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Guyeux C, Senelle G, Le Meur A, Supply P, Gaudin C, Phelan JE, Clark TG, Rigouts L, de Jong B, Sola C, Refrégier G. Newly Identified Mycobacterium africanum Lineage 10, Central Africa. Emerg Infect Dis 2024; 30:560-563. [PMID: 38407162 PMCID: PMC10902520 DOI: 10.3201/eid3003.231466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Analysis of genome sequencing data from >100,000 genomes of Mycobacterium tuberculosis complex using TB-Annotator software revealed a previously unknown lineage, proposed name L10, in central Africa. Phylogenetic reconstruction suggests L10 could represent a missing link in the evolutionary and geographic migration histories of M. africanum.
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Dahl VN, Butova T, Rosenthal A, Grinev A, Gabrielian A, Vashakidze S, Shubladze N, Toxanbayeva B, Chingissova L, Crudu V, Chesov D, Kalmambetova G, Saparova G, Wejse CM, Butov D. Drug-Resistant Tuberculosis, Georgia, Kazakhstan, Kyrgyzstan, Moldova, and Ukraine, 2017-2022. Emerg Infect Dis 2024; 30:831-833. [PMID: 38526186 PMCID: PMC10977852 DOI: 10.3201/eid3004.231732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
In 2021, the World Health Organization recommended new extensively drug-resistant (XDR) and pre-XDR tuberculosis (TB) definitions. In a recent cohort of TB patients in Eastern Europe, we show that XDR TB as currently defined is associated with exceptionally poor treatment outcomes, considerably worse than for the former definition (31% vs. 54% treatment success).
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Spies R, Hong HN, Trieu PP, Lan LK, Lan K, Hue NN, Huong NTL, Thao TTLN, Quang NL, Anh TDD, Vinh TV, Ha DTM, Dat PT, Hai NP, Van LH, Thwaites GE, Thuong NTT, Watson JA, Walker TM. Spatial Analysis of Drug-Susceptible and Multidrug-Resistant Cases of Tuberculosis, Ho Chi Minh City, Vietnam, 2020-2023. Emerg Infect Dis 2024; 30:499-509. [PMID: 38407176 PMCID: PMC10902525 DOI: 10.3201/eid3003.231309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
We characterized the spatial distribution of drug-susceptible (DS) and multidrug-resistant (MDR) tuberculosis (TB) cases in Ho Chi Minh City, Vietnam, a major metropolis in southeastern Asia, and explored demographic and socioeconomic factors associated with local TB burden. Hot spots of DS and MDR TB incidence were observed in the central parts of Ho Chi Minh City, and substantial heterogeneity was observed across wards. Positive spatial autocorrelation was observed for both DS TB and MDR TB. Ward-level TB incidence was associated with HIV prevalence and the male proportion of the population. No ward-level demographic and socioeconomic indicators were associated with MDR TB case count relative to total TB case count. Our findings might inform spatially targeted TB control strategies and provide insights for generating hypotheses about the nature of the relationship between DS and MDR TB in Ho Chi Minh City and the wider southeastern region of Asia.
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Mullen B, Houpt ER, Colston J, Becker L, Johnson S, Young L, Hearn J, Falkinham J, Heysell SK. Geographic Variation and Environmental Predictors of Nontuberculous Mycobacteria in Laboratory Surveillance, Virginia, USA, 2021-2023 1. Emerg Infect Dis 2024; 30:548-554. [PMID: 38407146 PMCID: PMC10902533 DOI: 10.3201/eid3003.231162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Because epidemiologic and environmental risk factors for nontuberculous mycobacteria (NTM) have been reported only infrequently, little information exists about those factors. The state of Virginia, USA, requires certain ecologic features to be included in reports to the Virginia Department of Health, presenting a unique opportunity to study those variables. We analyzed laboratory reports of Mycobacterium avium complex (MAC) and M. abscessus infections in Virginia during 2021-2023. MAC/M. abscessus was isolated from 6.19/100,000 persons, and 2.37/100,000 persons had MAC/M. abscessus lung disease. M. abscessus accounted for 17.4% and MAC for 82.6% of cases. Saturated vapor pressure was associated with MAC/M. abscessus prevalence (prevalence ratio 1.414, 95% CI 1.011-1.980; p = 0.043). Self-supplied water use was a protective factor (incidence rate ratio 0.304, 95% CI 0.098-0.950; p = 0.041). Our findings suggest that a better understanding of geographic clustering and environmental water exposures could help develop future targeted prevention and control efforts.
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Günther G, Mhuulu L, Diergaardt A, Dreyer V, Moses M, Anyolo K, Ruswa N, Claassens M, Niemann S, Nepolo E. Bedaquiline Resistance after Effective Treatment of Multidrug-Resistant Tuberculosis, Namibia. Emerg Infect Dis 2024; 30:568-571. [PMID: 38407158 PMCID: PMC10902537 DOI: 10.3201/eid3003.240134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Bedaquiline is currently a key drug for treating multidrug-resistant or rifampin-resistant tuberculosis. We report and discuss the unusual development of resistance to bedaquiline in a teenager in Namibia, despite an optimal background regimen and adherence. The report highlights the risk for bedaquiline resistance development and the need for rapid drug-resistance testing.
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Humayun M, Mukasa L, Ye W, Bates JH, Yang Z. Racial and Ethnic Disparities in Tuberculosis Incidence, Arkansas, USA, 2010-2021. Emerg Infect Dis 2024; 30:116-124. [PMID: 38146997 PMCID: PMC10756389 DOI: 10.3201/eid3001.230778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
We conducted an epidemiologic assessment of disease distribution by race/ethnicity to identify subpopulation-specific drivers of tuberculosis (TB). We used detailed racial/ethnic categorizations for the 932 TB cases diagnosed in Arkansas, USA, during 2010-2021. After adjusting for age and sex, racial/ethnic disparities persisted; the Native Hawaiian/Pacific Islander (NHPI) group had the highest risk for TB (risk ratio 173.6, 95% CI 140.6-214.2) compared with the non-Hispanic White group, followed by Asian, Hispanic, and non-Hispanic Black. Notable racial/ethnic disparities existed across all age groups; NHPI persons 0-14 years of age were at a particularly increased risk for TB (risk ratio 888, 95% CI 403-1,962). The risks for sputum smear-positive pulmonary TB and extrapulmonary TB were both significantly higher for racial/ethnic minority groups. Our findings suggest that TB control in Arkansas can benefit from a targeted focus on subpopulations at increased risk for TB.
