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Fulltext A case of miliary adenocarcinoma of lung masquerading as miliary tuberculosis

Nik Azlan, N.M.

Medicine & Health, 2020;15(1):274-279.
MyJurnal

Adenokarsinoma paru-paru miliari adalah sangat jarang dan agresif. Adenokarsinoma paru-paru biasanya menunjukkan sifat ketulan pada peparu yang berkaitan dengan kerosakan paru-paru dan efusi pleura. Adenokarsinoma ini jarang jarang berpunca daripada tapak selain daripada tapak primer, tidak seperti kanser-kanser lain contohnya kanser tiroid, koriokarsinoma dan sarcoma. Kami membentangkan di sini kes seorang suri rumah berusia 50 tahun yang mengadu batuk-batuk, hilang selera makan dan sukar untuk bernafas selama 1 bulan. Perawat perubatan primer telah merawat beliau sebagai jangkitan kuman pada paru-paru. Disebabkan keadaan yang tidak pulih dan semakin melarat, beliau dibawa ke Jabatan Kecemasan. Oksigen beliau dikesan sebanyak 93% atas udara bilik. Berdasarkan sejarah pesakit dan penemuan X-ray paru-paru, rawatan untuk tuberculosis miliari telah di beri walaupun ujian Mantoux dan kahak negatif. Berikutan peningkatan tanda-tanda dan intubasi, bronkoskopi kemudian mendedahkan diagnosis adenokarsinoma paru-paru. Sebagai pelajaran, penampilan miliari radiografi tidak dikelirukan kepada tuberkulosis sahaja, kerana sebab-sebab berbahaya yang lain perlu disiasat. Bronkoskop dengan analisis histopatologi diperlukan, terutamanya jika Mantoux dan sputum adalah negatif.

Matched MeSH terms: Tuberculin Test
COMPARATIVE TUBERCULIN TESTING IN MALAYA

CHIN J

Tubercle, 1964 Jun;45:114-24.
PMID: 14161910
Matched MeSH terms: Tuberculin Test*
Fulltext Case series of ocular tuberculosis; the great masquerader

Loh, Ui Lyn, Nadras, Indira, Yeong, Choo Mee, Nadarajah, Gaayathri, Fazilawati Qamarruddin, Shelina Oli Mohamed, et al.

Journal of Biomedical and Clinical Sciences, 2018;3(2):1-5.
MyJurnal

Tuberculosis, an ancient disease, still thrives today as the leading infection caused by Mycobacterium tuberculosis. Diagnosis of ocular tuberculosis poses a great challenge due to the varied clinical presentations. We report 3 cases of primary ocular tuberculosis with varied presentations: conjunctival abscess, sclera-uveitis and occlusive vasculitis. There were no symptoms suggestive of pulmonary tuberculosis in all cases. All patients presented with acute, unilateral painful red eye. The first case had good visual acuity (VA) OD (6/9) with a swollen upper lid, localized perilimbal-hemorrhagic conjunctival swelling superiorly, keratic precipitates and mild anterior chamber reaction. The posterior segment was normal. The second case had a VA of 6/60 OD. There was presence of conjunctival injection, keratic precipitates, posterior synechiae and anterior chamber reaction of 1+. A few days later, there was a progression to vitritis OU and hyperemic optic disc OD with choroidal folds, cystoid macula edema and a positive T sign on B scan ultrasonography. The third case had VA of 6/6 OU, AC reaction of 2+ OD. There was multiple peripheral choroiditis with peripheral vasculitis seen in the posterior segment OU. Fundus fluorescein angiography (FFA) showed peripheral periphlebitis in all 4 quadrants OU. All 3 cases had positive Tuberculin Skin Test (Mantoux test) results which were more than 20mm. Anti-tuberculous treatment was promptly started and all patients showed significant clinical improvement. This case series highlights the diverse clinical presentations of ocular tuberculosis. A high clinical index of suspicion led to prompt initiation of anti-tuberculous therapy which resulted in good clinical outcomes for all cases.

