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Prevalence and Antimicrobial Susceptibility of Non-tuberculous Mycobacteria Isolated from Sputum Samples of Patients with Pulmonary Infections in China. Jundishapur J Microbiol 2021. [DOI: 10.5812/jjm.109676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Non-tuberculous mycobacteria (NTM) are widely associated with pulmonary diseases. Evidence is lacking on the transmission of NTM from one person to another. Hence, it has gained lower public health priority than tuberculosis. Objectives: We determined the prevalence and antibiotic resistance rate of NTM isolated from sputum samples of patients with pulmonary infections. Methods: A total of 375 duplicate sputum samples were collected from 375 patients on consecutive days. The NTM growth was assessed using BACTEC 960 mycobacterial growth indicator tubes. The GenoType Mycobacterium CM/AS line probe assay was used for the species-level identification of mycobacteria. Antibiotic susceptibility tests were performed using the auto-MODS assay. Results: The overall NTM prevalence rate was 34.4%. Mycobacterium avium complex (24.8%) was the predominant species identified, followed by M. kansasii (24%) and M. abscessus complex (20.2%). Of the 129 NTM isolates tested for antibiotic susceptibility, 62.8% were resistant to rifampicin, 60.5% to levofloxacin, 58.1% to ofloxacin, 55.8% to ethambutol, 49.6% to isoniazid, 48.1% to streptomycin, and 41.9% to amikacin. Seventy-three (56.6%) isolates were identified as multidrug-resistant (MDR) isolates. Conclusions: Mycobacterium avium complex was the predominant species identified, and the majority of the organisms were resistant to commonly used anti-tuberculosis drugs. The high prevalence of NTM and drug resistance towards the tested antibiotics suggests that NTM can no more be ignored as a contaminant, reiterating the need for periodic surveillance and species-specific treatment for effective management of diseases caused by NTM.
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Butler TE, Lee AJ, Yang Y, Newton MD, Kargupta R, Puttaswamy S, Sengupta S. Direct-from-sputum rapid phenotypic drug susceptibility test for mycobacteria. PLoS One 2020; 15:e0238298. [PMID: 32857802 PMCID: PMC7454970 DOI: 10.1371/journal.pone.0238298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 08/13/2020] [Indexed: 12/18/2022] Open
Abstract
Background The spread of multi-drug resistant tuberculosis (MDR-TB) is a leading global public-health challenge. Because not all biological mechanisms of resistance are known, culture-based (phenotypic) drug-susceptibility testing (DST) provides important information that influences clinical decision-making. Current phenotypic tests typically require pre-culture to ensure bacterial loads are at a testable level (taking 2–4 weeks) followed by 10–14 days to confirm growth or lack thereof. Methods and findings We present a 2-step method to obtain DST results within 3 days of sample collection. The first involves selectively concentrating live mycobacterial cells present in relatively large volumes of sputum (~2-10mL) using commercially available magnetic-nanoparticles (MNPs) into smaller volumes, thereby bypassing the need for pre-culture. The second involves using microchannel Electrical Impedance Spectroscopy (m-EIS) to monitor multiple aliquots of small volumes (~10μL) of suspension containing mycobacterial cells, MNPs, and candidate-drugs to determine whether cells grow, die, or remain static under the conditions tested. m-EIS yields an estimate for the solution “bulk capacitance” (Cb), a parameter that is proportional to the number of live bacteria in suspension. We are thus able to detect cell death (bactericidal action of the drug) in addition to cell-growth. We demonstrate proof-of-principle using M. bovis BCG and M. smegmatis suspended in artificial sputum. Loads of ~ 2000–10,000 CFU of mycobacteria were extracted from ~5mL of artificial sputum during the decontamination process with efficiencies of 84% -100%. Subsequently, suspensions containing ~105 CFU/mL of mycobacteria with 10 mg/mL of MNPs were monitored in the presence of bacteriostatic and bactericidal drugs at concentrations below, at, and above known MIC (Minimum Inhibitory Concentration) values. m-EIS data (ΔCb) showed data consistent with growth, death or stasis as expected and/or recorded using plate counts. Electrical signals of death were visible as early as 3 hours, and growth was seen in < 3 days for all samples, allowing us to perform DST in < 3 days. Conclusion We demonstrated “proof of principle” that (a) live mycobacteria can be isolated from sputum using MNPs with high efficiency (almost all the bacteria that survive decontamination) and (b) that the efficacy of candidate drugs on the mycobacteria thus isolated (in suspensions containing MNPs) could be tested in real-time using m-EIS.