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Nsengiyumva NP, Khan A, Gler MMTS, Tonquin ML, Marcelo D, Andrews MC, Duverger K, Ahmed S, Ibrahim T, Banu S, Sultana S, Morales ML, Villanueva A, Efo E, Onjare B, Celan C, Schwartzman K. Costs of Digital Adherence Technologies for Tuberculosis Treatment Support, 2018-2021. Emerg Infect Dis 2024; 30:79-88. [PMID: 38146969 PMCID: PMC10756355 DOI: 10.3201/eid3001.230427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
Digital adherence technologies are increasingly used to support tuberculosis (TB) treatment adherence. Using microcosting, we estimated healthcare system costs (in 2022 US dollars) of 2 digital adherence technologies, 99DOTS medication sleeves and video-observed therapy (VOT), implemented in demonstration projects during 2018-2021. We also obtained cost estimates for standard directly observed therapy (DOT). Estimated per-person costs of 99DOTS for drug-sensitive TB were $98 in Bangladesh (n = 719), $119 in the Philippines (n = 396), and $174 in Tanzania (n = 976). Estimated per-person costs of VOT were $1,154 in Haiti (87 drug-sensitive), $304 in Moldova (173 drug-sensitive), $452 in Moldova (135 drug-resistant), and $661 in the Philippines (110 drug-resistant). 99DOTS costs may be similar to or less expensive than standard DOT. VOT is more expensive, although in some settings, labor cost offsets or economies of scale may yield savings. 99DOTS and VOT may yield savings to local programs if donors cover infrastructure costs.
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Singh N, Khare R, Mazumder S. Mycobacterium senegalense Infection in Kidney Transplant Patient with Diabetes, Memphis, Tennessee, USA. Emerg Infect Dis 2024; 30:192-194. [PMID: 38147514 PMCID: PMC10756380 DOI: 10.3201/eid3001.231013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Abstract
Fewer than 30 cases of Mycobacterium senegalense infection have been reported. We report a complicated case of M. senegalense infection in Memphis, Tennessee, in the southeastern United States. The patient's comorbidities of past organ transplant and insulin-dependent diabetes required delicate consideration of those health conditions to guide treatment.
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LaFleur M, Rasoanaivo HA, Andrianarivo TH, Andrianomanana FR, McKernan S, Raherison MS, Andrianantenaina R, Miller M, Ratsimbazafy J, Lapierre SG, Ranaivomanana P, Rakotosamimanana N. Tuberculosis in Lemurs and a Fossa at National Zoo, Madagascar, 2022. Emerg Infect Dis 2023; 29:2587-2589. [PMID: 37987598 PMCID: PMC10683818 DOI: 10.3201/eid2912.231159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
We diagnosed Mycobacterium tuberculosis in captive lemurs and a fossa in Antananarivo, Madagascar. We noted clinical signs in the animals and found characteristic lesions during necropsy. The source of infection remains unknown. Our results illustrate the potential for reverse zoonotic infections and intraspecies transmission of tuberculosis in captive wildlife.
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Modongo C, Barilar I, Wang Q, Molefi T, Makhondo T, Niemann S, Shin SS. Tuberculosis Variant with Rifampin Resistance Undetectable by Xpert MTB/RIF, Botswana. Emerg Infect Dis 2023; 29:2403-2406. [PMID: 37877680 PMCID: PMC10617350 DOI: 10.3201/eid2911.230987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
GeneXpert MTB/RIF, a tool widely used for diagnosing tuberculosis, has limitations for detecting rifampin resistance in certain variants. We report transmission of a pre-extensively drug-resistant variant in Botswana that went undetected by GeneXpert. The public health impact of misdiagnosis emphasizes the need for comprehensive molecular testing to identify resistance and guide treatment.
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Winston CA, Marks SM, Carr W. Estimated Costs of 4-Month Pulmonary Tuberculosis Treatment Regimen, United States. Emerg Infect Dis 2023; 29:2102-2104. [PMID: 37735769 PMCID: PMC10521593 DOI: 10.3201/eid2910.230314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
We estimated direct costs of a 4-month or 6-month regimen for drug-susceptible pulmonary tuberculosis treatment in the United States. Costs were $23,000 per person treated. Actual treatment costs will vary depending on examination and medication charges, as well as expenses associated with directly observed therapy.
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Nabity SA, Marks SM, Goswami ND, Smith SR, Timme E, Price SF, Gross L, Self JL, Toren KG, Narita M, Wegener DH, Wang SH. Characteristics of and Deaths among 333 Persons with Tuberculosis and COVID-19 in Cross-Sectional Sample from 25 Jurisdictions, United States. Emerg Infect Dis 2023; 29:2016-2023. [PMID: 37647628 PMCID: PMC10521611 DOI: 10.3201/eid2910.230286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Little is known about co-occurring tuberculosis (TB) and COVID-19 in low TB incidence settings. We obtained a cross-section of 333 persons in the United States co-diagnosed with TB and COVID-19 within 180 days and compared them to 4,433 persons with TB only in 2020 and 18,898 persons with TB during 2017‒2019. Across both comparison groups, a higher proportion of persons with TB-COVID-19 were Hispanic, were long-term care facility residents, and had diabetes. When adjusted for age, underlying conditions, and TB severity, COVID-19 co-infection was not statistically associated with death compared with TB infection only in 2020 (adjusted prevalence ratio 1.0 [95% CI 0.8‒1.4]). Among TB-COVID-19 patients, death was associated with a shorter interval between TB and COVID-19 diagnoses, older age, and being immunocompromised (non-HIV). TB-COVID-19 deaths in the United States appear to be concentrated in subgroups sharing characteristics known to increase risk for death from either disease alone.
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McNamara BJ, Blasdell KR, Yerramilli A, Smith IL, Clayton SL, Dunn M, Tay EL, Gibney KB, Waidyatillake NT, Hussain MA, Muleme M, O'Brien DP, Athan E. Comprehensive Case-Control Study of Protective and Risk Factors for Buruli Ulcer, Southeastern Australia. Emerg Infect Dis 2023; 29:2032-2043. [PMID: 37735741 PMCID: PMC10521623 DOI: 10.3201/eid2910.230011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
To examine protective and risk factors for Buruli ulcer (BU), we conducted a case-control study of 245 adult BU cases and 481 postcode-matched controls across BU-endemic areas of Victoria, Australia. We calculated age- and sex-adjusted odds ratios for socio-environmental, host, and behavioral factors associated with BU by using conditional logistic regression. Odds of BU were >2-fold for persons with diabetes mellitus and persons working outdoors who had soil contact in BU-endemic areas (compared with indoor work) but were lower among persons who had bacillus Calmette-Guérin vaccinations. BU was associated with increasing numbers of possums and with ponds and bore water use at residences. Using insect repellent, covering arms and legs outdoors, and immediately washing wounds were protective; undertaking multiple protective behaviors was associated with the lowest odds of BU. Skin hygiene/protection behaviors and previous bacillus Calmette-Guérin vaccination might provide protection against BU in BU-endemic areas.
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Louie JK, Agraz-Lara R, Romo L, Deiterich C, Xing C, Graves S. Uniting for Ukraine Tuberculosis Screening Experience, San Francisco, California, USA. Emerg Infect Dis 2023; 29:1651-1654. [PMID: 37486210 PMCID: PMC10370851 DOI: 10.3201/eid2908.230347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Ukraine surveillance data suggest high tuberculosis (TB) incidence, including multidrug resistance. Of 299 newcomers from Ukraine screened in San Francisco, California, USA, by using an interferon-γ-release-assay (IGRA) and chest radiograph, 7.4% were IGRA positive and 1 had laboratory-confirmed pansusceptible TB. Screening with IGRA and chest radiograph can help characterize TB risk.
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Abstract
Florida, USA, has witnessed an increased incidence of leprosy cases lacking traditional risk factors. Those trends, in addition to decreasing diagnoses in foreign-born persons, contribute to rising evidence that leprosy has become endemic in the southeastern United States. Travel to Florida should be considered when conducting leprosy contact tracing in any state.
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Mejia-Chew C, Chavez MA, Lian M, McKee A, Garrett L, Bailey TC, Spec A, Agarwal M, Turabelidze G. Spatial Epidemiologic Analysis and Risk Factors for Nontuberculous Mycobacteria Infections, Missouri, USA, 2008-2019. Emerg Infect Dis 2023; 29:1540-1546. [PMID: 37486160 PMCID: PMC10370856 DOI: 10.3201/eid2908.230378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Nontuberculous mycobacteria (NTM) infections are caused by environmental exposure. We describe spatial distribution of NTM infections and associations with sociodemographic factors and flooding in Missouri, USA. Our retrospective analysis of mycobacterial cultures reported to the Missouri Department of Health and Social Services surveillance system during January 1, 2008-December 31, 2019, detected geographic clusters of infection. Multilevel Poisson regression quantified small-area geographic variations and identified characteristics associated with risk for infection. Median county-level NTM infection rate was 66.33 (interquartile range 51-91)/100,000 persons. Risk of clustering was significantly higher in rural areas (rate ratio 2.82, 95% CI 1.90-4.19) and in counties with >5 floodings per year versus no flooding (rate ratio 1.38, 95% CI 1.26-1.52). Higher risk for NTM infection was associated with older age, rurality, and more flooding. Clinicians and public health professionals should be aware of increased risk for NTM infections, especially in similar environments.
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Shapiro K, Cross SJ, Morton TH, Inaba H, Holland A, Fasipe FR, Adderson EE. Healthcare-Associated Infections Caused by Mycolicibacterium neoaurum. Emerg Infect Dis 2023; 29. [PMID: 37486155 PMCID: PMC10370869 DOI: 10.3201/eid2908.230007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Mycolicibacterium neoaurum is a rapidly growing mycobacterium and an emerging cause of human infections. M. neoaurum infections are uncommon but likely underreported, and our understanding of the disease spectrum and optimum management is incomplete. We summarize demographic and clinical characteristics of a case of catheter-related M. neoaurum bacteremia in a child with leukemia and those of 36 previously reported episodes of M. neoaurum infection. Most infections occurred in young to middle-aged adults with serious underlying medical conditions and commonly involved medical devices. Overall, infections were not associated with severe illness or death. In contrast to other mycobacteria species, M. neoaurum was generally susceptible to multiple antimicrobial drugs and responded promptly to treatment, and infections were associated with good outcomes after relatively short therapy duration and device removal. Delays in identification and susceptibility testing were common. We recommend using combination antimicrobial drug therapy and removal of infected devices to eradicate infection.
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Keita ML, Morsli M, Levy M, Basse G, Verrier C, Drancourt M. Detection of Mycobacterium angelicum in Human Urinary Tract, French Polynesia. Emerg Infect Dis 2023; 29:1490-1492. [PMID: 37347937 PMCID: PMC10310377 DOI: 10.3201/eid2907.221864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
We definitively characterized Mycobacterium angelicum, an aquatic zoonotic opportunistic pathogen of the M. szulgai complex, using a polyphasic approach that included whole-genome sequencing. The sequence was obtained on the island of Tahiti, French Polynesia, from a urine specimen collected from a patient experiencing a urinary tract infection.
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Woodruff R, Miramontes R. Tuberculosis Infection among Non-US-Born Persons and Persons ≥60 Years of Age, United States, 2019-2020. Emerg Infect Dis 2023; 29:1470-1472. [PMID: 37347846 PMCID: PMC10310369 DOI: 10.3201/eid2907.230324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
We examined tuberculosis (TB) infection results for the United States from the 2019-2020 National Health and Nutrition Examination Survey. Over this period, 10% of non-US-born persons and 7% of those >60 years of age tested positive for TB infection. These results provide up-to-date information on TB infection among study subpopulations.