Matched MeSH terms: Tuberculin Test
Fulltext Cell-mediated immunity in nasopharyngeal carcinoma and allergic rhinitis: a controlled study

Wong HT, Shahrizal TA, Prepageran N, Lim WK, Raman R

Ear Nose Throat J, 2007 May;86(5):292-4.
PMID: 17580811

We conducted a prospective study of 60 patients in a tertiary care referral center to ascertain the status of cell-mediated immunity as determined by delayed hypersensitivity reactions in patients with nasopharyngeal carcinoma (NPC) or allergic rhinitis. Delayed hypersensitivity as detected by Mantoux testing is generally accepted as a reflection of the level of cell-mediated immunoactivity-the less hypersensitivity reaction that occurs, the lower the level of immunoactivity is, and vice versa. Our study population was made up of three groups: 20 newly diagnosed patients with NPC (pretreatment), 20 age- and sex-matched patients with allergic rhinitis, and 20 matched controls without either disease. A negative Mantoux test (0- to 5-mm induration) was seen in 13 patients with NPC (65.0%), in 17 patients with allergic rhinitis (85.0%), and in 16 controls (80.0%); none of these differences was statistically significant. However, it is interesting that while the NPC group had the lowest percentage of negative Mantoux results overall, it had the highest percentage of patients who had no reaction at all (i.e., 0-mm induration); a complete absence of any reaction was seen in 7 of the 13 Mantoux-negative NPC patients (53.8%), compared with 2 of the 17 Mantoux-negative allergic rhinitis patients (11.8%) and 3 of the 16 Mantoux-negative controls (18.8%). An absence of a reaction generally indicates a very limited degree of cell-mediated immunoactivity. Therefore, we conclude that patients with NPC appear to have significantly less cell-mediated immunity than do patients with allergic rhinitis and normal controls; no statistically significant difference was noted between the latter two groups.
Study site: ENT clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Tuberculin Test
Changes in serum proteins, erythrocyte sedimentation rate and Mantoux tuberculin skin test reactivity in active tuberculosis

Liam CK, Lim KH, Wong CMM

JUMMEC, 1998;3:47-53.

The records of 141 consecutive patients with proven tuberculosis (TB) were reviewed to examine for changes in their serum proteins, erythrocyte sedimentation rate (ESR) and tuberculin skin test reactivity. Hypoalbuminaemia was present in 73% of patients and hyperglobulinaemia was seen in 92% of patients. ESR showed a negative correlation with the serum albumin level but a positive correlation with the serum globulin level. In the case of pulmonary TB, ESR was higher in patients with radiologically more extensive disease. Tuberculin reactivity was reduced in patients who were older, those with more severe hypoalbuminaemia and those with disseminated TB. KEYWORDS: Albumin, erythrocyte sedimentation rate, globulin, tuberculin reactivity, tuberculosis

Matched MeSH terms: Tuberculin Test
Fulltext Clinical Practice Guidelines for the Control & Management of Tuberculosis, Third Edition

ISBN: 978-967-0399-39-3

Citation: Clinical Practice Guidelines for the Control & Management of Tuberculosis, Third Edition. Putrajaya: Ministry of Health, Malaysia; 2012
Quick Reference: http://www.acadmed.org.my/view_file.cfm?fileid=568
Training Manual: http://www.acadmed.org.my/view_file.cfm?fileid=628

Older version: First Edition (2002); Second Edition (2006)

Matched MeSH terms: Tuberculin Test
Fulltext Clinical significance of Mantoux test in Malaysian patients

Yaacob I, Ahmad Z

Med J Malaysia, 1990 Sep;45(3):231-4.
PMID: 2152084

The value of tuberculin skin testing in the diagnosis of active tuberculosis remains uncertain. Interpretation of tuberculin tests would be easier if the tuberculin test profiles in different communities were accurately known. We reviewed 468 Mantoux test reactions in patients coming to Hospital Universiti Sains Malaysia with suspected tuberculosis. Eighty six percent of patients with active tuberculosis had a positive Mantoux test. Forty two percent of the cases of positive Mantoux test did not have evidence of active tuberculosis. Most of these cases had evidence of past infection with tuberculosis. We conclude that Mantoux test is a sensitive but a non-specific test in the diagnosis of active tuberculosis.
Study site: outpatients, inpatients; