4201
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Das D, Satapathy P, Murmu B. First Line Anti-TB Drug Resistance in an Urban Area of Odisha, India. J Clin Diagn Res 2016; 10:DC04-DC06. [PMID: 28050363 DOI: 10.7860/jcdr/2016/20289.8846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/24/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Drug resistance is a major cause for increasing the global burden of Tuberculosis (TB). However in countries with larger geographical areas and different climatic conditions like India the prevalence of drug resistance varies from place to place. Information on anti-TB drug resistance patterns particularly among newly diagnosed cases is crucial for planning an effective TB control program. AIM To determine the prevalence of resistance against first line anti-TB drugs and Multi Drug Resistance (MDR) in Mycobacterium tuberculosis isolates. MATERIALS AND METHODS The prospective study was carried out in National Reference Laboratory (NRL) of Regional Medical Research Centre (RMRC), Bhubaneswar. During this period from January to September 2014, sputum specimens were collected from 850 suspected pulmonary TB patients attending Designated Microscopy Center (DMC) of Capital Hospital, Bhubaneswar, Odisha. Sputum specimens were subjected to Acid Fast Bacilli (AFB) smear microscopy and further processed for isolation on solid Lowenstein Jensen (LJ) medium. Drug Susceptibility Testing (DST) on isolates with first line anti-TB drugs was performed as per Revised National Tuberculosis Control Programe (RNTCP) guidelines. RESULTS Out of all the 850 suspected pulmonary TB patients subjected to AFB microscopy and solid LJ culture, isolation of Mycobacterium tuberculosis was successful only in 161 (117 new and 44 previously treated) pulmonary TB patients. On DST by the RNTCP approved proportion method, prevalence of MDR- TB among 0.85% new and 4.54% previously treated cases was observed. Prevalence of mono resistance to streptomycin, isoniazid, rifampicin and ethambutol observed among new and previously treated cases were 3.41%, 2.56%, 0, 0.85% and 2.27%, 13.6%, 2.27%, 0 respectively. Only one patient from each category showed resistance to both streptomycin and isoniazid in previously treated as well as in new case. CONCLUSION The study reports an unchanged low level of MDR-TB prevalence among new cases in an urban area of Odisha over a decade. This could be due to the success of Directly Observed Treatment Short-course (DOTS) in effective treatment of drug-susceptible TB in the state and non-transmission from primary Drug Resistance (DR) TB cases.
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Affiliation(s)
- Dasarathi Das
- Scientist-E, Regional Medical Research Centre , Bhubaneswar, Odisha, India
| | - Prakasini Satapathy
- Senior Research Fellow, ICMR, Regional Medical Research Centre , Bhubaneswar, Odisha, India
| | - Biswanath Murmu
- Technical Assistant (Research), Regional Medical Research Centre , Bhubaneswar, Odisha, India
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4202
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Chahed H, Hachicha H, Berriche A, Abdelmalek R, Mediouni A, Kilani B, Amor MB, Benaissa HT, Besbes G. Paradoxical reaction associated with cervical lymph node tuberculosis: predictive factors and therapeutic management. Int J Infect Dis 2016; 54:4-7. [PMID: 27810522 DOI: 10.1016/j.ijid.2016.10.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 10/23/2016] [Accepted: 10/24/2016] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES The aims of this study were to determine predictive factors of paradoxical reaction in patients with cervical lymph node tuberculosis (TB) and to discuss the therapeutic management of this condition. MATERIALS AND METHODS A retrospective study was performed of 501 patients managed for cervical lymph node TB over a period of 12 years (from January 2000 to December 2011). Statistical data were analyzed using IBM SPSS Statistics version 20.0. RESULTS Paradoxical reaction occurred in 67 patients (13.4%), with a median delay to onset after starting TB treatment of 7 months. Lymph node size ≥3cm and associated extra-lymph node TB were independently associated with paradoxical reaction. Treatment consisted of surgical excision (71.6%), restarting quadruple therapy (10.4%), reintroduction of ethambutol (23.8%), and addition of ciprofloxacin (20.8%); steroids were given in two cases . All patients recovered after an average treatment duration of 14.91±7.03 months. CONCLUSION The occurrence of paradoxical reaction in cervical lymph node TB seems to be predicted by associated extra-lymph node TB and a swelling size ≥3cm. The treatment of paradoxical reaction remains unclear and more randomized trials are necessary to improve its management.
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Affiliation(s)
- Houda Chahed
- Faculty of Medicine, Université de Tunis El Manar, Tunis, Tunisia; Otorhinolaryngology Department, Rabta Hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia.
| | - Hela Hachicha
- Faculty of Medicine, Université de Tunis El Manar, Tunis, Tunisia; Otorhinolaryngology Department, Rabta Hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| | - Aida Berriche
- Faculty of Medicine, Université de Tunis El Manar, Tunis, Tunisia; Infectious Diseases Department, Rabta Hospital, Tunis, Tunisia
| | - Rim Abdelmalek
- Faculty of Medicine, Université de Tunis El Manar, Tunis, Tunisia; Infectious Diseases Department, Rabta Hospital, Tunis, Tunisia
| | - Azza Mediouni
- Faculty of Medicine, Université de Tunis El Manar, Tunis, Tunisia; Otorhinolaryngology Department, Rabta Hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| | - Badreddine Kilani
- Faculty of Medicine, Université de Tunis El Manar, Tunis, Tunisia; Infectious Diseases Department, Rabta Hospital, Tunis, Tunisia
| | - Mohamed Ben Amor
- Faculty of Medicine, Université de Tunis El Manar, Tunis, Tunisia; Otorhinolaryngology Department, Rabta Hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
| | - Hanene Tiouiri Benaissa
- Faculty of Medicine, Université de Tunis El Manar, Tunis, Tunisia; Infectious Diseases Department, Rabta Hospital, Tunis, Tunisia
| | - Ghazi Besbes
- Faculty of Medicine, Université de Tunis El Manar, Tunis, Tunisia; Otorhinolaryngology Department, Rabta Hospital, Jebel Lakhdar Bab Saadoune, 1007 Tunis, Tunisia
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4203
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Alinejad Dizaj M, Mahdaviani SA, Tabarsi P, Ahari H, Ebrahimi A, Nadji SA, Emami H, Mortaz E. Association of Mycobacterium
infections in patients with Mendelian susceptibility to mycobacterial disease with venous thromboembolism. Microbiol Immunol 2016; 60:678-686. [DOI: 10.1111/1348-0421.12442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/05/2016] [Accepted: 09/27/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Maryam Alinejad Dizaj
- Chronic Respiratory Diseases Research Center; National Research Institute of Tuberculosis and Lung Diseases
| | - Seyed Alireza Mahdaviani
- Pediatric Respiratory Diseases Research Center; National Research Institute of Tuberculosis and Lung Diseases
| | - Payam Tabarsi
- Clinical Tuberculosis and Epidemiology Research Center; National Research Institute for Tuberculosis and Lung Diseases
| | - Hamed Ahari
- Department of Food Science and Technology; Science and Research branch; Islamic Azad University; Tehran Iran
| | - Ahmad Ebrahimi
- Department of Cellular and Molecular Biology; Endocrinology Research Center
| | - Seyed Alireza Nadji
- Virology Research Center; National Research Institute for Tuberculosis and Lung Diseases
| | - Habib Emami
- Tobacco Prevention and Control Research Center; National Research Institute of Tuberculosis and Lung Diseases; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Esmaeil Mortaz
- Chronic Respiratory Diseases Research Center; National Research Institute of Tuberculosis and Lung Diseases
- Clinical Tuberculosis and Epidemiology Research Center; National Research Institute for Tuberculosis and Lung Diseases
- Molecular Biology Group; Airways Disease Section; National Heart and Lung Institute; Imperial College London Dovehouse Street London UK
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4204
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Ibrahim WH, Alousi FH, Al-Khal A, Bener A, AlSalman A, Aamer A, Khaled A, Raza T. Diagnostic Delay among Adults with Pulmonary Tuberculosis in a High Gross Domestic Product Per Capita Country: Reasons and Magnitude of the Problem. Int J Prev Med 2016; 7:116. [PMID: 27857829 PMCID: PMC5093889 DOI: 10.4103/2008-7802.193091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 09/06/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To determine the mean and median delays in pulmonary tuberculosis (PTB) diagnosis among adults in one of the world's highest gross domestic product per capita countries and identify patient and health system-related reasons for these delays. METHODS This is a cross-sectional, face-to-face, prospective study of 100 subjects with confirmed PTB, conducted at main tuberculosis (TB) admitting facilities in Qatar. The mean and median diagnostic delays were measured. The Chi-square test with two-sided P < 0.05 was considered to determine the association between factors and diagnostic delay. RESULTS The mean and median total diagnostic delays of PTB were 53 (95% confidence interval [CI] 42.61-63.59) and 30 (interquartile range; Q1-Q3, 15-60) days, respectively. The mean patient factor delay was 45.7 (95% CI 28.1-63.4) days, and the median was 30 (interquartile range; Q1-Q3, 15-60) days. The mean health system factor delay was 46.3 (95% CI 35.46-57.06) days, and the median was 30 (interquartile range; Q1-Q3, 18-60) days. The most common cause of patient factor delay was neglect of TB symptoms by patients (in 39% of cases), and for health-care system factor delay was a failure (mostly at general and private care levels) to suspect PTB by doctors (in 57% of cases). There were no significant associations between the presence of language barrier, patient occupation or nationality, and diagnostic delay. CONCLUSIONS Despite a favorable comparison to other countries, there is a substantial delay in the diagnosis of PTB in Qatar. Relevant actions including health education on TB are required to minimize this delay.
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Affiliation(s)
| | - Faraj H. Alousi
- Infectious Disease Division, Hamad Medical Corporation, Doha, Qatar
| | | | - Abdulbari Bener
- Departmant of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmed AlSalman
- Department of Medicine, Hamad General Hospital, Doha, Qatar
| | - Aaiza Aamer
- Department of Medicine, Hamad General Hospital, Doha, Qatar
| | - Ahmed Khaled
- Department of Medicine, Hamad General Hospital, Doha, Qatar
| | - Tasleem Raza
- Pulmonary Division, Hamad General Hospital, Doha, Qatar
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4205
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Kotwal A, Biswas D, Raghuvanshi S, Sindhwani G, Kakati B, Sharma S. Diagnostic performance of automated liquid culture and molecular line probe assay in smear-negative pulmonary tuberculosis. Trop Doct 2016; 47:118-123. [PMID: 27784827 DOI: 10.1177/0049475516675236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The diagnosis of smear-negative pulmonary tuberculosis (PTB) is particularly challenging, and automated liquid culture and molecular line probe assays (LPA) may prove particularly useful. The objective of our study was to evaluate the diagnostic potential of automated liquid culture (ALC) technology and commercial LPA in sputum smear-negative PTB suspects. Spot sputum samples were collected from 145 chest-symptomatic smear-negative patients and subjected to ALC, direct drug susceptibility test (DST) testing and LPA, as per manufacturers' instructions. A diagnostic yield of 26.2% was observed among sputum smear-negative TB suspects with 47.4% of the culture isolates being either INH- and/or rifampicin-resistant. Complete agreement was observed between the results of ALC assay and LPA except for two isolates which demonstrated sensitivity to INH and rifampicin at direct DST but were rifampicin-resistant in LPA. Two novel mutations were also detected among the multidrug isolates by LPA. In view of the diagnostic challenges associated with the diagnosis of TB in sputum smear-negative patients, our study demonstrates the applicability of ALC and LPA in establishing diagnostic evidence of TB.