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Gerdes ME, Miko S, Kunz JM, Hannapel EJ, Hlavsa MC, Hughes MJ, Stuckey MJ, Francois Watkins LK, Cope JR, Yoder JS, Hill VR, Collier SA. Estimating Waterborne Infectious Disease Burden by Exposure Route, United States, 2014. Emerg Infect Dis 2023; 29:1357-1366. [PMID: 37347505 PMCID: PMC10310388 DOI: 10.3201/eid2907.230231] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
More than 7.15 million cases of domestically acquired infectious waterborne illnesses occurred in the United States in 2014, causing 120,000 hospitalizations and 6,600 deaths. We estimated disease incidence for 17 pathogens according to recreational, drinking, and nonrecreational nondrinking (NRND) water exposure routes by using previously published estimates. In 2014, a total of 5.61 million (95% credible interval [CrI] 2.97-9.00 million) illnesses were linked to recreational water, 1.13 million (95% CrI 255,000-3.54 million) to drinking water, and 407,000 (95% CrI 72,800-1.29 million) to NRND water. Recreational water exposure was responsible for 36%, drinking water for 40%, and NRND water for 24% of hospitalizations from waterborne illnesses. Most direct costs were associated with pathogens found in biofilms. Estimating disease burden by water exposure route helps direct prevention activities. For each exposure route, water management programs are needed to control biofilm-associated pathogen growth; public health programs are needed to prevent biofilm-associated diseases.
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Affiliation(s)
| | | | - Jasen M. Kunz
- Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes)
- Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)
| | - Elizabeth J. Hannapel
- Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes)
- Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)
| | - Michele C. Hlavsa
- Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes)
- Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)
| | - Michael J. Hughes
- Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes)
- Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)
| | - Matthew J. Stuckey
- Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes)
- Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)
| | - Louise K. Francois Watkins
- Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes)
- Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)
| | - Jennifer R. Cope
- Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes)
- Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)
| | - Jonathan S. Yoder
- Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes)
- Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)
| | - Vincent R. Hill
- Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes)
- Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)
| | - Sarah A. Collier
- Chenega Corporation, Atlanta, Georgia, USA (M.E. Gerdes)
- Centers for Disease Control and Prevention, Atlanta (M.E. Gerdes, S. Miko, J.M. Kunz, E.J. Hannapel, M.C. Hlavsa, M.J. Hughes, M.J. Stuckey, L.K. Francois Watkins, J.R. Cope, J.S. Yoder, V.R. Hill, S.A. Collier)
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Collin SM, Lima A, Heringer S, Sanders V, Pessotti HA, Deps P. Systematic Review of Hansen Disease Attributed to Mycobacterium lepromatosis. Emerg Infect Dis 2023; 29:1376-1385. [PMID: 37347507 PMCID: PMC10310392 DOI: 10.3201/eid2907.230024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
In 2008, bacilli from 2 Hansen disease (leprosy) cases were identified as a new species, Mycobacterium lepromatosis. We conducted a systematic review of studies investigating M. lepromatosis as a cause of HD. Twenty-one case reports described 27 patients with PCR-confirmed M. lepromatosis infection (6 dual M. leprae/M. lepromatosis): 10 case-patients in the United States (7 originally from Mexico), 6 in Mexico, 3 in the Dominican Republic, 2 each in Singapore and Myanmar, and 1 each in Indonesia, Paraguay, Cuba, and Canada. Twelve specimen surveys reported 1,098 PCR-positive findings from 1,428 specimens, including M. lepromatosis in 44.9% (133/296) from Mexico, 3.8% (5/133) in Colombia, 12.5% (10/80) in Brazil, and 0.9% (2/224) from the Asia-Pacific region. Biases toward investigating M. lepromatosis as an agent in cases of diffuse lepromatous leprosy or from Mesoamerica precluded conclusions about clinicopathologic manifestations and geographic distribution. Current multidrug treatments seem effective for this infection.
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Marras TK, Nelson P, Peci A, Richard-Greenblatt M, Brode S, Sullivan A, Jamieson FB, Kus JV. Pulmonary Nontuberculous Mycobacteria, Ontario, Canada, 2020. Emerg Infect Dis 2023; 29:1415-1419. [PMID: 37347810 PMCID: PMC10310396 DOI: 10.3201/eid2907.230216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
We measured annual prevalence of microbiologically defined nontuberculous mycobacterial lung disease in Ontario, Canada. Mycobacterium avium prevalence was 13 cases/100,000 persons in 2020, a 2.5-fold increase from 2010, indicating a large increase in true M. avium lung disease. During the same period, M. xenopi decreased nearly 50%, to 0.84 cases/100,000 persons.
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Mah J, Walding K, Liang B, Rinsky L, Mathew R, Budvytiene I, Banaei N. Mycobacterium marinum Infection after Iguana Bite in Costa Rica. Emerg Infect Dis 2023; 29:1278-1280. [PMID: 37209698 PMCID: PMC10202850 DOI: 10.3201/eid2906.230062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
Infections after reptile bites are uncommon, and microbial etiologies are not well defined. We describe a case of Mycobacterium marinum soft-tissue infection after an iguana bite in Costa Rica that was diagnosed through 16S rRNA sequencing and mycobacterial culture. This case informs providers of potential etiologies of infection after iguana bites.
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Noroc E, Chesov D, Merker M, Gröschel MI, Barilar I, Dreyer V, Ciobanu N, Reimann M, Crudu V, Lange C. Limited Nosocomial Transmission of Drug-Resistant Tuberculosis, Moldova. Emerg Infect Dis 2023; 29:1046-1050. [PMID: 37081601 PMCID: PMC10124655 DOI: 10.3201/eid2905.230035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Applying whole-genome-sequencing, we aimed to detect transmission events of multidrug-resistant/rifampin-resistant strains of Mycobacterium tuberculosis complex at a tuberculosis hospital in Chisinau, Moldova. We recorded ward, room, and bed information for each patient and monitored in-hospital transfers over 1 year. Detailed molecular and patient surveillance revealed only 2 nosocomial transmission events.
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25
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Millard J, Rimmer S, Nimmo C, O'Donnell M. Therapeutic Failure and Acquired Bedaquiline and Delamanid Resistance in Treatment of Drug-Resistant TB. Emerg Infect Dis 2023; 29:1081-1084. [PMID: 37081529 PMCID: PMC10124645 DOI: 10.3201/eid2905.221716] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
New classes of antitubercular drugs, diarylquinolines and nitroimidazoles, have been associated with improved outcomes in the treatment of drug-resistant tuberculosis, but that success is threatened by emerging drug resistance. We report a case of bedaquiline and delamanid resistance in a 55-year-old woman in South Africa with extensively drug-resistant tuberculosis and known HIV.
