in recent years, for COVID-19 case-finding might be warranted. We analyze the potential of using TB diagnostic and research infrastructures for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. We focused on quality control by adapting the 12 Quality System Essentials framework to the COVID-19 and TB context. We conclude that diagnostic infrastructures for TB can in principle be leveraged to scale-up SARS-CoV-2 testing, in particular in resource-poor settings. TB research infrastructures also can support sequencing of SARS-CoV-2 to study virus evolution and diversity globally. However, fundamental principles of quality management must be followed for both TB and SARS-CoV-2 testing to ensure valid results and to minimize biosafety hazards, and the continuity of TB diagnostic services must be guaranteed at all times.
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103
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Morgado de Abreu MAM, Nai GA, Molina JD, Gomes RT, Paula ND, Roselino AM. Mycobacterium leprae on Palatine Tonsils and Adenoids of Asymptomatic Patients, Brazil. Emerg Infect Dis 2020; 26:2518-2520. [PMID: 32946726 PMCID: PMC7510695 DOI: 10.3201/eid2610.191267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We investigated palatine tonsil and adenoid specimens excised from otorhinolaryngological patients in a leprosy-endemic region of Brazil. Fite-Faraco staining identified Mycobacterium spp. in 9 of 397 specimen blocks. Immunohistochemistry and molecular analysis confirmed the presence of Mycobacterium leprae, indicating that these organs can house M. leprae in persons inhabiting a leprosy-endemic region.
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104
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Ramsay LC, Shing E, Wang J, Marras TK, Kwong JC, Brode SK, Jamieson FB, Sander B. Costs Associated with Nontuberculous Mycobacteria Infection, Ontario, Canada, 2001-2012. Emerg Infect Dis 2020; 26:2097-2107. [PMID: 32818392 PMCID: PMC7454113 DOI: 10.3201/eid2609.190524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
To determine incidence-based healthcare costs attributable to nontuberculous mycobacterial (NTM) pulmonary disease (PD) and NTM pulmonary isolation (PI), from the healthcare payer perspective, we conducted a population-based matched cohort study in Ontario, Canada. We established cohorts of patients with incident NTM-PD and NTM-PI during 2001–2012 by using individually linked laboratory data and health administrative data, matched to unexposed persons from the general population. To estimate attributable costs for acute and long-term illness, we used a phase-of-care approach. Costs were stratified by age, sex, and healthcare resource, and reported in 2018 Canadian dollars (CAD) and US dollars (USD), standardized to 10 days. Costs were highest during the before-death phase (NTM-PD CAD $1,352 [USD $1,044]; NTM-PI CAD $731 [USD $565]). The cumulative mean attributable 1-year costs were CAD $14,953 (USD $11,541) for NTM-PD and CAD $8,729 (USD $6,737) for NTM-PI. Costs for patients with NTM-PD and NTM-PI were higher than those for unexposed persons.
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105
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Dean SG, Ricotta EE, Fintzi J, Lai YL, Kadri SS, Olivier KN, Zelazny A, Prevots DR. Mycobacterial Testing Trends, United States, 2009-2015 1. Emerg Infect Dis 2020; 26:2243-2246. [PMID: 32818422 PMCID: PMC7454078 DOI: 10.3201/eid2609.200749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We studied 31 US healthcare facilities to characterize trends in mycobacterial testing. During 2009-2015, testing for acid-fast bacilli increased 3.2% annually, and prevalence of pathogenic nontuberculous mycobacteria increased 4.5% annually. These increases were highest for subpopulations at high risk of infection, including older women, Asians, and patients with concurrent conditions.
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106
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Jenks JD, Garfein RS, Zhu W, Hogarth M. Latent Tuberculosis Screening Using Electronic Health Record Data. Emerg Infect Dis 2020; 26:2285-2287. [PMID: 32818426 PMCID: PMC7454063 DOI: 10.3201/eid2609.191391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Screening for latent tuberculosis infection is recommended for foreign-born persons in the United States. We used proxy data from electronic health records to determine that 17.5% of foreign-born outpatients attending the UC San Diego Health clinic (San Diego, CA, USA) underwent screening. Ending the global tuberculosis epidemic requires improved screening.
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107
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Jaspard M, Butel N, El Helali N, Marigot-Outtandy D, Guillot H, Peytavin G, Veziris N, Bodaghi B, Flandre P, Petitjean G, Caumes E, Pourcher V. Linezolid-Associated Neurologic Adverse Events in Patients with Multidrug-Resistant Tuberculosis, France. Emerg Infect Dis 2020; 26:1792-1800. [PMID: 32687026 PMCID: PMC7392460 DOI: 10.3201/eid2608.191499] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Linezolid is one of the most effective drugs for treating multidrug-resistant tuberculosis (MDR TB), but adverse effects remain problematic. We evaluated 57 MDR TB patients who had received >1 dose of linezolid during 2011–2016. Overall, patients received 600 mg/day of linezolid for a median of 13 months. In 33 (58%) patients, neurologic or ophthalmologic signs developed, and 18 (32%) had confirmed peripheral neuropathy, which for 78% was irreversible at 12 months after the end of TB treatment despite linezolid withdrawal. Among the 19 patients who underwent ophthalmologic evaluation, 14 patients had optic neuropathy that fully reversed for 2. A total of 16 (33%) of 49 patients had a linezolid trough concentration >2 mg/L, and among these, 14 (88%) experienced adverse effects. No significant association was found between trough concentration and neurologic toxicity. These findings suggest the need to closely monitor patients for neurologic signs and discuss optimal duration of linezolid treatment.
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108
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Abstract
After South Korea raised its infectious disease alert to the highest level in response to coronavirus disease emergence, tuberculosis notification during the first 18 weeks of 2020 decreased significantly from the same period for each year during 2015-2019. Adequate measures to diagnose, control, and prevent tuberculosis need to be maintained.
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109
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Yao Z, Chen J, Wang Q, Liu W, Zhang Q, Nan J, Huang H, Wu Y, Li L, Liang L, You L, Liu Y, Yu H. Three Patients with COVID-19 and Pulmonary Tuberculosis, Wuhan, China, January-February 2020. Emerg Infect Dis 2020; 26:2755-2758. [PMID: 32667282 PMCID: PMC7588523 DOI: 10.3201/eid2611.201536] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During January–February 2020, coronavirus disease (COVID-19) and tuberculosis were diagnosed for 3 patients in Wuhan, China. All 3 patients had COVID-19 pneumonia. One severely ill patient died after acute respiratory distress syndrome developed. Clinicians and public health officials should be aware of underlying chronic infections such as tuberculosis in COVID-19 patients.
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110
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Tham SM, Lim WY, Lee CK, Loh J, Premkumar A, Yan B, Kee A, Chai L, Tambyah PA, Yan G. Four Patients with COVID-19 and Tuberculosis, Singapore, April-May 2020. Emerg Infect Dis 2020; 26:2764-2766. [PMID: 32667283 PMCID: PMC7588516 DOI: 10.3201/eid2611.202752] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Coronavirus disease (COVID-19) and tuberculosis (TB) developed in 4 foreign workers living in dormitories in Singapore during April–May 2020. Clinical manifestations and atypical radiographic features of COVID-19 led to the diagnosis of TB through positive interferon-gamma release assay and culture results. During the COVID-19 pandemic, TB should not be overlooked.
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111
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Xie B, Chen Y, Wang J, Gao W, Jiang H, Sun J, Jin X, Sang X, Yu X, Wang H. Mycobacterium marseillense Infection in Human Skin, China, 2018. Emerg Infect Dis 2020; 25:1991-1993. [PMID: 31538923 PMCID: PMC6759254 DOI: 10.3201/eid2510.190695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe a case of facial skin infection and sinusitis caused by Mycobacterium marseillense in an immunocompetent woman in China in 2018. The infection was cleared with clarithromycin, moxifloxacin, and amikacin. Antimicrobial drug treatments could not be predicted by genetic analyses; further genetic characterization would be required to do so.
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112
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Michienzi SM, Burgos RM, Novak RM. Mycobacterium conceptionense Pneumonitis in Patient with HIV/AIDS 1. Emerg Infect Dis 2020; 25:1986-1988. [PMID: 31538928 PMCID: PMC6759238 DOI: 10.3201/eid2510.190444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Approximately 21 human cases of infection with Mycobacterium conceptionense have been reported. However, most cases were outside the United States, and optimal treatment remains uncertain. We report a case of M. conceptionense pneumonitis in a patient with HIV/AIDS in the United States. The patient was cured with azithromycin and doxycycline.
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113
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Vonnahme LA, Haddad MB, Navin TR. Factoring Prior Treatment into Tuberculosis Infection Prevalence Estimates, United States, 2011-2012. Emerg Infect Dis 2020; 25:1949-1951. [PMID: 31538921 PMCID: PMC6759264 DOI: 10.3201/eid2510.190439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To refine estimates of how many persons in the United States are candidates for treatment of latent tuberculosis, we removed from analysis persons who self-reported prior treatment on the National Health and Nutrition Examination Survey 2011-2012. We estimate that 12.6 million persons could benefit from treatment to prevent active tuberculosis.