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Affiliation(s)
- Aarti Kotwal
- 1 Associate Professor, Department of Microbiology, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Debasis Biswas
- 2 Professor, Department of Microbiology, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Shailendra Raghuvanshi
- 3 Professor, Department of Radiodiagnosis, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Girish Sindhwani
- 4 Professor, Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Barnali Kakati
- 1 Associate Professor, Department of Microbiology, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Shweta Sharma
- 5 Postgraduate Student, Department of Microbiology, Himalayan Institute of Medical Sciences, Dehradun, India
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4206
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Dalton JP, Uy B, Okuda KS, Hall CJ, Denny WA, Crosier PS, Swift S, Wiles S. Screening of anti-mycobacterial compounds in a naturally infected zebrafish larvae model. J Antimicrob Chemother 2016; 72:421-427. [PMID: 27798206 DOI: 10.1093/jac/dkw421] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 08/28/2016] [Accepted: 09/07/2016] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Mycobacterium tuberculosis is a deadly human pathogen that causes the lung disease TB. M. tuberculosis latently infects a third of the world's population, resulting in ∼1.5 million deaths per year. Due to the difficulties and expense of carrying out animal drug trials using M. tuberculosis and rodents, infections of the zebrafish Danio rerio with Mycobacterium marinum have become a useful surrogate. However, the infection methods described to date require specialized equipment and a high level of operator expertise. METHODS We investigated whether zebrafish larvae could be naturally infected with bioluminescently labelled M. marinum by immersion, and whether infected larvae could be used for rapid screening of anti-mycobacterial compounds using bioluminescence. We used rifampicin and a variety of nitroimidazole-based next-generation and experimental anti-mycobacterial drugs, selected for their wide range of potencies against M. tuberculosis, to validate this model for anti-mycobacterial drug discovery. RESULTS We observed that five of the six treatments (rifampicin, pretomanid, delamanid, SN30488 and SN30527) significantly reduced the bioluminescent signal from M. marinum within naturally infected zebrafish larvae. Importantly, these same five treatments also retarded the growth of M. tuberculosis in vitro. In contrast, only three of the six treatments tested (rifampicin, delamanid and SN30527) retarded the growth of M. marinum in vitro. CONCLUSIONS We have demonstrated that zebrafish larvae naturally infected with bioluminescent M. marinum M can be used for the rapid screening of anti-mycobacterial compounds with readily available equipment and limited expertise. The result is an assay that can be carried out by a wide variety of laboratories for minimal cost and without high levels of zebrafish expertise.
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Affiliation(s)
- J P Dalton
- Bioluminescent Superbugs Lab, University of Auckland, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
| | - B Uy
- Bioluminescent Superbugs Lab, University of Auckland, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - K S Okuda
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - C J Hall
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
| | - W A Denny
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand.,Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - P S Crosier
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
| | - S Swift
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - S Wiles
- Bioluminescent Superbugs Lab, University of Auckland, Auckland, New Zealand .,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
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4207
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Vijayakumar S, Vaseeharan B, Malaikozhundan B, Shobiya M. Laurus nobilis leaf extract mediated green synthesis of ZnO nanoparticles: Characterization and biomedical applications. Biomed Pharmacother 2016; 84:1213-1222. [PMID: 27788479 DOI: 10.1016/j.biopha.2016.10.038] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/05/2016] [Accepted: 10/13/2016] [Indexed: 12/20/2022] Open
Abstract
The present study reports the green synthesis of zinc oxide nanoparticles using the aqueous leaf extract of Laurus nobilis (Ln-ZnO NPs) by co-precipitation method. The synthesized Ln-ZnO NPs were characterized by UV-Vis spectroscopy, FTIR, XRD, TEM, SEM and EDX. Ln-ZnO NPs were crystalline in nature, flower like and have hexagonal wurtzite structure with a mean particle size of 47.27nm. The antibacterial activity of Ln-ZnO NPs was greater against Gram positive (Staphylococcus aureus) bacteria than Gram negative (Pseudomonas aeruginosa) bacteria. The zone of inhibition against S. aureus was 11.4, 12.6 and 14.2mm at 25, 50 and 75μgmL-1. The zone of inhibition against P. aeruginosa was 9.8, 10.2 and 11.3mm at 25, 50 and 75μgmL-1. The light and confocal laser scanning microscopic images evidenced that Ln-ZnO NPs effectively inhibited the biofilm growth of S. aureus and P. aeruginosa at 75μgmL-1. The cytotoxicity studies revealed that Ln-ZnO NPs showed no effect on normal murine RAW264.7 macrophage cells. On the other hand, Ln-ZnO NPs were effective in inhibiting the viability of human A549 lung cancer cells at higher concentrations of 80μgmL-1. The morphological changes in the Ln-ZnO NPs treated A549 lung cancer cells were observed under phase contrast microscope.
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Affiliation(s)
- Sekar Vijayakumar
- Nanobiosciences and Nanopharmacology Division, Biomaterials and Biotechnology in Animal Health Lab, Department of Animal Health and Management, Alagappa University, Karaikudi-630004, Tamil Nadu, India
| | - Baskaralingam Vaseeharan
- Nanobiosciences and Nanopharmacology Division, Biomaterials and Biotechnology in Animal Health Lab, Department of Animal Health and Management, Alagappa University, Karaikudi-630004, Tamil Nadu, India.
| | - Balasubramanian Malaikozhundan
- Nanobiosciences and Nanopharmacology Division, Biomaterials and Biotechnology in Animal Health Lab, Department of Animal Health and Management, Alagappa University, Karaikudi-630004, Tamil Nadu, India
| | - Malaikkarasu Shobiya
- Nanobiosciences and Nanopharmacology Division, Biomaterials and Biotechnology in Animal Health Lab, Department of Animal Health and Management, Alagappa University, Karaikudi-630004, Tamil Nadu, India
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4208
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rpoB Gene Sequencing for Identification of Rapidly Growing Mycobacteria. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2016. [DOI: 10.5812/pedinfect.40001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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4209
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Edson JA, Kwon YJ. Design, challenge, and promise of stimuli-responsive nanoantibiotics. NANO CONVERGENCE 2016; 3:26. [PMID: 28191436 PMCID: PMC5271158 DOI: 10.1186/s40580-016-0085-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 09/22/2016] [Indexed: 05/18/2023]
Abstract
Over the past few years, there have been calls for novel antimicrobials to combat the rise of drug-resistant bacteria. While some promising new discoveries have met this call, it is not nearly enough. The major problem is that although these new promising antimicrobials serve as a short-term solution, they lack the potential to provide a long-term solution. The conventional method of creating new antibiotics relies heavily on the discovery of an antimicrobial compound from another microbe. This paradigm of development is flawed due to the fact that microbes can easily transfer a resistant mechanism if faced with an environmental pressure. Furthermore, there has been some evidence to indicate that the environment of the microbe can provide a hint as to their virulence. Because of this, the use of materials with antimicrobial properties has been garnering interest. Nanoantibiotics, (nAbts), provide a new way to circumvent the current paradigm of antimicrobial discovery and presents a novel mechanism of attack not found in microbes yet; which may lead to a longer-term solution against drug-resistance formation. This allows for environment-specific activation and efficacy of the nAbts but may also open up and create new design methods for various applications. These nAbts provide promise, but there is still ample work to be done in their development. This review looks at possible ways of improving and optimizing nAbts by making them stimuli-responsive, then consider the challenges ahead, and industrial applications.Graphical abstractA graphic detailing how the current paradigm of antibiotic discovery can be circumvented by the use of nanoantibiotics.
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Affiliation(s)
- Julius A. Edson
- Department of Chemical Engineering and Material Science, University of California, Irvine, Irvine, CA USA
| | - Young Jik Kwon
- Department of Chemical Engineering and Material Science, University of California, Irvine, Irvine, CA USA
- Department of Pharmaceutical Sciences, University of California, Irvine, Irvine, CA USA
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA USA
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA USA
- 132 Sprague Hall, Irvine, CA USA
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4210
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Riyahi Zaniani F, Moghim S, Mirhendi H, Ghasemian Safaei H, Fazeli H, Salehi M, Nasr Esfahani B. Genetic Lineages of Mycobacterium tuberculosis Isolates in Isfahan, Iran. Curr Microbiol 2016; 74:14-21. [PMID: 27743106 DOI: 10.1007/s00284-016-1145-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 10/06/2016] [Indexed: 11/29/2022]
Abstract
In this study, we aimed to identify the genetic lineages of Mycobacterium tuberculosis isolates in Isfahan via the mycobacterial interspersed repetitive-unit-variable number tandem repeat typing method based on 15 loci. Forty-nine M. tuberculosis isolates were collected between 2013 and 2015 from Tuberculosis patients in Mollahadi Sabzevari Tuberculosis Center in Isfahan. All isolates were typed by 15-locus MIRU-VNTR typing. The highest percentage of isolates, 44.89 % (22/49), belonged to the Euro-American lineage, while the frequencies of the East-African-Indian, East-Asian, and Indo-Oceanic lineages were 28.57 % (14/49), 24.4 % (12/49), and 2.04 % (1/49), respectively. Among the 22 isolates of the Euro-American lineage, those belonging to the NEW-1 sub-lineage were most prevalent (24.4 %). Approximately, the same proportion of isolates belonging to the Delhi/CAS, Beijing, and NEW-1 sub-lineages were identified in Iranian and Afghan immigrant patients. The Delhi/CAS and Beijing sub-lineage isolates were prevalent among patients who had been previously treated for TB. Results showed that all of the 49 MIRU-VNTR patterns were unique and the clustering rate of the 15-locus MIRU-VNTR was 0.0 (minimum recent transmission). The results of this study show that the lineages of M. tuberculosis isolates in Isfahan are similar to those reported in the Eastern Mediterranean region (indicative of the epidemiological relationship between the countries in the region). The low clustering rate in our results reveals that transmission of tuberculosis in Isfahan is, in most cases, a reactivation of previous tuberculosis infection and the role of recently transmitted disease is minor.
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Affiliation(s)
- Fatemeh Riyahi Zaniani
- Department of Microbiology, Faculty of Medicine, Isfahan University of Medical Sciences, Esfahān, Iran
| | - Sharareh Moghim
- Department of Microbiology, Faculty of Medicine, Isfahan University of Medical Sciences, Esfahān, Iran
| | - Hossein Mirhendi
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Isfahan University of Medical Sciences, Esfahān, Iran
| | - Hajieh Ghasemian Safaei
- Department of Microbiology, Faculty of Medicine, Isfahan University of Medical Sciences, Esfahān, Iran
| | - Hossein Fazeli
- Department of Microbiology, Faculty of Medicine, Isfahan University of Medical Sciences, Esfahān, Iran
| | - Mahshid Salehi
- Regional Tuberculosis Reference Laboratories in Esfahan, Esfahān, Iran
| | - Bahram Nasr Esfahani
- Department of Microbiology, Faculty of Medicine, Isfahan University of Medical Sciences, Esfahān, Iran.