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Baker CR, Barilar I, de Araujo LS, Rimoin AW, Parker DM, Boyd R, Tobias JL, Moonan PK, Click ES, Finlay A, Oeltmann JE, Minin VN, Modongo C, Zetola NM, Niemann S, Shin SS. Use of High-Resolution Geospatial and Genomic Data to Characterize Recent Tuberculosis Transmission, Botswana. Emerg Infect Dis 2023; 29:977-987. [PMID: 37081530 PMCID: PMC10124643 DOI: 10.3201/eid2905.220796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Combining genomic and geospatial data can be useful for understanding Mycobacterium tuberculosis transmission in high-burden tuberculosis (TB) settings. We performed whole-genome sequencing on M. tuberculosis DNA extracted from sputum cultures from a population-based TB study conducted in Gaborone, Botswana, during 2012-2016. We determined spatial distribution of cases on the basis of shared genotypes among isolates. We considered clusters of isolates with ≤5 single-nucleotide polymorphisms identified by whole-genome sequencing to indicate recent transmission and clusters of ≥10 persons to be outbreaks. We obtained both molecular and geospatial data for 946/1,449 (65%) participants with culture-confirmed TB; 62 persons belonged to 5 outbreaks of 10-19 persons each. We detected geospatial clustering in just 2 of those 5 outbreaks, suggesting heterogeneous spatial patterns. Our findings indicate that targeted interventions applied in smaller geographic areas of high-burden TB identified using integrated genomic and geospatial data might help interrupt TB transmission during outbreaks.
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Nguyen HV, Brals D, Tiemersma E, Gasior R, Nguyen NV, Nguyen HB, Van Nguyen H, Le Thi NA, Cobelens F. Influence of Sex and Sex-Based Disparities on Prevalent Tuberculosis, Vietnam, 2017-2018. Emerg Infect Dis 2023; 29:967-976. [PMID: 37081548 PMCID: PMC10124636 DOI: 10.3201/eid2905.221476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
To assess sex disparities in tuberculosis in Vietnam, we conducted a nested, case-control study based on a 2017 tuberculosis prevalence survey. We defined the case group as all survey participants with laboratory-confirmed tuberculosis and the control group as a randomly selected group of participants with no tuberculosis. We used structural equation modeling to describe pathways from sex to tuberculosis according to an a priori conceptual framework. Our analysis included 1,319 participants, of whom 250 were case-patients. We found that sex was directly associated with tuberculosis prevalence (adjusted odds ratio for men compared with women 3.0 [95% CI 1.7-5.0]) and indirectly associated through other domains. The strong sex difference in tuberculosis prevalence is explained by a complex interplay of factors relating to behavioral and environmental risks, access to healthcare, and clinical manifestations. However, after controlling for all those factors, a direct sex effect remains that might be caused by biological factors.
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Sharma M, Mathesh K, Dandapat P, Mariappan AK, Kumar R, Kumari S, Kapur V, Maan S, Jindal N, Bansal N, Kadiwar R, Kumar A, Gupta N, Pawde AM, Sharma AK. Emergence of Mycobacterium orygis-Associated Tuberculosis in Wild Ruminants, India. Emerg Infect Dis 2023; 29:661-663. [PMID: 36823735 PMCID: PMC9973683 DOI: 10.3201/eid2903.221228] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Tuberculosis caused by Mycobacterium orygis was detected in 2 spotted deer from a wildlife sanctuary in western India and an Indian bison from a national park in central India. Nationwide surveillance is urgently required to clarify the epidemiology of the Mycobacterium tuberculosis complex at the human-livestock-wildlife interface.
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Meesawat S, Warit S, Hamada Y, Malaivijitnond S. Prevalence of Mycobacterium tuberculosis Complex among Wild Rhesus Macaques and 2 Subspecies of Long-Tailed Macaques, Thailand, 2018-2022. Emerg Infect Dis 2023; 29:551-560. [PMID: 36823033 PMCID: PMC9973699 DOI: 10.3201/eid2903.221486] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
We identified tuberculosis in 1,836 macaques from 6 wild rhesus (Macaca mulatta), 23 common long-tailed (M. fascicularis fascicularis), and 6 Burmese long-tailed (M. fascicularis aurea) macaque populations in Thailand. We captured, anesthetized, and collected throat, buccal, and rectal swab specimens from the macaques. We screened swabs for Mycobacterium tuberculosis complex (MTBC) using insertion sequence 6110-specific nested PCR. We found higher MTBC prevalence at both population and individual levels among M. mulatta than M. fascicularis fascicularis macaques; all 3 M. fascicularis aurea macaque populations were positive for tuberculosis. We found that throat swab specimens provided the best sample medium for detecting MTBC. Our results showed no difference in MTBC prevalence between male and female animals, but a higher percentage of adults were infected than subadults and juveniles. Although we detected no association between frequency of human-macaque interaction and MTBC prevalence, bidirectional zoonotic transmission should be considered a possible public health concern.
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Lukoye D, Gustavson G, Namuwenge PM, Muchuro S, Birabwa E, Dejene S, Ssempiira J, Kalamya JN, Baveewo S, Ferroussier-Davis O, Mills LA, Dirlikov E, Nelson LJ, Turyahabwe S. Tuberculosis Preventive Therapy among Persons Living with HIV, Uganda, 2016-2022. Emerg Infect Dis 2023; 29:609-613. [PMID: 36823496 PMCID: PMC9973710 DOI: 10.3201/eid2903.221353] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
During October 2016-March 2022, Uganda increased tuberculosis (TB) preventive therapy coverage among persons living with HIV from 0.6% to 88.8%. TB notification rates increased from 881.1 to 972.5 per 100,000 persons living with HIV. Timely TB screening, diagnosis, and earlier treatment should remain high priorities for TB/HIV prevention programming.
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Romero-Alvarez D, Garzon-Chavez D, Jackson M, Avanzi C, Peterson AT. Mycobacterium leprae in Armadillo Tissues from Museum Collections, United States. Emerg Infect Dis 2023; 29:622-626. [PMID: 36823763 PMCID: PMC9973711 DOI: 10.3201/eid2903.221636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
We examined armadillos from museum collections in the United States using molecular assays to detect leprosy-causing bacilli. We found Mycobacterium leprae bacilli in samples from the United States, Bolivia, and Paraguay; prevalence was 14.8% in nine-banded armadillos. US isolates belonged to subtype 3I-2, suggesting long-term circulation of this genotype.
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Miyahara R, Piboonsiri P, Chiyasirinroje B, Imsanguan W, Nedsuwan S, Yanai H, Tokunaga K, Palittapongarnpim P, Murray M, Mahasirimongkol S. Risk for Prison-to-Community Tuberculosis Transmission, Thailand, 2017-2020. Emerg Infect Dis 2023; 29:477-483. [PMID: 36823074 PMCID: PMC9973682 DOI: 10.3201/eid2903.221023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
To determine contributions of previously incarcerated persons to tuberculosis (TB) transmission in the community, we performed a healthcare facility-based cohort study of TB patients in Thailand during 2017-2020. We used whole-genome sequencing of Mycobacterium tuberculosis isolates from patients to identify genotypic clusters and assess the association between previous incarceration and TB transmission in the community. We identified 4 large genotype clusters (>10 TB patients/cluster); 28% (14/50) of the patients in those clusters were formerly incarcerated. Formerly incarcerated TB patients were more likely than nonincarcerated patients to be included in large clusters. TB patients within the large genotype clusters were geographically dispersed throughout Chiang Rai Province. Community TB transmission in the community was associated with the presence of formerly incarcerated individuals in Thailand. To reduce the risk for prison-to-community transmission, we recommend TB screening at the time of entry and exit from prisons and follow-up screening in the community.
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Ranson EL, Tsevat RK, von Bredow B, Kamau E, Yang S, Prabaker KK. Catheter-Related Bloodstream Infection Caused by Mycolicibacterium iranicum, California, USA. Emerg Infect Dis 2023; 29:217-219. [PMID: 36573647 PMCID: PMC9796217 DOI: 10.3201/eid2901.220851] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We describe a case of catheter-related bacteremia caused by Mycolicibacterium iranicum in the United States. The case highlights the value of using next-generation sequencing to identify infrequent and emerging pathogens and the challenges associated with choosing appropriate treatments because of limited knowledge of drug resistance mechanisms in those emerging pathogens.
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Oladele RO, Osaigbovo II, Akanmu AS, Adekanmbi OA, Ekeng BE, Mohammed Y, Alex-Wele MA, Okolo MO, Ayanbeku ST, Unigwe US, Akase IE, Dan-Jumbo A, Isralski D, Denning DW, Pasqualotto AC, Chiller T. Prevalence of Histoplasmosis among Persons with Advanced HIV Disease, Nigeria. Emerg Infect Dis 2022; 28:2261-2269. [PMID: 36286009 PMCID: PMC9622240 DOI: 10.3201/eid2811.220542] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
We sought to determine the prevalence of probable disseminated histoplasmosis among advanced HIV disease (AHD) patients in Nigeria. We conducted a cross-sectional study in 10 sites across 5 of 6 geopolitical zones in Nigeria. We identified patients with urinary samples containing CD4 cell counts <200 cells/mm3 or World Health Organization stage 3 or 4 disease who also had >2 clinical features of disseminated histoplasmosis, and we tested them for Histoplasma antigen using a Histoplasma enzyme immune assay. Of 988 participants we recruited, 76 (7.7%) were antigen-positive. The 76 Histoplasma antigen-positive participants had significantly lower (p = 0.03) CD4 counts; 9 (11.8%) were also co-infected with tuberculosis. Most antigen-positive participants (50/76; 65.8%; p = 0.015) had previously received antiretroviral treatment; 26/76 (34.2%) had not. Because histoplasmosis is often a hidden disease among AHD patients in Nigeria, Histoplasma antigen testing should be required in the AHD package of care.
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Diaz JCN, Anselmi M, Calvopiña M, Vera MEP, Cabrera YLC, Perlaza JJ, Cabezas LAO, Gaspar COR, Buonfrate D. Pulmonary Paragonimiasis in Native Community, Esmeraldas Province, Ecuador, 2022. Emerg Infect Dis 2022; 28:2114-2116. [PMID: 36148987 PMCID: PMC9514360 DOI: 10.3201/eid2810.220927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Paragonimiasis is a food-borne infection caused by several species of the Paragonimus fluke. Clinical manifestations can mimic tuberculosis and contribute to diagnostic delay. We report a cluster of paragonimiasis in a community in Ecuador, where active surveillance was set up after detection of the first 2 cases.
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McCreesh N, Mohlamonyane M, Edwards A, Olivier S, Dikgale K, Dayi N, Gareta D, Wood R, Grant AD, White RG, Middelkoop K. Improving Estimates of Social Contact Patterns for Airborne Transmission of Respiratory Pathogens. Emerg Infect Dis 2022; 28:2016-2026. [PMID: 36048756 PMCID: PMC9514345 DOI: 10.3201/eid2810.212567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Data on social contact patterns are widely used to parameterize age-mixing matrices in mathematical models of infectious diseases. Most studies focus on close contacts only (i.e., persons spoken with face-to-face). This focus may be appropriate for studies of droplet and short-range aerosol transmission but neglects casual or shared air contacts, who may be at risk from airborne transmission. Using data from 2 provinces in South Africa, we estimated age mixing patterns relevant for droplet transmission, nonsaturating airborne transmission, and Mycobacterium tuberculosis transmission, an airborne infection where saturation of household contacts occurs. Estimated contact patterns by age did not vary greatly between the infection types, indicating that widespread use of close contact data may not be resulting in major inaccuracies. However, contact in persons >50 years of age was lower when we considered casual contacts, and therefore the contribution of older age groups to airborne transmission may be overestimated.
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Laemmle-Ruff I, Graham SM, Williams B, Horyniak D, Majumdar SS, Paxton GA, Soares Caplice LV, Hellard ME, Trauer JM. Detecting Mycobacterium tuberculosis Infection in Children Migrating to Australia. Emerg Infect Dis 2022; 28:1833-1841. [PMID: 35997353 PMCID: PMC9423895 DOI: 10.3201/eid2809.212426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
In 2015, Australia updated premigration screening for tuberculosis (TB) disease in children 2-10 years of age to include testing for infection with Mycobacterium tuberculosis and enable detection of latent TB infection (LTBI). We analyzed TB screening results in children <15 years of age during November 2015-June 2017. We found 45,060 child applicants were tested with interferon-gamma release assay (IGRA) (57.7% of tests) or tuberculin skin test (TST) (42.3% of tests). A total of 21 cases of TB were diagnosed: 4 without IGRA or TST, 10 with positive IGRA or TST, and 7 with negative results. LTBI was detected in 3.3% (1,473/44,709) of children, for 30 applicants screened per LTBI case detected. LTBI-associated factors included increasing age, TB contact, origin from a higher TB prevalence region, and testing by TST. Detection of TB and LTBI benefit children, but the updated screening program's effect on TB in Australia is likely to be limited.
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Kherabi Y, Fréchet-Jachym M, Rioux C, Yazdanpanah Y, Méchaï F, Pourcher V, Robert J, Guglielmetti L. Revised Definitions of Tuberculosis Resistance and Treatment Outcomes, France, 2006-2019. Emerg Infect Dis 2022; 28:1796-1804. [PMID: 35997386 PMCID: PMC9423894 DOI: 10.3201/eid2809.220458] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Definitions of resistance in multidrug-resistant tuberculosis (MDR TB) and extensively drug-resistant tuberculosis (XDR TB) have been updated. Pre-XDR TB, defined as MDR TB with additional resistance to fluoroquinolones, and XDR TB, with additional resistance to bedaquiline or linezolid, are frequently associated with treatment failure and toxicity. We retrospectively determined the effects of pre-XDR/XDR TB resistance on outcomes and safety of MDR TB treatment in France. The study included 298 patients treated for MDR TB at 3 reference centers during 2006-2019. Of those, 205 (68.8%) cases were fluoroquinolone-susceptible MDR TB and 93 (31.2%) were pre-XDR/XDR TB. Compared with fluoroquinolone-susceptible MDR TB, pre-XDR/XDR TB was associated with more cavitary lung lesions and bilateral disease and required longer treatment. Overall, 202 patients (67.8%) had favorable treatment outcomes, with no significant difference between pre-XDR/XDR TB (67.7%) and fluoroquinolone-susceptible MDR TB (67.8%; p = 0.99). Pre-XDR/XDR TB was not associated with higher risk for serious adverse events.
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Campbell JR, Nsengiyumva P, Chiang LY, Jamieson F, Khadawardi H, Mah HKH, Oxlade O, Rasberry H, Rea E, Romanowski K, Sabur NF, Sander B, Uppal A, Johnston JC, Schwartzman K, Brode SK. Costs of Tuberculosis at 3 Treatment Centers, Canada, 2010-2016. Emerg Infect Dis 2022; 28:1814-1823. [PMID: 35997366 PMCID: PMC9423918 DOI: 10.3201/eid2809.220092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
We estimated costs of managing different forms of tuberculosis (TB) across Canada by conducting a retrospective chart review and cost assessment of patients treated for TB infection, drug-susceptible TB (DS TB), isoniazid-resistant TB, or multidrug-resistant TB (MDR TB) at 3 treatment centers. We included 90 patients each with TB infection and DS TB, 71 with isoniazid-resistant TB, and 62 with MDR TB. Median per-patient costs for TB infection (in 2020 Canadian dollars) were $804 (interquartile range [IQR] $587-$1,205), for DS TB $12,148 (IQR $4,388-$24,842), for isoniazid-resistant TB $19,319 (IQR $7,117-$41,318), and for MDR TB $119,014 (IQR $80,642-$164,015). Compared with costs for managing DS TB, costs were 11.1 (95% CI 9.1-14.3) times lower for TB infection, 1.7 (95% CI 1.3-2.1) times higher for isoniazid-resistant TB, and 8.1 (95% CI 6.1-10.6) times higher for MDR TB. Broadened TB infection treatment could avert high costs associated with managing TB disease.
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Blakney RA, Ricotta EE, Frankland TB, Honda S, Zelazny A, Mayer-Barber KD, Dean SG, Follmann D, Olivier KN, Daida YG, Prevots DR. Incidence of Nontuberculous Mycobacterial Pulmonary Infection, by Ethnic Group, Hawaii, USA, 2005-2019. Emerg Infect Dis 2022; 28:1543-1550. [PMID: 35876462 PMCID: PMC9328927 DOI: 10.3201/eid2808.212375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To further clarify differences in the risk for nontuberculous mycobacterial pulmonary infection (NTM-PI) among ethnic populations in Hawaii, USA, we conducted a retrospective cohort study among beneficiaries of Kaiser Permanente Hawaii (KPH). We abstracted demographic, socioeconomic, clinical, and microbiological data from KPH electronic health records for 2005-2019. An NTM-PI case-patient was defined as a person from whom >1 NTM pulmonary isolate was obtained. We performed Cox proportional hazards regression to estimate incidence of NTM-PI while controlling for confounders. Across ethnic groups, risk for NTM-PI was higher among persons who were underweight (body mass index [BMI] <18.5 kg/m2). Among beneficiaries who self-identified as any Asian ethnicity, risk for incident NTM-PI was increased by 30%. Low BMI may increase susceptibility to NTM-PI, and risk may be higher for persons who self-identify as Asian, independent of BMI.
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Raats D, Brode SK, Mehrabi M, Marras TK. Increasing and More Commonly Refractory Mycobacterium avium Pulmonary Disease, Toronto, Ontario, Canada. Emerg Infect Dis 2022; 28:1589-1596. [PMID: 35876492 PMCID: PMC9328931 DOI: 10.3201/eid2808.220464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In mid-2014, Public Health Ontario Laboratories identified coincident increasing Mycobacterium avium isolation and falling M. xenopi isolation in the Toronto, Ontario, Canada, area. We performed a retrospective cohort of all patients in a Toronto clinic who began treatment for either M. avium or M. xenopi pulmonary disease during 2009–2012 (early period) or 2015–2018 (late period), studying their relative proportions and sputum culture conversion. We conducted a subgroup analysis among patients who lived in the Toronto-York region. The proportion of patients with M. avium was higher in the late period (138/146 [94.5%] vs. 82/106 [77.4%]; p<0.001). Among M. avium patients, conversion was lower in the late period (26.1% vs. 39.0%; p = 0.05). The increase in the proportion of patients with M. avium pulmonary disease and the reduction in the frequency of sputum culture conversion is unexplained but could suggest an increase in environmental M. avium exposure.