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114
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Murray KO, Castillo-Carandang NT, Mandalakas AM, Cruz AT, Leining LM, Gatchalian SR. Prevalence of Tuberculosis in Children After Natural Disasters, Bohol, Philippines. Emerg Infect Dis 2020; 25:1884-1892. [PMID: 31538561 PMCID: PMC6759243 DOI: 10.3201/eid2510.190619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In 2013, a severe earthquake and typhoon affected Bohol, Philippines. To assess the postdisaster risk for emergence of Mycobacterium tuberculosis infection in children, we conducted a cross-sectional multistage cluster study to estimate the prevalence of tuberculin skin test (TST) positivity and tuberculosis (TB) in children from 200 villages in heavily affected and less affected disaster areas. Of the 5,476 children we enrolled, 355 were TST-positive (weighted prevalence 6.4%); 16 children had active TB. Fourteen (7%) villages had >20% TST-positive prevalence. Although prevalence did not differ significantly between heavily affected and less affected areas, living in a shelter with >25 persons approached significance. TST positivity was independently associated with older age, prior TB treatment, known contact with a person with TB, and living on a geographically isolated island. We found a high TST-positive prevalence, suggesting that national programs should consider the differential vulnerability of children and the role of geographically isolated communities in TB emergence.
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115
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Frayne KMF, Chappell BR, Davies JL, Macbeth BJ, Ngeleka M, Rothenburger JL. Lesions of Mycobacterium avium spp. hominissuis Infection Resembling M. bovis Lesions in a Wild Mule Deer, Canada 1. Emerg Infect Dis 2020; 26. [PMID: 32568050 PMCID: PMC7323542 DOI: 10.3201/eid2607.200187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We used molecular analyses to confirm Mycobacterium avium spp. hominissuis infection in lung granulomas and pyogranulomas in the tracheobronchial lymph node in a wild mule deer in Banff, Canada. These lesions are similar to those found in M. bovis–infected animals, emphasizing the critical need for disease surveillance in wildlife populations.
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116
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Chambers ST, Ioteba N, Timeon E, Rimon E, Murdoch H, Green J, Trowbridge E, Buckingham J, Cunanan A, Williman J, Priest P. Surveillance of Leprosy in Kiribati, 1935-2017. Emerg Infect Dis 2020; 26:833-840. [PMID: 32308192 PMCID: PMC7181941 DOI: 10.3201/eid2605.181746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
In Kiribati, unlike most countries, high and increasing numbers of cases of leprosy have been reported despite the availability of multidrug therapy and efforts to improve case finding and management. Historic records show that 28 cases had been identified by 1925. A systematic population survey in 1997 identified 135 new cases; the mean incidence rate for 1993–1997 was 7.4/10,000 population. After administering mass chemoprophylaxis, the country reached the elimination threshold (prevalence <1/10,000), but case numbers have rebounded. The mean annualized rate of new cases in 2013–2017 was 15/10,000 population, with the highest new case rates (>20/10,000 population) in the main population centers of South Tarawa and Betio. Spread is expected to continue in areas where crowding and poor socioeconomic conditions persist and may accelerate as sea levels rise from climate change. New initiatives to improve social conditions are needed, and efforts such as postexposure chemoprophylaxis should be implemented to prevent spread.
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117
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Greif G, Coitinho C, van Ingen J, Robello C. Species Distribution and Isolation Frequency of Nontuberculous Mycobacteria, Uruguay. Emerg Infect Dis 2020; 26:1014-1018. [PMID: 32310057 PMCID: PMC7181928 DOI: 10.3201/eid2605.191631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Nontuberculous mycobacteria (NTM) increasingly are recognized as opportunistic pathogens of humans. NTM species distribution is well documented in Europe and North America, but data from other regions are scarce. We assessed NTM isolation frequency and species distribution in Uruguay during 2006–2018.
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118
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O'Connor CM, Abid M, Walsh AL, Behbod B, Roberts T, Booth LV, Thomas HL, Smith NH, Palkopoulou E, Dale J, Nunez-Garcia J, Morgan D. Cat-to-Human Transmission of Mycobacterium bovis, United Kingdom. Emerg Infect Dis 2020; 25:2284-2286. [PMID: 31742516 PMCID: PMC6874266 DOI: 10.3201/eid2512.190012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Human infection with Mycobacterium bovis is reported infrequently in the United Kingdom. Most cases involve previous consumption of unpasteurized milk. We report a rare occurrence of 2 incidents of cat-to-human transmission of M. bovis during a cluster of infection in cats.