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4211
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Barua AG, Raj H, Konch P, Hussain P, Barua CC. Evaluation of in vivo antimycobacterial activity of some folklore medicinal plants and enumeration of colony forming unit in murine model. Indian J Pharmacol 2016; 48:526-530. [PMID: 27721538 PMCID: PMC5051246 DOI: 10.4103/0253-7613.190737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives: The present study was carried out to investigate the in vivo antimycobacterial activity of methanol extract of Alstonia scholaris and Mucuna imbricata in murine model. Materials and Methods: Female BALB/c mice were infected with the Mycobacterium tuberculosis H37Rv suspension. Extracts were administered orally for 2 weeks from 7th day postinfection at a dose of 200 mg/kg and rifampicin at 20 mg/kg as standard. The synergistic groups were 10 and 100 mg/kg for rifampicin and extract, respectively. Results: The final body weight of mycobacteria-infected group was significantly reduced (15.41 ± 0.42, P < 0.01), but following treatment with the plant extract plus rifampicin could elevate the body weight. Colony forming unit (CFU) count of lung (8.71 ± 0.01) and spleen (8.59 ± 0.01) was significantly higher in infected and untreated group (P < 0.01). It was observed that activity of the synergistic group displayed powerful and maximum response against tuberculosis (TB) infection with lower CFU counts. Histopathology study showed cells such as lymphocytes, epithelioid, Langhans giant cell, and fibrous tissue proliferation in lungs; depletion of lymphocytes in the spleen. Conclusions: The data indicate that methanol extract of A. scholaris has potential antimycobacterial activity, and the synergistic group consisting of rifampicin and A. scholaris could be a rational choice for the treatment of TB.
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Affiliation(s)
- Acheenta Gohain Barua
- Department of Veterinary Public Health, College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati, Assam, India
| | - Himangshu Raj
- Department of Veterinary Public Health, College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati, Assam, India
| | - Pranab Konch
- Department of Veterinary Pathology, College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati, Assam, India
| | - P Hussain
- Department of Veterinary Public Health, College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati, Assam, India
| | - Chandana C Barua
- Department of Pharmacology and Toxicology, College of Veterinary Science, Assam Agricultural University, Khanapara, Guwahati, Assam, India
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4212
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Abstract
Treatment of non-tuberculous mycobacterial lung disease (NTM-LD) is challenging for several reasons including the relative resistance of NTM to currently available drugs and the difficulty in tolerating prolonged treatment with multiple drugs. Yet-to-be-done, large, multicenter, prospective randomized studies to establish the best regimens will also be arduous because multiple NTM species are known to cause human lung disease, differences in virulence and response to treatment between different species and strains within a species will make randomization more difficult, the need to distinguish relapse from a new infection, and the difficulty in adhering to the prescribed treatment due to intolerance, toxicity, and/or drug-drug interactions, often necessitating modification of therapeutic regimens. Furthermore, the out-of-state resident status of many patients seen at the relatively few centers that care for large number of NTM-LD patients pose logistical issues in monitoring response to treatment. Thus, current treatment regimens for NTM-LD is largely based on small case series, retrospective analyses, and guidelines based on expert opinions. It has been nearly 10 years since the publication of a consensus guideline for the treatment of NTM-LD. This review is a summary of the available evidence on the treatment of the major NTM-LD until more definitive studies and guidelines become available.
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4213
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Islam MM, Hameed HMA, Mugweru J, Chhotaray C, Wang C, Tan Y, Liu J, Li X, Tan S, Ojima I, Yew WW, Nuermberger E, Lamichhane G, Zhang T. Drug resistance mechanisms and novel drug targets for tuberculosis therapy. J Genet Genomics 2016; 44:21-37. [PMID: 28117224 DOI: 10.1016/j.jgg.2016.10.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/26/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
Abstract
Drug-resistant tuberculosis (TB) poses a significant challenge to the successful treatment and control of TB worldwide. Resistance to anti-TB drugs has existed since the beginning of the chemotherapy era. New insights into the resistant mechanisms of anti-TB drugs have been provided. Better understanding of drug resistance mechanisms helps in the development of new tools for the rapid diagnosis of drug-resistant TB. There is also a pressing need in the development of new drugs with novel targets to improve the current treatment of TB and to prevent the emergence of drug resistance in Mycobacterium tuberculosis. This review summarizes the anti-TB drug resistance mechanisms, furnishes some possible novel drug targets in the development of new agents for TB therapy and discusses the usefulness using known targets to develop new anti-TB drugs. Whole genome sequencing is currently an advanced technology to uncover drug resistance mechanisms in M. tuberculosis. However, further research is required to unravel the significance of some newly discovered gene mutations in their contribution to drug resistance.
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Affiliation(s)
- Md Mahmudul Islam
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - H M Adnan Hameed
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Julius Mugweru
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Chiranjibi Chhotaray
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Changwei Wang
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China; Institute of Chemical Biology and Drug Discovery, Stony Brook University-State University of New York, Stony Brook, NY 11794-3400, USA
| | - Yaoju Tan
- State Key Laboratory of Respiratory Disease, Department of Clinical Laboratory, The Guangzhou Chest Hospital, Guangzhou 510095, China
| | - Jianxiong Liu
- State Key Laboratory of Respiratory Disease, Department of Clinical Laboratory, The Guangzhou Chest Hospital, Guangzhou 510095, China
| | - Xinjie Li
- State Key Laboratory of Respiratory Disease, Department of Clinical Laboratory, The Guangzhou Chest Hospital, Guangzhou 510095, China
| | - Shouyong Tan
- State Key Laboratory of Respiratory Disease, Department of Clinical Laboratory, The Guangzhou Chest Hospital, Guangzhou 510095, China
| | - Iwao Ojima
- Institute of Chemical Biology and Drug Discovery, Stony Brook University-State University of New York, Stony Brook, NY 11794-3400, USA
| | - Wing Wai Yew
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric Nuermberger
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University, Baltimore, MD 21231-1002, USA
| | - Gyanu Lamichhane
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University, Baltimore, MD 21231-1002, USA
| | - Tianyu Zhang
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China; University of Chinese Academy of Sciences, Beijing 100049, China.
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4214
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Santucci P, Bouzid F, Smichi N, Poncin I, Kremer L, De Chastellier C, Drancourt M, Canaan S. Experimental Models of Foamy Macrophages and Approaches for Dissecting the Mechanisms of Lipid Accumulation and Consumption during Dormancy and Reactivation of Tuberculosis. Front Cell Infect Microbiol 2016; 6:122. [PMID: 27774438 PMCID: PMC5054039 DOI: 10.3389/fcimb.2016.00122] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 09/22/2016] [Indexed: 12/11/2022] Open
Abstract
Despite a slight decline since 2014, tuberculosis (TB) remains the major deadly infectious disease worldwide with about 1.5 million deaths each year and with about one-third of the population being latently infected with Mycobacterium tuberculosis, the etiologic agent of TB. During primo-infection, the recruitment of immune cells leads to the formation of highly organized granulomas. Among the different cells, one outstanding subpopulation is the foamy macrophage (FM), characterized by the abundance of triacylglycerol-rich lipid bodies (LB). M. tuberculosis can reside in FM, where it acquires, from host LB, the neutral lipids which are subsequently processed and stored by the bacilli in the form of intracytosolic lipid inclusions (ILI). Although host LB can be viewed as a reservoir of nutrients for the pathogen during latency, the molecular mechanisms whereby intraphagosomal mycobacteria interact with LB and assimilate the LB-derived lipids are only beginning to be understood. Past studies have emphasized that these physiological processes are critical to the M. tuberculosis infectious-life cycle, for propagation of the infection, establishment of the dormancy state and reactivation of the disease. In recent years, several animal and cellular models have been developed with the aim of dissecting these complex processes and of determining the nature and contribution of their key players. Herein, we review some of the in vitro and in vivo models which allowed to gain significant insight into lipid accumulation and consumption in M. tuberculosis, two important events that are directly linked to pathogenicity, granuloma formation/maintenance and survival of the tubercle bacillus under non-replicative conditions. We also discuss the advantages and limitations of each model, hoping that this will serve as a guide for future investigations dedicated to persistence and innovative therapeutic approaches against TB.
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Affiliation(s)
- Pierre Santucci
- Aix-Marseille Université, Centre National de la Recherche Scientifique, EIPL Marseille, France
| | - Feriel Bouzid
- Aix-Marseille Université, Centre National de la Recherche Scientifique, EIPLMarseille, France; Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de Recherche pour le Développement, URMITEMarseille, France
| | - Nabil Smichi
- Aix-Marseille Université, Centre National de la Recherche Scientifique, EIPLMarseille, France; Centre d'études d'agents Pathogènes et Biotechnologies pour la Santé, Centre National de la Recherche Scientifique FRE3689, Université de MontpellierMontpellier, France
| | - Isabelle Poncin
- Aix-Marseille Université, Centre National de la Recherche Scientifique, EIPL Marseille, France
| | - Laurent Kremer
- Centre d'études d'agents Pathogènes et Biotechnologies pour la Santé, Centre National de la Recherche Scientifique FRE3689, Université de MontpellierMontpellier, France; Centre d'études d'agents Pathogènes et Biotechnologies pour la Santé, Institut National de la Santé et de la Recherche MédicaleMontpellier, France
| | - Chantal De Chastellier
- Aix-Marseille Université, Centre National de la Recherche Scientifique, EIPL Marseille, France
| | - Michel Drancourt
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de Recherche pour le Développement, URMITE Marseille, France
| | - Stéphane Canaan
- Aix-Marseille Université, Centre National de la Recherche Scientifique, EIPL Marseille, France
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4215
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Nasreen S, Shokoohi M, Malvankar-Mehta MS. Prevalence of Latent Tuberculosis among Health Care Workers in High Burden Countries: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0164034. [PMID: 27711155 PMCID: PMC5053544 DOI: 10.1371/journal.pone.0164034] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 09/19/2016] [Indexed: 12/17/2022] Open
Abstract
Background Tuberculosis is one of the leading causes of death worldwide. Twenty-two high burden countries contributed to the majority of worldwide tuberculosis cases in 2015. Health care workers are at high risk of acquiring tuberculosis through occupational exposure. Objective To estimate the prevalence of latent tuberculosis infection (LTBI) among health care workers in high burden countries. Methods Databases including MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ovid) and ISI Web of Science (Thompson-Reuters), and grey literature were searched for English language records on relevant medical subject headings (MeSH) terms of LTBI and health care providers. Literature was systematically reviewed using EPPI-Reviewer4 software. Prevalence and incidence of LTBI and 95% confidence intervals (CI) were reported. Pooled prevalence of LTBI and 95% CI were calculated using random-effects meta-analysis models and heterogeneity was assessed using I2 statistics. Sub-group analysis was conducted to assess the cause of heterogeneity. Results A total of 990 records were identified. Of those, 18 studies from only 7 high burden countries representing 10,078 subjects were included. Tuberculin skin test results were available for 9,545 participants. The pooled prevalence of LTBI was 47% (95% CI 34% to 60%, I2 = 99.6%). In subgroup analyses according to the country of the study, the pooled prevalence of LTBI was lowest in Brazil (37%) and highest in South Africa (64%). The pooled prevalence of LTBI among medical and nursing students was 26% (95% CI 6% to 46%, I2 = 99.3%) while the prevalence among all types of health care workers was 57% (95% CI 44% to 70%, I2 = 99.1%). Incidence of LTBI was available for health care workers in four countries. The cumulative incidence ranged from 2.8% in Brazilian medical students to 38% among all types of health care workers in South Africa. Conclusion The findings of this study suggest that there is a high burden of LTBI among health care workers in high burden countries. Adequate infection control measures are warranted to prevent and control transmission in health care settings.