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Affiliation(s)
- Timothy E. Butler
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, Missouri, United States of America
| | - Aiden J. Lee
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, Missouri, United States of America
| | - Yongqiang Yang
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, Missouri, United States of America
| | | | - Roli Kargupta
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, Missouri, United States of America
| | - Sachidevi Puttaswamy
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, Missouri, United States of America
| | - Shramik Sengupta
- Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, Missouri, United States of America
- * E-mail:
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Silva SYBE, Pinto ESG, Medeiros ERD, Rebouças DGDC, Paiva ACDS, Nascimento CPAD, Souza NLD. Strategies for the evaluation of interventions for the control of tuberculosis: integrative review. Rev Bras Enferm 2019; 72:1370-1377. [DOI: 10.1590/0034-7167-2017-0922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/05/2018] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: Identifying the available evidence in the scientific literature about the strategies used in the evaluations of interventions for the control of tuberculosis. Method: Integrative review with searches in databases Lilacs, CINAHL and PubMed in August 2017. Thirty-three articles were selected and the theoretical referential of health assessment was used for analysis. Results: The prevalent interventions were health programs (60.7%), 69.7% focusing on results and 81.9% having quantitative character (81.9%). Final considerations: The evaluation of interventions for the control of tuberculosis is beneficial for the health services’ users and aids in the decision making of managers and health professionals.
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Fan L, Li D, Zhang S, Yao L, Hao X, Gu J, Li H, Niu J, Zhang Z, Zhu C. Parallel Tests Using Culture, Xpert MTB/RIF, and SAT-TB in Sputum Plus Bronchial Alveolar Lavage Fluid Significantly Increase Diagnostic Performance of Smear-Negative Pulmonary Tuberculosis. Front Microbiol 2018; 9:1107. [PMID: 29973917 PMCID: PMC6020777 DOI: 10.3389/fmicb.2018.01107] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 05/08/2018] [Indexed: 11/18/2022] Open
Abstract
At present, tuberculosis remains a serious threat to human health. The diagnosis of pulmonary tuberculosis (PTB) is still difficult, and the prominent challenge for diagnosis is the lack of a highly sensitive and specific method. In order to explore the diagnostic value of parallel tests, this study prospectively enrolled 258 patients with smear-negative PTB from May 2, 2015 to December 31, 2016. The sputum specimens and bronchial alveolar lavage fluid (BALF) samples from all patients were assessed for MTB detection by culture, Xpert MTB/RIF, and simultaneous amplification and testing method for TB (SAT-TB). Overall, the sensitivity of any single test using culture, Xpert MTB/RIF, or SAT-TB was lower than that for parallel tests (p < 0.05), and the sensitivity rates for MTB detection in BALF were significantly higher than those in sputum samples. There were lower agreements in the detection results between sputum samples and BALF for all tests (p < 0.05). The parallel tests models of using culture plus Xpert MTB/RIF plus SAT-TB, culture plus Xpert, or culture plus SAT-TB achieved higher sensitivities compared with all three single test models (p < 0.05). Additionally, joint detection using sputum and BALF samples achieved a high sensitivity (0.8566, 95% CI: 0.8086–0.8941). In conclusion, the parallel tests model using culture, Xpert MTB/RIF, and SAT-TB in sputum plus BALF significantly increases the diagnostic performance of smear-negative PTB; thus, this method should be applied clinically when PTB is suspected but smear results are negative.
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Affiliation(s)
- Lin Fan
- Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Danfeng Li
- Department of Laboratory Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Shaojun Zhang
- Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lan Yao
- Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaohui Hao
- Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jin Gu
- Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hong Li
- Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jinxia Niu
- Department of Laboratory Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Zhemin Zhang
- Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Changtai Zhu
- Department of Laboratory Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Sanogo M, Kone B, Diarra B, Maiga M, Baya B, Somboro AM, Sarro YS, Togo ACG, Dembele BPP, Goita D, Kone A, M'Baye O, Coulibaly N, Diabate S, Traore B, Diallo MH, Coulibaly YI, Saleeb P, Belson M, Orsega S, Siddiqui S, Polis MA, Dao S, Murphy RL, Diallo S. Performance of microscopic observation drug susceptibility for the rapid diagnosis of tuberculosis and detection of drug resistance in Bamako, Mali. Clin Microbiol Infect 2017; 23:408.e1-408.e6. [PMID: 28110049 PMCID: PMC5441965 DOI: 10.1016/j.cmi.2017.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 11/08/2016] [Accepted: 01/04/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES In Mali early detection and treatment of multidrug-resistant tuberculosis (MDR-TB) are still challenging due to the cost, time and/or complexity associated with regular tests. Microscopic Observation Drug Susceptibility (MODS) is a low-cost assay validated by WHO in 2010. It is a liquid-culture-based assay to detect the 'cording' characteristic of Mycobacterium tuberculosis complex and to assess susceptibility to both isoniazid and rifampicin defining multidrug-resistant tuberculosis (MDR-TB). In this study we aimed to evaluate the performance of MODS as diagnostic tool compared with a validated method-Mycobacteria Growth Indicator Tube/Antimicrobial Susceptibility Testing/Streptomycin, Isoniazid, Rifampicin and Ethambutol (MGIT/AST/SIRE). METHODS AND RESULTS Between January 2010 and October 2015 we included 98 patients with suspected TB in an observational cohort study. The sensitivity and specificity of MODS assay for detecting TB were respectively 94.12% and 85.71% compared with the reference MGIT/7H11 culture, with a Cohen κ coefficient of 0.78 (95% CI 0.517-1.043). The median time to culture positivity for MODS assay and MGIT (plus interquartile range, IQR) was respectively 8 days (IQR 5-11) and 6 days (IQR 5-6). In detecting patients with MDR-TB, the sensitivity and specificity of MODS assay were respectively 100% and 95.92%. The positive predictive value and negative predictive value were, respectively, 66.7% and 100%. The median turnaround times for obtaining MDR-TB results using MODS assay and MGIT/AST/SIRE was respectively 9 days and 35 days. Hence, the MODS assay rapidly identifies MDR-TB in Mali compared with the MGIT/AST/SIRE. CONCLUSION As an easy, simple, fast and affordable method, the MODS assay could significantly improve the management of TB.
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Affiliation(s)
- M Sanogo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Kone
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Diarra
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali; Institute of Tropical Medicine (ITM), Biomedical Department, Antwerp, Belgium.
| | - M Maiga
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali; Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., NCI Campus at Frederick, Frederick, MD, USA
| | - B Baya
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A M Somboro
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Y S Sarro
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A C G Togo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B P P Dembele
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - D Goita
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Kone
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - O M'Baye
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - N Coulibaly
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Diabate
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Traore
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M H Diallo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Y I Coulibaly
- Filariasis Unit of the Malaria Research and Training Centre (MRTC), USTTB, Bamako, Mali
| | - P Saleeb
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - M Belson
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - S Orsega
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - S Siddiqui
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - M A Polis
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - S Dao
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - R L Murphy
- Division of Infectious Diseases, Northwestern University, Chicago, IL, USA
| | - S Diallo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
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