Cough-aerosol cultures of Mycobacterium tuberculosis in the prediction of outcomes after exposure. A household contact study in Brazil.
Cough-aerosol cultures of Mycobacterium tuberculosis in the prediction of outcomes after exposure. A household contact study in Brazil.
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DOI：
10.1371/journal.pone.0206384
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Jones-López EC
中科院分区：
文献类型：
--
作者：
Acuña-Villaorduña C;Schmidt-Castellani LG;Marques-Rodrigues P;White LF;Hadad DJ;Gaeddert M;Ellner JJ;Fennelly KP;Palaci M;Dietze R;Jones-López EC
肺结核患者咳嗽产生的气雾剂的结核分枝杆菌培养是一种定量方法，用于测量传染性和预测接触者的二次结局。然而，它们的重复性还没有确定。目的评价巴西家庭接触者咳嗽气雾剂中结核分枝杆菌菌落形成单位(CFU)对继发感染和疾病的预测价值。成人痰涂片阳性和培养阳性肺结核病例接受了标准评估，并根据气溶胶CFU进行分类。我们评估了家庭接触者在基线和8周时感染TST和IGRA以及继发性疾病的情况。我们登记了48例指标性肺结核病例；40%的患者气溶胶呈阴性，27%的患者气溶胶浓度低(10cfu)，33%的患者气溶胶浓度高(≥为10cfu)。在2 30名接触者中，8周时≥为10 mm的比例分别为59%、65%和75%(P=0.34)。与低气溶胶接触者(0.8，0.2-10)或无气溶胶接触者(0.1，0-3.7；p=0.08)相比，高气溶胶接触者的IGRA读数(中位数4.6IU/毫升，IQR0.02-10)更高。气溶胶浓度高的患者TST转换器的IGRA读数(中位数为20IU/mL，IQR为10-24)大于气溶胶阴性患者的IGRA读数(0.13，0.04-3；p=o.o2)。8/9(89%)培养+继发肺结核病例发生在气雾剂接触者+病例中。气溶胶CFU可定量预测涂阳肺结核患者家庭接触者的IGRA读数。我们的结果加强了使用咳嗽气雾剂来指导有针对性的预防性治疗策略的论点，这是当前消除结核病预测的必要组成部分。
Mycobacterium tuberculosis cultures of cough-generated aerosols from patients with pulmonary tuberculosis (TB) are a quantitative method to measure infectiousness and to predict secondary outcomes in exposed contacts. However, their reproducibility has not been established. To evaluate the predictive value of colony-forming units (CFU) of M. tuberculosis in cough aerosols on secondary infection and disease in household contacts in Brazil. Adult sputum smear+ and culture+ pulmonary TB cases underwent a standard evaluation and were categorized according to aerosol CFU. We evaluated household contacts for infection at baseline and at 8 weeks with TST and IGRA, and secondary disease. We enrolled 48 index TB cases; 40% had negative aerosols, 27% low aerosols (<10 CFU) and 33% high aerosols (≥10 CFU). Of their 230 contacts, the proportion with a TST ≥10 mm at 8 weeks was 59%, 65% and 75%, respectively (p = 0.34). Contacts of high aerosol cases had greater IGRA readouts (median 4.6 IU/mL, IQR 0.02–10) when compared to those with low (0.8, 0.2–10) or no aerosol (0.1, 0–3.7; p = 0.08). IGRA readouts in TST converters of high aerosol cases (median 20 IU/mL, IQR 10–24) were larger than those from aerosol-negative (0.13, 0.04–3; p = o.o2). 8/9 (89%) culture+ secondary TB cases occurred in contacts of aerosol+ cases. Aerosol CFU predicts quantitatively IGRA readouts among household contacts of smear positive TB cases. Our results strengthen the argument of using cough aerosols to guide targeted preventive treatment strategies, a necessary component of current TB elimination projections.
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影响因子：
--
作者：
Patterson, Benjamin;Morrow, Carl;Wood, Robin
通讯作者：
Wood, Robin
DOI：
10.5588/ijtld.12.0027
发表时间：
2012-08-01
影响因子：
4
作者：
Mandalakas, A. M.;Kirchner, H. L.;Hesseling, A. C.
通讯作者：
Hesseling, A. C.
影响因子：
3.2
作者：
Raj, Anita A.;Birring, Surinder S.
通讯作者：
Birring, Surinder S.
影响因子：
120.7
作者：
Dye, C;Scheele, S;Raviglione, RC
通讯作者：
Raviglione, RC
影响因子：
64.8
作者：
Lloyd-Smith JO;Schreiber SJ;Kopp PE;Getz WM
通讯作者：
Getz WM