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Affiliation(s)
- Sharifa Nasreen
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- * E-mail: ;
| | - Mostafa Shokoohi
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Monali S. Malvankar-Mehta
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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4216
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Predicting promiscuous antigenic T cell epitopes of Mycobacterium tuberculosis mymA operon proteins binding to MHC Class I and Class II molecules. INFECTION GENETICS AND EVOLUTION 2016; 44:182-189. [DOI: 10.1016/j.meegid.2016.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 06/24/2016] [Accepted: 07/03/2016] [Indexed: 11/21/2022]
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4217
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Nasiri MJ, Imani Fooladi AA, Dabiri H, Pormohammad A, Salimi Chirani A, Dadashi M, Houri H, Heidary M, Feizabadi MM. Primary ethambutol resistance among Iranian pulmonary tuberculosis patients: a systematic review. Ther Adv Infect Dis 2016; 3:133-138. [PMID: 28149517 PMCID: PMC5256191 DOI: 10.1177/2049936116661962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Ethambutol (EMB) is an anti-mycobacterial agent that is most commonly used in combination with other anti-tuberculosis (TB) drugs in the treatment of TB. Studies have shown that primary resistance rates of Mycobacterium tuberculosis to EMB vary widely, that is, from 1% to as high as 14%. In this study, we aimed to determine the exact prevalence of primary EMB resistance among pulmonary TB cases. METHODS Several databases, including Medline, Embase, and Iranian databases, were searched from March 2000 to January 2016 to identify studies addressing EMB-resistant TB in Iran. Comprehensive meta-analysis (V2.2, Biostat) software was used to analyze the data. RESULTS Of the 112 records identified from the databases, 10 studies fulfilled the eligibility criteria. The pooled prevalence of primary EMB-resistant TB was estimated at 4.2% [95% confidence interval (CI) 1.8-9.0]. No evidence of publication bias was observed among the included studies (p = 0.4 for Begg rank correlation analysis; p = 0.2 for Egger weighted regression analysis). CONCLUSION Results of systematic review and meta-analyses indicated that effective strategies to minimize the acquired drug resistance, to improve the drug susceptibility testing (DST) capability, and to control the transmission of resistance should be attached importance for control of TB in Iran.
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Affiliation(s)
- Mohammad Javad Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Ali Imani Fooladi
- Applied Microbiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hossein Dabiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Pormohammad
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Salimi Chirani
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Dadashi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Houri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Heidary
- Department of Microbiology, School of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Mohammad Mehdi Feizabadi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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4218
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Treatment outcome of new smear positive pulmonary tuberculosis patients in Hamadan, Iran: A registry-based cross-sectional study. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2016. [DOI: 10.1016/j.ejcdt.2016.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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4219
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Pleiotropic regulations of neutrophil receptors response to sepsis. Inflamm Res 2016; 66:197-207. [DOI: 10.1007/s00011-016-0993-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/24/2016] [Accepted: 09/20/2016] [Indexed: 12/21/2022] Open
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4220
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Albay A, Güney M, Tekin K, Kısa Ö, Sığ AK. Pulmoner ve ekstrapulmoner örneklerde tüberkülozun erken tanısı ve rifampisin direncinin tespiti için geneXpert MTB/RIF testinin değerlendirilmesi. ACTA ACUST UNITED AC 2016. [DOI: 10.17826/cukmedj.237514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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4221
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Exosomes and Exosomal miRNA in Respiratory Diseases. Mediators Inflamm 2016; 2016:5628404. [PMID: 27738390 PMCID: PMC5055958 DOI: 10.1155/2016/5628404] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/28/2016] [Indexed: 12/21/2022] Open
Abstract
Exosomes are nanosized vesicles released from every cell in the body including those in the respiratory tract and lungs. They are found in most body fluids and contain a number of different biomolecules including proteins, lipids, and both mRNA and noncoding RNAs. Since they can release their contents, particularly miRNAs, to both neighboring and distal cells, they are considered important in cell-cell communication. Recent evidence has shown their possible importance in the pathogenesis of several pulmonary diseases. The differential expression of exosomes and of exosomal miRNAs in disease has driven their promise as biomarkers of disease enabling noninvasive clinical diagnosis in addition to their use as therapeutic tools. In this review, we summarize recent advances in this area as applicable to pulmonary diseases.
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4222
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Saraav I, Pandey K, Misra R, Singh S, Sharma M, Sharma S. Characterization of MymA protein as a flavin-containing monooxygenase and as a target of isoniazid. Chem Biol Drug Des 2016; 89:152-160. [DOI: 10.1111/cbdd.12840] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/12/2016] [Accepted: 08/06/2016] [Indexed: 01/29/2023]
Affiliation(s)
- Iti Saraav
- D S Kothari Centre for Research and Innovation in Science Education; Miranda House; Delhi India
- Department of Zoology; Miranda House, University of Delhi; Delhi India
| | - Kirti Pandey
- D S Kothari Centre for Research and Innovation in Science Education; Miranda House; Delhi India
- Department of Zoology; Miranda House, University of Delhi; Delhi India
| | - Richa Misra
- D S Kothari Centre for Research and Innovation in Science Education; Miranda House; Delhi India
- Department of Zoology; Miranda House, University of Delhi; Delhi India
| | - Swati Singh
- D S Kothari Centre for Research and Innovation in Science Education; Miranda House; Delhi India
- Department of Zoology; Miranda House, University of Delhi; Delhi India
| | - Monika Sharma
- D S Kothari Centre for Research and Innovation in Science Education; Miranda House; Delhi India
- Department of Zoology; Miranda House, University of Delhi; Delhi India
| | - Sadhna Sharma
- D S Kothari Centre for Research and Innovation in Science Education; Miranda House; Delhi India
- Department of Zoology; Miranda House, University of Delhi; Delhi India
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4223
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Owusu E, Newman MJ, Akumwena A, Ofosu-Appiah L, Pluschke G. Maximizing microscopy as a diagnostic tool in peripheral health centres of BU endemic areas in Ghana. Int J Mycobacteriol 2016; 4:184-90. [PMID: 27649864 DOI: 10.1016/j.ijmyco.2015.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 03/14/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Buruli ulcer (BU) disease, a skin condition caused by Mycobacterium ulcerans (M. ulcerans) is endemic in remote rural areas. Disease diagnosis on clinical basis alone can be misleading, requiring definitive diagnosis based on laboratory tests. Resource constraints in BU endemic areas make microscopy for the detection of acid fast bacilli (AFB) an important and useful method. It is rapid, user-friendly, convenient and cheap. Despite its usefulness, its performance is relatively low. This study investigated modifications of the current method aimed at improving its performance. Forty (IS) 2404 polymerase chain reactions (PCR) positive BU samples were processed by eight physical (centrifugation and overnight sedimentation) and chemical (phenol ammonium sulphate and sodium hypochlorite) modifications of the current direct method. Assessments were based on standard AFB evaluation coupled with in house criteria; positivity (P), clarity and contrast (C) release of bacilli from specimen (R). Overall AFB positivity rate was 64% (409/640). Each protocol had 80 smears. The percentage positivity (P) for the conventional method was 58% (46/80) smears. The highest positivity rate of 57/80 (%) was by protocol 7 (5% phenol in 4% ammonium sulphate (PhAS) and concentrated by overnight gravitational sedimentation). The least positivity rate at 35% (28/80) was by protocol 1 (smears from direct application of swab tips). The differences in performance between the two chemical tested; 5% phenol in 4% ammonium sulphate (PhAS) and 3.5% NaHOCl was significant (p<0.05). The differences between the two physical methods were however not significant (p>0.05). This study concluded that BU samples treated with a solution of 5% phenol in 4% ammonium sulphate and concentrated by either centrifugation or overnight sedimentation is useful for maximizing AFB detection by bright field microscopy. This can be useful in rural health facilities with resource constraints.