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Trauth J, Discher T, Fritzenwanker M, Imirzalioglu C, Arnold T, Steiner D, Richter E, Crisponi L, Grimbacher B, Herold S. Hodgkin Lymphoma after Disseminated Mycobacterium genavense Infection, Germany. Emerg Infect Dis 2022; 28:1506-1509. [PMID: 35731199 PMCID: PMC9239878 DOI: 10.3201/eid2807.220425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mycobacterium genavense infection, a rare nontuberculous mycobacteria infection, occurs in heavily immunocompromised patients (i.e., those with advanced HIV disease, genetic disorders, or acquired immunologic disorders and those undergoing immunosuppressive therapy). We report a case of disseminated M. genavense infection preceding Hodgkin lymphoma in a patient without obvious risk factors for this infection.
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Shea J, Smith C, Halse TA, Kohlerschmidt D, Rourke AK, Musser KA, Escuyer V, Lapierre P. Novel Mycobacterium tuberculosis Complex Genotype Related to M. caprae. Emerg Infect Dis 2022; 28:1431-1436. [PMID: 35731170 PMCID: PMC9239888 DOI: 10.3201/eid2807.212353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report the unusual genotypic characterization of a bacterium isolated from a clinical sample of a patient who grew up in Bangladesh and lives in the United States. Using whole-genome sequencing, we identified the bacterium as a member of the Mycobacterium tuberculosis complex (MTBC). Phylogenetic placement of this strain suggests a new MTBC genotype. Even though it had the same spoligotype as M. caprae strains, single-nucleotide polymorphism–based phylogenetic analysis placed the isolate as a sister lineage distinct from M. caprae, most closely related to 5 previously sequenced genomes isolated from primates and elephants in Asia. We propose a new animal-associated lineage, La4, within MTBC.
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Kuge T, Fukushima K, Matsumoto Y, Saito H, Abe Y, Akiba E, Haduki K, Nitta T, Kawano A, Tanaka M, Hattori Y, Kawasaki T, Matsuki T, Shiroyama T, Motooka D, Tsujino K, Miki K, Mori M, Kitada S, Nakamura S, Iida T, Kumanogoh A, Kida H. Chronic Pulmonary Disease Caused by Tsukamurella toyonakaense. Emerg Infect Dis 2022; 28:1437-1441. [PMID: 35731181 PMCID: PMC9239891 DOI: 10.3201/eid2807.212320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Unidentified Mycobacterium species are sometimes detected in respiratory specimens. We identified a novel Tsukamurella species (Tsukamurella sp. TY48, RIMD 2001001, CIP 111916T), Tsukamurella toyonakaense, from a patient given a misdiagnosis of nontuberculous mycobacterial pulmonary disease caused by unidentified mycobacteria. Genomic identification of this Tsukamurella species helped clarify its clinical characteristics and epidemiology.
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McNamara KX, Perz JF, Perkins KM. Association of Healthcare and Aesthetic Procedures with Infections Caused by Nontuberculous Mycobacteria, France, 2012-2020. Emerg Infect Dis 2022; 28:1303. [PMID: 35608927 PMCID: PMC9155896 DOI: 10.3201/eid2806.220520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Abstract
Leprosy is a granulomatous infection caused by infection with Mycobacterium leprae or M. lepromatosis. We evaluated skin biopsy and slit skin smear samples from 92 leprosy patients in Colombia by quantitative PCR. Five (5.4%) patients tested positive for M. lepromatosis, providing evidence of the presence of this pathogen in Colombia.
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Le Ray LF, Aubry A, Sougakoff W, Revest M, Robert J, Bonnet I, Veziris N, Morel F. atpE Mutation in Mycobacterium tuberculosis Not Always Predictive of Bedaquiline Treatment Failure. Emerg Infect Dis 2022; 28:1062-1064. [PMID: 35447056 PMCID: PMC9045433 DOI: 10.3201/eid2805.212517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We report the emergence of an atpE mutation in a clinical Mycobacterium tuberculosis strain. Genotypic and phenotypic bedaquiline susceptibility testing displayed variable results over time and ultimately were not predictive of treatment outcome. This observation highlights the limits of current genotypic and phenotypic methods for detection of bedaquiline resistance.
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Vera-Cabrera L, Ramos-Cavazos CJ, Youssef NA, Pearce CM, Molina-Torres CA, Avalos-Ramirez R, Gagneux S, Ocampo-Candiani J, Gonzalez-Juarrero M, Mayorga-Rodriguez JA, Mayorga-Garibaldi L, Spencer JS, Jackson M, Avanzi C. Mycobacterium leprae Infection in a Wild Nine-Banded Armadillo, Nuevo León, Mexico. Emerg Infect Dis 2022; 28:747-749. [PMID: 35202538 PMCID: PMC8888246 DOI: 10.3201/eid2803.211295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Nine-banded armadillos (Dasypus novemcinctus) are naturally infected with Mycobacterium leprae and are implicated in the zoonotic transmission of leprosy in the United States. In Mexico, the existence of such a reservoir remains to be characterized. We describe a wild armadillo infected by M. leprae in the state of Nuevo León, Mexico.
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Abstract
The treatment of leprosy is long and complex, benefiting from the development of sterilizing, rapidly-acting drugs. Reductive evolution made Mycobacterium leprae exquisitely sensitive to Telacebec, a phase 2 drug candidate for tuberculosis. The unprecedented potency of Telacebec against M. leprae warrants further validation in clinical trials.
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Mei YM, Zhang Q, Zhang WY, Jiang HQ, Shi Y, Xiong JS, Wang L, Chen YQ, Long SY, Pan C, Ge G, Wang ZZ, Wu ZW, Wang Y, Jiang YQ, Wang HS. Isolation of Novel Mycobacterium Species from Skin Infection in an Immunocompromised Person. Emerg Infect Dis 2021. [PMID: 34670653 DOI: 10.3201//eid2711.210426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We investigated a case of cutaneous infection in an immunocompromised patient in China that was caused by a novel species within the Mycobacterium gordonae complex. Results of whole-genome sequencing indicated that some strains considered to be M. gordonae complex are actually polyphyletic and should be designated as closely related species.
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