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119
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Omansen TF, Erbowor-Becksen A, Yotsu R, van der Werf TS, Tiendrebeogo A, Grout L, Asiedu K. Global Epidemiology of Buruli Ulcer, 2010-2017, and Analysis of 2014 WHO Programmatic Targets. Emerg Infect Dis 2020; 25:2183-2190. [PMID: 31742506 PMCID: PMC6874257 DOI: 10.3201/eid2512.190427] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Buruli ulcer is a neglected tropical disease caused by Myocobacterium ulcerans; it manifests as a skin lesion, nodule, or ulcer that can be extensive and disabling. To assess the global burden and the progress on disease control, we analyzed epidemiologic data reported by countries to the World Health Organization during 2010–2017. During this period, 23,206 cases of Buruli ulcer were reported. Globally, cases declined to 2,217 in 2017, but local epidemics seem to arise, such as in Australia and Liberia. In 2013, the World Health Organization formulated 4 programmatic targets for Buruli ulcer that addressed PCR confirmation, occurrence of category III (extensive) lesions and ulcerative lesions, and movement limitation caused by the disease. In 2014, only the movement limitation goal was met, and in 2019, none are met, on a global average. Our findings support discussion on future Buruli ulcer policy and post-2020 programmatic targets.
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120
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Fellag M, Saad J, Armstrong N, Chabrière E, Eldin C, Lagier JC, Drancourt M. Routine Culture-Resistant Mycobacterium tuberculosis Rescue and Shell-Vial Assay, France. Emerg Infect Dis 2020; 25:2131-2133. [PMID: 31625862 PMCID: PMC6810202 DOI: 10.3201/eid2511.190431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
We used shell-vial assay with a medium that buffered rifampin to isolate routine culture–resistant Mycobacterium tuberculosis bacteria from cerebrospinal fluid and rifampin-containing intervertebral disc and vertebral corpus of a patient in treatment for Pott’s disease and disseminated tuberculosis. Whole-genome sequencing confirmed M. tuberculosis lineage 4 (Euro-American) strain.
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121
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Pooransingh S, Sakhamuri S. Need for BCG Vaccination to Prevent TB in High-Incidence Countries and Populations. Emerg Infect Dis 2020; 26:624-625. [PMID: 31922950 PMCID: PMC7045831 DOI: 10.3201/eid2603.191232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An estimated one quarter of persons worldwide are infected with Mycobacterium tuberculosis. In 2018, the World Health Organization issued revised guidance on BCG vaccine for high-risk groups. The World Health Organization should consider guiding countries on a case-by-case basis in developing appropriate BCG policies to deliver equitable healthcare and protect public health.
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122
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Getahun M, Blumberg HM, Sinshaw W, Diriba G, Mollalign H, Tesfaye E, Yenew B, Taddess M, Zewdie A, Dagne K, Beyene D, Kempker RR, Ameni G. Low Prevalence of Mycobacterium bovis in Tuberculosis Patients, Ethiopia. Emerg Infect Dis 2020; 26:613-615. [PMID: 32091379 PMCID: PMC7045829 DOI: 10.3201/eid2603.190473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An estimated 17% of all tuberculosis cases in Ethiopia are caused by Mycobacterium bovis. We used M. tuberculosis complex isolates to identify the prevalence of M. bovis as the cause of pulmonary tuberculosis. Our findings indicate that the proportion of pulmonary tuberculosis due to M. bovis is small (0.12%).
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123
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Sommerstein R, Hasse B, Widmer AF. Invasive Mycobacterium chimaera Infections and Heater-Cooler Devices in Cardiac Surgery. Emerg Infect Dis 2020; 26:632-633. [PMID: 32091382 PMCID: PMC7045853 DOI: 10.3201/eid2603.191818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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124
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Guan Q, Almutairi TS, Alhalouli T, Pain A, Alasmari F. Metagenomics of Imported Multidrug-Resistant Mycobacterium leprae, Saudi Arabia, 2017. Emerg Infect Dis 2020; 26:615-617. [PMID: 32091380 PMCID: PMC7045828 DOI: 10.3201/eid2603.190661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Using shotgun metagenomics, we identified an imported case of multidrug-resistant Mycobacterium leprae in a Filipino resident of Saudi Arabia in 2017. We determined the phylogenomic lineage (3K1) and identified mutations in rpoB and rrs corresponding to the multidrug-resistance phenotype clinically observed. Metagenomics sequencing can be used to identify multidrug-resistant M. leprae.
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125
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Abstract
Chronic pulmonary blastomycosis is often misdiagnosed and treated as tuberculosis in disease-endemic and non–disease-endemic areas. We report the case of a 32-year-old man who after visiting Chicago, Illinois, USA, returned to India and received treatment for tuberculosis for 12 months before receiving the correct diagnosis of blastomycosis.
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