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Affiliation(s)
- Enid Owusu
- School of Biomedical and Allied Health Sciences, University of Ghana, Ghana
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4224
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Theron G, Peter J, Richardson M, Warren R, Dheda K, Steingart KR. GenoType ® MTBDRsl assay for resistance to second-line anti-tuberculosis drugs. Cochrane Database Syst Rev 2016; 9:CD010705. [PMID: 27605387 PMCID: PMC5034505 DOI: 10.1002/14651858.cd010705.pub3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Genotype® MTBDRsl (MTBDRsl) is a rapid DNA-based test for detecting specific mutations associated with resistance to fluoroquinolones and second-line injectable drugs (SLIDs) in Mycobacterium tuberculosis complex. MTBDRsl version 2.0 (released in 2015) identifies the mutations detected by version 1.0, as well as additional mutations. The test may be performed on a culture isolate or a patient specimen, which eliminates delays associated with culture. Version 1.0 requires a smear-positive specimen, while version 2.0 may use a smear-positive or -negative specimen. We performed this updated review as part of a World Health Organization process to develop updated guidelines for using MTBDRsl. OBJECTIVES To assess and compare the diagnostic accuracy of MTBDRsl for: 1. fluoroquinolone resistance, 2. SLID resistance, and 3. extensively drug-resistant tuberculosis, indirectly on a M. tuberculosis isolate grown from culture or directly on a patient specimen. Participants were people with rifampicin-resistant or multidrug-resistant tuberculosis. The role of MTBDRsl would be as the initial test, replacing culture-based drug susceptibility testing (DST), for detecting second-line drug resistance. SEARCH METHODS We searched the following databases without language restrictions up to 21 September 2015: the Cochrane Infectious Diseases Group Specialized Register; MEDLINE; Embase OVID; Science Citation Index Expanded, Conference Proceedings Citation Index-Science, and BIOSIS Previews (all three from Web of Science); LILACS; and SCOPUS; registers for ongoing trials; and ProQuest Dissertations & Theses A&I. We reviewed references from included studies and contacted specialists in the field. SELECTION CRITERIA We included cross-sectional and case-control studies that determined MTBDRsl accuracy against a defined reference standard (culture-based DST, genetic sequencing, or both). DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed quality using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. We synthesized data for versions 1.0 and 2.0 separately. We estimated MTBDRsl sensitivity and specificity for fluoroquinolone resistance, SLID resistance, and extensively drug-resistant tuberculosis when the test was performed indirectly or directly (smear-positive specimen for version 1.0, smear-positive or -negative specimen for version 2.0). We explored the influence on accuracy estimates of individual drugs within a drug class and of different reference standards. We performed most analyses using a bivariate random-effects model with culture-based DST as reference standard. MAIN RESULTS We included 27 studies. Twenty-six studies evaluated version 1.0, and one study version 2.0. Of 26 studies stating specimen country origin, 15 studies (58%) evaluated patients from low- or middle-income countries. Overall, we considered the studies to be of high methodological quality. However, only three studies (11%) had low risk of bias for the reference standard; these studies used World Health Organization (WHO)-recommended critical concentrations for all drugs in the culture-based DST reference standard. MTBDRsl version 1.0 Fluoroquinolone resistance: indirect testing, MTBDRsl pooled sensitivity and specificity (95% confidence interval (CI)) were 85.6% (79.2% to 90.4%) and 98.5% (95.7% to 99.5%), (19 studies, 2223 participants); direct testing (smear-positive specimen), pooled sensitivity and specificity were 86.2% (74.6% to 93.0%) and 98.6% (96.9% to 99.4%), (nine studies, 1771 participants, moderate quality evidence). SLID resistance: indirect testing, MTBDRsl pooled sensitivity and specificity were 76.5% (63.3% to 86.0%) and 99.1% (97.3% to 99.7%), (16 studies, 1921 participants); direct testing (smear-positive specimen), pooled sensitivity and specificity were 87.0% (38.1% to 98.6%) and 99.5% (93.6% to 100.0%), (eight studies, 1639 participants, low quality evidence). Extensively drug-resistant tuberculosis: indirect testing, MTBDRsl pooled sensitivity and specificity were 70.9% (42.9% to 88.8%) and 98.8% (96.1% to 99.6%), (eight studies, 880 participants); direct testing (smear-positive specimen), pooled sensitivity and specificity were 69.4% (38.8% to 89.0%) and 99.4% (95.0% to 99.3%), (six studies, 1420 participants, low quality evidence).Similar to the original Cochrane review, we found no evidence of a significant difference in MTBDRsl version 1.0 accuracy between indirect and direct testing for fluoroquinolone resistance, SLID resistance, and extensively drug-resistant tuberculosis. MTBDRsl version 2.0 Fluoroquinolone resistance: direct testing, MTBDRsl sensitivity and specificity were 97% (83% to 100%) and 98% (93% to 100%), smear-positive specimen; 80% (28% to 99%) and 100% (40% to 100%), smear-negative specimen. SLID resistance: direct testing, MTBDRsl sensitivity and specificity were 89% (72% to 98%) and 90% (84% to 95%), smear-positive specimen; 80% (28% to 99%) and 100% (40% to 100%), smear-negative specimen. Extensively drug-resistant tuberculosis: direct testing, MTBDRsl sensitivity and specificity were 79% (49% to 95%) and 97% (93% to 99%), smear-positive specimen; 50% (1% to 99%) and 100% (59% to 100%), smear-negative specimen.We had insufficient data to estimate summary sensitivity and specificity of version 2.0 (smear-positive and -negative specimens) or to compare accuracy of the two versions.A limitation was that most included studies did not consistently use the World Health Organization (WHO)-recommended concentrations for drugs in the culture-based DST reference standard. AUTHORS' CONCLUSIONS In people with rifampicin-resistant or multidrug-resistant tuberculosis, MTBDRsl performed on a culture isolate or smear-positive specimen may be useful in detecting second-line drug resistance. MTBDRsl (smear-positive specimen) correctly classified around six in seven people as having fluoroquinolone or SLID resistance, although the sensitivity estimates for SLID resistance varied. The test rarely gave a positive result for people without drug resistance. However, when second-line drug resistance is not detected (MTBDRsl result is negative), conventional DST can still be used to evaluate patients for resistance to the fluoroquinolones or SLIDs.We recommend that future work evaluate MTBDRsl version 2.0, in particular on smear-negative specimens and in different settings to account for different resistance-causing mutations that may vary by strain. Researchers should also consider incorporating WHO-recommended critical concentrations into their culture-based reference standards.
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Affiliation(s)
- Grant Theron
- Stellenbosch UniversityDST/NRF Centre of Excellence for Biomedical Tuberculosis Research, SAMRC Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health SciencesTygerbergSouth Africa
| | - Jonny Peter
- University of Cape TownDivision of Clinical Immunology and Allergology, Department of MedicineCape TownSouth Africa
| | - Marty Richardson
- Liverpool School of Tropical MedicineCochrane Infectious Diseases GroupPembroke PlaceLiverpoolUKL3 5QA
| | - Rob Warren
- Stellenbosch UniversityDST/NRF Centre of Excellence for Biomedical Tuberculosis Research, SAMRC Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health SciencesMatielandSouth Africa
| | - Keertan Dheda
- University of Cape TownLung Infection and Immunity Unit, Department of MedicineCape TownSouth Africa
| | - Karen R Steingart
- Liverpool School of Tropical MedicineCochrane Infectious Diseases GroupPembroke PlaceLiverpoolUKL3 5QA
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4225
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Salzer HJF, Wassilew N, Köhler N, Olaru ID, Günther G, Herzmann C, Kalsdorf B, Sanchez-Carballo P, Terhalle E, Rolling T, Lange C, Heyckendorf J. Personalized Medicine for Chronic Respiratory Infectious Diseases: Tuberculosis, Nontuberculous Mycobacterial Pulmonary Diseases, and Chronic Pulmonary Aspergillosis. Respiration 2016; 92:199-214. [PMID: 27595540 DOI: 10.1159/000449037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Chronic respiratory infectious diseases are causing high rates of morbidity and mortality worldwide. Tuberculosis, a major cause of chronic pulmonary infection, is currently responsible for approximately 1.5 million deaths per year. Although important advances in the fight against tuberculosis have been made, the progress towards eradication of this disease is being challenged by the dramatic increase in multidrug-resistant bacilli. Nontuberculous mycobacteria causing pulmonary disease and chronic pulmonary aspergillosis are emerging infectious diseases. In contrast to other infectious diseases, chronic respiratory infections share the trait of having highly variable treatment outcomes despite longstanding antimicrobial therapy. Recent scientific progress indicates that medicine is presently at a transition stage from programmatic to personalized management. We explain current state-of-the-art management concepts of chronic pulmonary infectious diseases as well as the underlying methods for therapeutic decisions and their implications for personalized medicine. Furthermore, we describe promising biomarkers and techniques with the potential to serve future individual treatment concepts in this field of difficult-to-treat patients. These include candidate markers to improve individual risk assessment for disease development, the design of tailor-made drug therapy regimens, and individualized biomarker-guided therapy duration to achieve relapse-free cure. In addition, the use of therapeutic drug monitoring to reach optimal drug dosing with the smallest rate of adverse events as well as candidate agents for future host-directed therapies are described. Taken together, personalized medicine will provide opportunities to substantially improve the management and treatment outcome of difficult-to-treat patients with chronic respiratory infections.
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Affiliation(s)
- Helmut J F Salzer
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
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4226
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Emerging clones of Mycobacterium tuberculosis in Russia and former Soviet Union countries: Beijing genotype and beyond. Int J Mycobacteriol 2016; 5 Suppl 1:S69-S70. [PMID: 28043622 DOI: 10.1016/j.ijmyco.2016.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/06/2016] [Indexed: 11/23/2022] Open
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4227
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Boddawar GD, Dhawale SC, Shaikh SS. Assessment of anti-inflammatory potential of Sesbania bispinosa Linn. leaf extracts and fractions by acute and chronic models. ALEXANDRIA JOURNAL OF MEDICINE 2016. [DOI: 10.1016/j.ajme.2015.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
| | | | - Shafik S. Shaikh
- School of Physical Sciences, SRTM University, Nanded 431606, MS, India
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4228
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Predictors of death among drug-resistant tuberculosis patients in Kuala Lumpur, Malaysia: A retrospective cohort study from 2009 to 2013. J Glob Antimicrob Resist 2016; 6:102-107. [DOI: 10.1016/j.jgar.2016.04.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 02/18/2016] [Accepted: 04/13/2016] [Indexed: 11/19/2022] Open
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4229
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Agarwal AK, Ginisha G, Preeti G, Dwivedi S, Swamai P. The association between diabetes and tuberculosis may be the next challenge for global tuberculosis control worldwide. Indian J Endocrinol Metab 2016; 20:732-733. [PMID: 27730090 PMCID: PMC5040060 DOI: 10.4103/2230-8210.190565] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Anil Kumar Agarwal
- Department of Community Medicine, G R Medical College, Gwalior, Madhya Pradesh, India
| | - Gupta Ginisha
- Department of Community Medicine, G R Medical College, Gwalior, Madhya Pradesh, India
| | - Gupta Preeti
- Government Medical College, Kota, Rajasthan, India
| | - S. Dwivedi
- Department of Community Medicine, G R Medical College, Gwalior, Madhya Pradesh, India
| | - P. Swamai
- Department of Community Medicine, G R Medical College, Gwalior, Madhya Pradesh, India
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4230
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Smirnova PA, Turkova A, Nikishova EI, Seddon JA, Chappell E, Zolotaya OA, Mironuk OM, Maryandyshev AO. Multidrug-resistant tuberculosis in children in northwest Russia: an observational cohort study. Eur Respir J 2016; 48:1496-1499. [PMID: 27587542 DOI: 10.1183/13993003.00354-2016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 07/06/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Polina A Smirnova
- Child and Adolescent Specialised Centre, Arkhangelsk Regional Tuberculosis Dispensary, Arkhangelsk, Russian Federation.,Both authors contributed equally
| | - Anna Turkova
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK .,Both authors contributed equally
| | - Elena I Nikishova
- Dept of Phthisiopulmonology, Northern State Medical University, Arkhangelsk, Russian Federation
| | - James A Seddon
- Dept of Academic Paediatrics, Imperial College London, London, UK
| | - Elizabeth Chappell
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - Olga A Zolotaya
- Child and Adolescent Specialised Centre, Arkhangelsk Regional Tuberculosis Dispensary, Arkhangelsk, Russian Federation
| | - Oxana M Mironuk
- Child and Adolescent Specialised Centre, Arkhangelsk Regional Tuberculosis Dispensary, Arkhangelsk, Russian Federation
| | - Andrey O Maryandyshev
- Dept of Phthisiopulmonology, Northern State Medical University, Arkhangelsk, Russian Federation
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4231
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Sex Differences in Tuberculosis Burden and Notifications in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis. PLoS Med 2016; 13:e1002119. [PMID: 27598345 PMCID: PMC5012571 DOI: 10.1371/journal.pmed.1002119] [Citation(s) in RCA: 226] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 07/29/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) case notification rates are usually higher in men than in women, but notification data are insufficient to measure sex differences in disease burden. This review set out to systematically investigate whether sex ratios in case notifications reflect differences in disease prevalence and to identify gaps in access to and/or utilisation of diagnostic services. METHODS AND FINDINGS In accordance with the published protocol (CRD42015022163), TB prevalence surveys in nationally representative and sub-national adult populations (age ≥ 15 y) in low- and middle-income countries published between 1 January 1993 and 15 March 2016 were identified through searches of PubMed, Embase, Global Health, and the Cochrane Database of Systematic Reviews; review of abstracts; and correspondence with the World Health Organization. Random-effects meta-analyses examined male-to-female (M:F) ratios in TB prevalence and prevalence-to-notification (P:N) ratios for smear-positive TB. Meta-regression was done to identify factors associated with higher M:F ratios in prevalence and higher P:N ratios. Eighty-three publications describing 88 surveys with over 3.1 million participants in 28 countries were identified (36 surveys in Africa, three in the Americas, four in the Eastern Mediterranean, 28 in South-East Asia and 17 in the Western Pacific). Fifty-six surveys reported in 53 publications were included in quantitative analyses. Overall random-effects weighted M:F prevalence ratios were 2.21 (95% CI 1.92-2.54; 56 surveys) for bacteriologically positive TB and 2.51 (95% CI 2.07-3.04; 40 surveys) for smear-positive TB. M:F prevalence ratios were highest in South-East Asia and in surveys that did not require self-report of signs/symptoms in initial screening procedures. The summary random-effects weighted M:F ratio for P:N ratios was 1.55 (95% CI 1.25-1.91; 34 surveys). We intended to stratify the analyses by age, HIV status, and rural or urban setting; however, few studies reported such data. CONCLUSIONS TB prevalence is significantly higher among men than women in low- and middle-income countries, with strong evidence that men are disadvantaged in seeking and/or accessing TB care in many settings. Global strategies and national TB programmes should recognise men as an underserved high-risk group and improve men's access to diagnostic and screening services to reduce the overall burden of TB more effectively and ensure gender equity in TB care.
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4232
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Sharma M, Sharma K, Sharma A, Gupta N, Rajwanshi A. Loop-mediated isothermal amplification (LAMP) assay for speedy diagnosis of tubercular lymphadenitis: The multi-targeted 60-minute approach. Tuberculosis (Edinb) 2016; 100:114-117. [DOI: 10.1016/j.tube.2016.07.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 07/13/2016] [Accepted: 07/23/2016] [Indexed: 11/25/2022]
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4233
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Upadhyaya SK, Pant ND, Bhandari R, Poudel A, Shrestha B. Light emitting diode fluorescence microscopy versus Ziehl–Neelsen smear microscopy for the diagnosis of pulmonary tuberculosis. Braz J Infect Dis 2016; 20:522-3. [PMID: 27542869 PMCID: PMC9425454 DOI: 10.1016/j.bjid.2016.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 07/19/2016] [Accepted: 07/24/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Narayan Dutt Pant
- Department of Microbiology, Grande International Hospital, Kathmandu, Nepal.
| | - Raju Bhandari
- Department of Microbiology, Goldengate International College, Kathmandu, Nepal
| | - Asia Poudel
- Department of Microbiology, Goldengate International College, Kathmandu, Nepal
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4234
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Kuznetsov V, Bissell K. Health service perceptions about implementation of a new TB diagnostic in Northern Russia: a qualitative study. Public Health Action 2016; 6:181-189. [PMID: 27695681 PMCID: PMC5034784 DOI: 10.5588/pha.16.0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/26/2016] [Indexed: 11/10/2022] Open
Abstract
Setting: Many tuberculosis services are implementing new diagnostics to accelerate treatment initiation for multidrug-resistant tuberculosis. Successful implementation and uptake are likely to depend on many factors. Objective: To describe the perceptions of the Arkhangelsk health services staff in Northern Russia on the process of introducing the line-probe assay and to determine what facilitates the process of uptake into practice. Design: Process evaluation; semi-structured, in-depth interviews with key informants from civil and penitentiary health services; content analysis. Results: A good working relationship between the civil and penitentiary sectors and a tradition of positive collaboration between doctors and managers were integral to success. Uptake and adaptation were facilitated by regular discussions between managers and implementers, flexibility in adapting routines and an iterative approach to improving procedures. It is beneficial to allow all types of health care workers affected by the diagnostic to learn about it and contribute to its integration. A multidisciplinary evaluation can detect problems elsewhere in the care pathway. Bringing about change in workplace mind-sets and attitudes takes time and management. Conclusion: People take time to observe the effects of innovations, assess relative advantages and become convinced, sometimes by different types of evidence. Multi-disciplinary opportunities for learning, reflecting on care pathways and adaptation should all be a part of introducing new diagnostics.
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Affiliation(s)
- V Kuznetsov
- Institute of Mental Medicine, Northern State Medical University, Arkhangelsk, Russia ; International School of Public Health, Northern State Medical University, Arkhangelsk, Russia ; University Hospital of Umeå, Umeå, Sweden
| | - K Bissell
- International Union Against Tuberculosis and Lung Disease, Paris, France ; School of Population Health, University of Auckland, Auckland, New Zealand
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4235
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Tahir Z, Ahmad MUD, Akhtar AM, Yaqub T, Mushtaq MH, Javed H. Diabetes mellitus among tuberculosis patients: a cross sectional study from Pakistan. Afr Health Sci 2016; 16:671-676. [PMID: 27917198 DOI: 10.4314/ahs.v16i3.5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The co-occurrence of diabetes mellitus (DM) and tuberculosis (TB) is largely associated with high frequency of morbidity. OBJECTIVE To determine the prevalence of DM among TB patients and describe the socio-demographic and behavioral factors associated with TB-DM co-occurrence. METHODS We enrolled 500 TB patients from September, 2014 to August 2015 at four major public sector hospitals of Lahore, Pakistan. A questionnaire was used to collect information regarding associated socio-demographic and behavioral factors of the patients. We monitored the fasting blood sugar of each patient by using a semi automated clinical chemistry analyzer followed by an HbA1c level check of all hyperglycemic patients. RESULTS The prevalence of TB-DM co-occurrence was 14.8%. The prevalence of TB-DM was higher (62.2%) among males. The >57 year age group had the highest proportion of patients (35.1%), with co-existent TB-DM. Most were illiterate (73.0%) and unemployed (48%). Moreover, among the 74 patients positive for TB-DM had a history of smoking. Age and education level were significantly associated with DM-TB while gender, occupation and smoking were not associated. CONCLUSION The study revealed a 14.8% prevalence of DM among TB patients. This was associated with several socio-demographic factors, including age, unemployment, literacy and polluted environment. Thus, poor and unhealthy lifestyles were the factors associated with DM among immunologically compromised individuals due to TB.
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4236
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Singh DK, Dwivedi VP, Ranganathan A, Bishai WR, Van Kaer L, Das G. Blockade of the Kv1.3 K+ Channel Enhances BCG Vaccine Efficacy by Expanding Central Memory T Lymphocytes. J Infect Dis 2016; 214:1456-1464. [PMID: 27571906 DOI: 10.1093/infdis/jiw395] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/17/2016] [Indexed: 02/01/2023] Open
Abstract
Tuberculosis is the oldest known infectious disease, yet there is no effective vaccine against adult pulmonary tuberculosis. Emerging evidence indicates that T-helper 1 and T-helper 17 cells play important roles in host protection against tuberculosis. However, tuberculosis vaccine efficacy in mice is critically dependent on the balance between antigen-specific central memory T (Tcm) and effector memory T (Tem) cells. Specifically, a high Tcm/Tem cell ratio is essential for optimal vaccine efficacy. Here, we show that inhibition of Kv1.3, a potassium channel preferentially expressed by Tem cells, by Clofazimine selectively expands Tcm cells during BCG vaccination. Furthermore, mice that received clofazimine after BCG vaccination exhibited significantly enhanced resistance against tuberculosis. This superior activity against tuberculosis could be adoptively transferred to naive, syngeneic mice by CD4+ T cells. Therefore, clofazimine enhances Tcm cell expansion, which in turn provides improved vaccine efficacy. Thus, Kv1.3 blockade is a promising approach for enhancing the efficacy of the BCG vaccine in humans.
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Affiliation(s)
- Dhiraj Kumar Singh
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, and.,International Center for Genetic Engineering and Biotechnology, New Delhi, India
| | - Ved Prakash Dwivedi
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, and.,International Center for Genetic Engineering and Biotechnology, New Delhi, India
| | - Anand Ranganathan
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, and.,International Center for Genetic Engineering and Biotechnology, New Delhi, India
| | - William R Bishai
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Luc Van Kaer
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Gobardhan Das
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, and
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4237
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Cardiac implantable electronic device infection due to Mycobacterium species: a case report and review of the literature. BMC Res Notes 2016; 9:414. [PMID: 27553460 PMCID: PMC4995631 DOI: 10.1186/s13104-016-2221-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 08/15/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Infection of cardiac implantable electronic devices is a serious cardiovascular disease and it is associated with a high mortality. Mycobacterium species may rarely cause cardiac implantable electronic devices infection. CASE PRESENTATION We are reporting a case of miliary tuberculosis in an Arab patient with dilated cardiomyopathy and a cardiac resynchronization therapy-defibrillator device that was complicated with infection of his cardiac resynchronization therapy-defibrillator device. To our knowledge, this is the third case in the literature with such a presentation and all patients died during the course of treatment. This underscores the importance of early diagnosis and management. We also performed a literature review of reported cases of cardiac implantable electronic devices infection related to Mycobacterium species. CONCLUSIONS Cardiac implantable electronic devices infection due to Mycobacterium species is an uncommon but a well-known entity. Early diagnosis and prompt management may result in a better outcome.
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4238
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Thakur MK, Sinha DK, Singh BR. Evaluation of complementary diagnostic tools for bovine tuberculosis detection in dairy herds from India. Vet World 2016; 9:862-8. [PMID: 27651675 PMCID: PMC5021836 DOI: 10.14202/vetworld.2016.862-868] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/08/2016] [Indexed: 12/03/2022] Open
Abstract
Aim: A cross-sectional study was undertaken to know the herd prevalence and evaluate the single intradermal tuberculin testing (SITT), culture isolation, and polymerase chain reaction (PCR) analysis for the diagnosis of bovine tuberculosis (TB). Materials and Methods: A total of 541 cows of three dairy farms of Bareilly and Mukteshwar were screened by SITT followed by collection of pre-scapular lymph node (PSLN) aspirates (71), milk (54), and blood (71) samples from reactor animals. These clinical samples were processed for culture isolation and direct PCR-based identification and species differentiation. Results: Out of 541 cows screened by SITT, 71 (13.12%) animals were found positive. Mycobacteria were isolated from 3 (4.22%) PSLN aspirate but not from any cultured milk and blood samples. 28 (39.43%) PSLN aspirate and 5 (9.25%) milk samples were positive for Mycobacterium TB (MTB) complex (MTC) by PCR amplification for the IS6110 insertion sequence; however, blood samples were found negative. For species differentiation, multiplex-PCR using 12.7 kb primers was conducted. Out of 28 PSLN aspirate, Mycobacterium bovis was detected in 18 (64.28%) and MTB in 8 (28.57%), whereas 2 aspirate samples (7.14%) were positive for both the species. All the five milk positive samples were positive for M. bovis. Conclusion: Direct detection of bovine TB by a molecular-based method in dairy animals after preliminary screening was appeared to be more sensitive and specific compared to the conventional method (i.e., culture isolation). Its application in form of serial testing methodology for the routine diagnosis and thereafter, culling of infected stock may be suggested for the control programs in dairy herds. The PSLN aspirate was found to be the most suitable specimen for culture isolation and PCR-based detection of Mycobacterium spp. among live infected animals.
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Affiliation(s)
- Mukesh Kumar Thakur
- School of Public Health & Zoonoses, Guru Angad Dev Veterinary & Animal Sciences University, Ludhiana, Punjab, India
| | - Dharmender Kumar Sinha
- Division of Epidemiology, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Bhoj Raj Singh
- Division of Epidemiology, Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
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4239
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Misombo-Kalabela A, Nguefack-Tsague G, Kalla GCM, Ze EA, Diangs K, Panda T, Kebela I, Fueza SB, Magazani N, Mbopi-Kéou FX. [Risk factors for multidrug-resistant tuberculosis in the city of Kinshasa in the Democratic Republic of Congo]. Pan Afr Med J 2016; 23:157. [PMID: 27516818 PMCID: PMC4967428 DOI: 10.11604/pamj.2016.23.157.6137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 02/07/2016] [Indexed: 11/11/2022] Open
Abstract
Introduction L'objectif de cette étude était de déterminer les facteurs de risque associés à la tuberculose multi résistance à Kinshasa en République Démocratique du Congo. Méthodes Il s'agissait d'une étude cas témoins. Les cas comprenaient tous les patients tuberculeux résistants à la rifampicine et à l'isoniazide notifiés à Kinshasa de janvier 2012 à juin 2013. Les témoins étaient les patients tuberculeux traités durant la même période que les cas et qui à la fin du traitement étaient déclarés guéris. Pour cette étude, nous avons obtenu une clairance éthique. Résultats L’échantillon était constitué de 213 participants dont 132 hommes (62%) et 81 femmes (38%). L’âge médian était de 31ans (16-73 ans). Les facteurs associés significatifs (p< 0,05) à la tuberculose multi résistante étaient le non-respect des heures de prise de médicaments (0R = 111) (80% chez les cas et 4% chez les témoins), l’échec au traitement (0R = 20) (76% chez les cas et 13% chez les témoins); la notion de tuberculose multi résistante dans la famille (0R = 6.4) (28% chez les cas et 6% chez les témoins); la méconnaissance de la tuberculose multi résistante (0R = 3.2) (31% chez les cas et 59% chez les témoins); un séjour en prison (0R = 7.6) (10% chez les cas et 1% chez les témoins) et l'interruption du traitement (0R = 6.1) ( 59% chez les cas et 19% chez les témoins). Conclusion L’émergence de la tuberculose multi résistante peut être évitée par la mise en place des stratégies de diagnostic et de traitement appropriées.
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Affiliation(s)
| | - Georges Nguefack-Tsague
- Université de Yaoundé I, Faculté de Médecine et des Sciences Biomédicales, Yaoundé, Cameroun
| | | | - Emmanuel Afane Ze
- Université de Yaoundé I, Faculté de Médecine et des Sciences Biomédicales, Yaoundé, Cameroun
| | - Kimpanga Diangs
- Université de Kinshasa, Faculté de Médecine, Département de Santé Publique, République Démocratique du Congo
| | - Tshapenda Panda
- Ministère de la Santé Publique, République Démocratique du Congo
| | - Ilunga Kebela
- Ministère de la Santé Publique, République Démocratique du Congo
| | | | - Nzanzu Magazani
- Ministère de la Santé Publique, République Démocratique du Congo
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4240
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Sama CB, Mbarga NF, Oben CE, Mbarga JA, Nfor EK, Angwafo Iii FF. Massive paediatric cervicofacial actinomycoses masquerading as an ulcerative malignancy. BMC Infect Dis 2016; 16:417. [PMID: 27526941 PMCID: PMC4986358 DOI: 10.1186/s12879-016-1768-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 08/09/2016] [Indexed: 11/12/2022] Open
Abstract
Background Paediatric cervicofacial actinomycosis is a rare infectious disease caused by Actinomyces spp. and usually presents as a chronic, suppurative and granulomatous inflammation with a propensity to mimic malignant conditions. Case presentation We discuss the case of an 11-year-old African female who presented with a chronic disfiguring cervical mass evolving over a 9 months period for which she had several unyielding consultations. Appropriate clinical and para-clinical evaluations were paramount to the diagnosis of an Actinomyces infection. We review the literature on its epidemiology, clinical presentation, diagnosis, treatment and prognosis. Conclusion Actinomycosis still poses a diagnostic challenge. It is important for clinicians to consider the possibility of such rare infections in apparently malignant looking masses and also in lesions not responding to several antimicrobial treatments. The condition generally carries a good prognosis if recognised early and histopathological diagnosis is the gold standard.
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Affiliation(s)
- Carlson-Babila Sama
- Islamic Medicalised Health Centre, Babessi, Cameroon and Galactic Corps Research Group (GCRG), Buea, Cameroon.
| | - Nicole Fouda Mbarga
- SporeData Inc., Durham, United States of America and Sangmelima District Hospital, South Region, Cameroon
| | - Calvin Eta Oben
- Islamic Medicalised Health Centre, Babessi, Cameroon and Galactic Corps Research Group (GCRG), Buea, Cameroon.,Community Humanitarian Emergency Board, Bangui, Central African Republic
| | - Jules A Mbarga
- Islamic Medicalised Health Centre, Babessi, Cameroon and Galactic Corps Research Group (GCRG), Buea, Cameroon.,Croix Rouge-Française, Yaoundé, Cameroon
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4241
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Tanner R, O'Shea MK, Fletcher HA, McShane H. In vitro mycobacterial growth inhibition assays: A tool for the assessment of protective immunity and evaluation of tuberculosis vaccine efficacy. Vaccine 2016; 34:4656-4665. [PMID: 27527814 DOI: 10.1016/j.vaccine.2016.07.058] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 06/07/2016] [Accepted: 07/29/2016] [Indexed: 01/28/2023]
Abstract
Tuberculosis (TB) continues to pose a serious global health threat, and the current vaccine, BCG, has variable efficacy. However, the development of a more effective vaccine is severely hampered by the lack of an immune correlate of protection. Candidate vaccines are currently evaluated using preclinical animal models, but experiments are long and costly and it is unclear whether the outcomes are predictive of efficacy in humans. Unlike measurements of single immunological parameters, mycobacterial growth inhibition assays (MGIAs) represent an unbiased functional approach which takes into account a range of immune mechanisms and their complex interactions. Such a controlled system offers the potential to evaluate vaccine efficacy and study mediators of protective immunity against Mycobacterium tuberculosis (M.tb). This review discusses the underlying principles and relative merits and limitations of the different published MGIAs, their demonstrated abilities to measure mycobacterial growth inhibition and vaccine efficacy, and what has been learned about the immune mechanisms involved.
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Affiliation(s)
- Rachel Tanner
- The Jenner Institute, University of Oxford, Oxford, UK.
| | | | | | - Helen McShane
- The Jenner Institute, University of Oxford, Oxford, UK
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4242
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Bhurayanontachai R, Maneenil K. Factors influencing development and mortality of acute respiratory failure in hospitalized patient with active pulmonary tuberculosis: a 10-year retrospective review. J Thorac Dis 2016; 8:1721-30. [PMID: 27499962 DOI: 10.21037/jtd.2016.06.22] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Pulmonary tuberculosis with acute respiratory failure is fatal and is a burden in the intensive care units and leads to mortality. This retrospective study identifies the factors influencing the development of pulmonary tuberculosis requiring mechanical ventilation (TBMV) and mortality in the hospitalized patients with pulmonary tuberculosis. METHODS The medical records of hospitalized adult patients with pulmonary tuberculosis were retrospectively reviewed. Demographic data, clinical presentations, radiographic findings, biochemical tests, and clinical outcomes were collected. Data were compared by Student's t-test and Chi-square test between groups. Select variables that were statistically significant with P values <0.1 were introduced into a forward, stepwise, logistic regression model. Odds ratios (ORs) and their 95% confidence intervals (CIs) identified the independent influencing factors in the development of TBMV and mortality. RESULTS Of 268 enrolled patients, 185 (69.0%) were male. The patients were equally divided between the TBMV and non-TBMV groups. The shorter duration of illness (OR, 0.99; 95% CI, 0.98-0.99), underlying disease of AIDS (OR, 14.55; 95% CI, 1.71-123.91), presentation of fever (OR, 2.11; 95% CI, 1.20-3.71) and dyspnea (OR, 3.51; 95% CI, 2.02-6.11), large amount of acid fast bacilli on sputum smear (OR, 3.76; 95% CI, 1.90-7.47), lower serum albumin level (OR, 0.39; 95% CI, 0.26-0.59), and delayed initiation of anti-tuberculosis agents (OR, 1.06; 95% CI, 1.00-1.12) were independent factors to develop TBMV. Male gender (OR, 2.16; 95% CI, 1.01-4.61), consolidation pattern on chest X-ray (OR, 2.41; 95% CI, 1.17-4.98), and lower serum albumin (OR, 0.39; 95% CI, 0.21-0.71) were correlated to mortality. CONCLUSIONS The incidence and mortality rate of TBMV patients were high. Acute tuberculous pneumonia, underlying disease of AIDS, amount of acid fast bacilli, and delayed administration of anti-tuberculosis agents were independent risk factors to develop TBMV. Male gender, consolidation on chest X-ray, and low serum albumin were significantly related to mortality.
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Affiliation(s)
- Rungsun Bhurayanontachai
- Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Kunlatida Maneenil
- Oncology Unit, Department of Internal Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
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4243
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Evaluation of Semiautomated IS6110-Based Restriction Fragment Length Polymorphism Typing for Mycobacterium tuberculosis in a High-Burden Setting. J Clin Microbiol 2016; 54:2547-52. [PMID: 27487956 DOI: 10.1128/jcm.00408-16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/27/2016] [Indexed: 11/20/2022] Open
Abstract
The manual IS6110-based restriction fragment length polymorphism (RFLP) typing method is highly discriminatory; however, it is laborious and technically demanding, and data exchange remains a challenge. In an effort to improve IS6110-based RFLP to make it a faster format, DuPont Molecular Diagnostics recently introduced the IS6110-PvuII kit for semiautomated typing of Mycobacterium tuberculosis using the RiboPrinter microbial characterization system. This study aimed to evaluate the semiautomated RFLP typing against the standard manual method. A total of 112 isolates collected between 2013 and 2014 were included. All isolates were genotyped using manual and semiautomated RFLP typing methods. Clustering rates and discriminatory indexes were compared between methods. The overall performance of semiautomated RFLP compared to manual typing was excellent, with high discriminatory index (0.990 versus 0.995, respectively) and similar numbers of unique profiles (72 versus 74, respectively), numbers of clustered isolates (33 versus 31, respectively), cluster sizes (2 to 6 and 2 to 5 isolates, respectively), and clustering rates (21.9% and 17.1%, respectively). The semiautomated RFLP system is technically simple and significantly faster than the manual RFLP method (8 h versus 5 days). The analysis is fully automated and generates easily manageable databases of standardized fingerprints that can be easily exchanged between laboratories. Based on its high-throughput processing with minimal human effort, the semiautomated RFLP can be a very useful tool as a first-line method for routine typing of M. tuberculosis isolates, especially where Beijing strains are highly prevalent, followed by manual RFLP typing if resolution is not achieved, thereby saving time and labor.
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4244
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Rodrigues-Junior VS, Villela AD, Gonçalves RS, Abbadi BL, Trindade RV, López-Gavín A, Tudó G, González-Martín J, Basso LA, de Souza MV, Campos MM, Santos DS. Mefloquine and its oxazolidine derivative compound are active against drug-resistant Mycobacterium tuberculosis strains and in a murine model of tuberculosis infection. Int J Antimicrob Agents 2016; 48:203-7. [DOI: 10.1016/j.ijantimicag.2016.04.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 04/14/2016] [Accepted: 04/16/2016] [Indexed: 12/30/2022]
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4245
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Pediatric non-tuberculous mycobacterial cervicofacial adenitis: A systematic review. J Infect 2016; 73:388-91. [PMID: 27475786 DOI: 10.1016/j.jinf.2016.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 07/19/2016] [Accepted: 07/22/2016] [Indexed: 11/23/2022]
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4246
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El-Shimy WS, Bediwy AS, Hassan AM, Ismail LR. Serum neopterin level in cases of pulmonary tuberculosis and pneumonia. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2016. [DOI: 10.4103/1687-8426.184360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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4247
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Shao Y, Wang Z, Lv Z, Li C, Zhang W, Li Y, Duan X. NF-κB/Rel, not STAT5, regulates nitric oxide synthase transcription in Apostichopus japonicus. DEVELOPMENTAL AND COMPARATIVE IMMUNOLOGY 2016; 61:42-47. [PMID: 27005898 DOI: 10.1016/j.dci.2016.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 03/17/2016] [Accepted: 03/18/2016] [Indexed: 06/05/2023]
Abstract
Nitric oxide (NO) is an important signaling molecular in the immune system of all vertebrates and invertebrates for pathologic and physiologic process, and it is largely produced by inducible nitric oxide synthase (iNOS). To uncover key mechanisms regulating NOS expression in sea cucumber Apostichopus japonicus, we amplified a fragment of the NOS promoter by genome walking approach and characterized putative transcription factor binding motifs using luciferase assay. Transient transfection of EPC cells using 5'-deletion constructs linked to luciferase reporter revealed that the region -614/+39 contributed importantly to expression of the AjNOS gene, and the -614 bp of the 5'-flanking region of the AjNOS gene responded well to LPS. Analysis of the functional promoter region revealed the presence of two potential NF-κB (-375 bp to -366 bp, -76 bp to -67 bp) and three STAT binding sites (-284 bp to -276 bp, -95 bp to 87 bp, -81 bp to -73 bp). When luciferase reporter vector and expression vector co-transfected revealed that NF-κB/Rel, but not STAT5, activate the AjNOS promoter fragment. Furthermore, two truncated reporter vectors co-transfected with vector expressing NF-κB/Rel revealed that the first NF-κB binding site (-375 bp to -366 bp) was essential for the ability of this promoter to induce AjNOS transcription. In addition, blocking the AjRel by SN50 (NF-κB inhibitory peptide) depressed the AjNOS expression and NO production both in vivo and in vitro, respectively, revealing that AjRel might directly modulate AjNOS. All our findings confirmed that NF-κB dependent mechanisms regulating expression of AjNOS and suggested a means of linking NO production to the immune response.
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Affiliation(s)
- Yina Shao
- School of Marine Sciences, Ningbo University, Ningbo, 315211, PR China
| | - Zhenhui Wang
- School of Marine Sciences, Ningbo University, Ningbo, 315211, PR China
| | - Zhimeng Lv
- School of Marine Sciences, Ningbo University, Ningbo, 315211, PR China
| | - Chenghua Li
- School of Marine Sciences, Ningbo University, Ningbo, 315211, PR China.
| | - Weiwei Zhang
- School of Marine Sciences, Ningbo University, Ningbo, 315211, PR China
| | - Ye Li
- School of Marine Sciences, Ningbo University, Ningbo, 315211, PR China
| | - Xuemei Duan
- School of Marine Sciences, Ningbo University, Ningbo, 315211, PR China
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4248
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Lesnic E, Ustian A, Pop CM. The role of exogenous risk factors of antituberculosis treatment failure. ACTA ACUST UNITED AC 2016; 89:396-401. [PMID: 27547060 PMCID: PMC4990436 DOI: 10.15386/cjmed-608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 12/22/2015] [Accepted: 01/12/2016] [Indexed: 11/23/2022]
Abstract
Background and aim The Republic of Moldova reports the highest incidence of tuberculosis and the lowest treatment success rate among European region countries. In most of the patients the antituberculosis treatment failure is correlated with social risk factors (low socio-economical state, epidemiological danger characteristics) and biological factors (young age, male sex, physiological conditions, associated diseases). Clinical factors (advanced forms of tuberculosis, chronic evolution, immune disturbances), therapeutic factors (treatment errors and interruptions, individualized regimens) and administrative factors (drug interruption in supply, suboptimal treatment quality) prevail in regions with defficient in health care delivery. The association of risk factors has a higher impact than the severity of one risk factor. The risk factor assessment is very important before initiation of the treatment, for establishing the plan of risk reduction measures for increasing the success rate. The aim of the study was to determine the impact of exogenous risk factors on antituberculosis treatment failure. Methods The study was conducted on 201 patients with pulmonary tuberculosis and treatment failure and 105 patients with pulmonary tuberculosis who successfully finished the antituberculosis treatment. Selected cases were investigated according national standards. Results The treatment failure occurred in patients belonging to socially disadvantaged groups, patients with harmful habits (alcohol abuse, drug use, active smoking), patients from infectious clusters. Migration, homelessness and detention releasing imperil the quality of treatment, thus predisposing to the treatment failure. Social, educational support and the substitutive therapy and withdrawal techniques (tobacco, alcohol, psycho-active substances) must be implemented in the high risk groups in order to diminish the risk of treatment failure and to increase the treatment success rate. Conclusions The study of exogenous risk factors in vulnerable groups will contribute to the precocious detection of patients predisposed to failing the tuberculosis treatment and will permit the initiation of measures centered on patient that will favor the increase of treatment quality and success rate.
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Affiliation(s)
- Evelina Lesnic
- Pneumophthisiology Department, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Aurelia Ustian
- Pneumophthisiology Department, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Carmen Monica Pop
- Pneumology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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4249
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Thirumurugan R, Kathirvel M, Vallayyachari K, Surendar K, Samrot AV, Muthaiah M. Molecular analysis of rpoB gene mutations in rifampicin resistant Mycobacterium tuberculosis isolates by multiple allele specific polymerase chain reaction in Puducherry, South India. J Infect Public Health 2016; 8:619-25. [PMID: 26117709 DOI: 10.1016/j.jiph.2015.05.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/16/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND rpoB gene mutations in Mycobacterium tuberculosis (MTB) make the bacteria resistant to rifampicin. Thus, these mutations are surrogate markers for multi-drug resistance (MDR). The objective of this study was to evaluate an allele-specific multiplex-polymerase chain reaction (MAS-PCR) assay to detect mutations at codons 516, 526 and 531 of the rpoB gene. METHODS In total, 127 M. tuberculosis clinical isolates were subjected to standard drug susceptibility tests. A MAS-PCR assay was then performed to detect mutations in the rpoB gene. Three different allele-specific PCR assays were performed (single-step MAS-PCR) and the amplified products were sequenced. RESULTS Of the 127 isolates, 69 (54.3%) were multidrug resistant M. tuberculosis (MDR-TB), 21 (16.5%) were rifampicin mono-resistant and 37 (29.1%) were drug susceptible. The frequency of mutations at codons 531, 526 and 516 was 54.4%, 18.9% and 5.6%, respectively. A triple mutation was found in 4 (4.4%) isolates. Mutations in regions other than the 81-bp region were observed at codons 413 (11.1%), 511 (12.2%) and 521 (15.6%) of the rpoB gene. CONCLUSIONS The simplicity and specificity of the MAS-PCR assay allows for easy implementation in clinical laboratories to detect rifampicin drug resistance in MDR-TB strains.
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Affiliation(s)
- Ravibalan Thirumurugan
- Department of Microbiology, Intermediate Reference Laboratory, State TB Training and Demonstration Centre, Government Hospital for Chest Diseases, Gorimedu, Puducherry 605006, India; Department of Biotechnology, Sathyabama University, Jeppiaar Nagar, Rajiv Gandhi Salai, Sholinganallur, Chennai 600119, Tamil Nadu, India
| | - Maruthai Kathirvel
- Department of Biotechnology, Sathyabama University, Jeppiaar Nagar, Rajiv Gandhi Salai, Sholinganallur, Chennai 600119, Tamil Nadu, India
| | - Kommoju Vallayyachari
- Department of Biotechnology, Sathyabama University, Jeppiaar Nagar, Rajiv Gandhi Salai, Sholinganallur, Chennai 600119, Tamil Nadu, India
| | - Kesavan Surendar
- Department of Biotechnology, Sathyabama University, Jeppiaar Nagar, Rajiv Gandhi Salai, Sholinganallur, Chennai 600119, Tamil Nadu, India
| | - Antony V Samrot
- Department of Microbiology, Intermediate Reference Laboratory, State TB Training and Demonstration Centre, Government Hospital for Chest Diseases, Gorimedu, Puducherry 605006, India
| | - Muthuraj Muthaiah
- Department of Biotechnology, Sathyabama University, Jeppiaar Nagar, Rajiv Gandhi Salai, Sholinganallur, Chennai 600119, Tamil Nadu, India.
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4250
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Imidazo[1,2-a]Pyridine-3-Carboxamides Are Active Antimicrobial Agents against Mycobacterium avium Infection In Vivo. Antimicrob Agents Chemother 2016; 60:5018-22. [PMID: 27216051 DOI: 10.1128/aac.00618-16] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 05/13/2016] [Indexed: 11/20/2022] Open
Abstract
A panel of six imidazo[1,2-a]pyridine-3-carboxamides (IAPs) were shown to have low-micromolar activity against Mycobacterium avium strains. Compound ND-10885 (compound 2) showed significant activity in the lung, spleen, and liver in a mouse M. avium infection model. A combined regimen consisting of ND-10885 (compound 2) and rifampin was additive in its anti-M. avium activity in the lung. Our data indicate that IAPs represent a new class of antibiotics that are active against M. avium and could potentially serve as an effective addition to a combined treatment regimen.
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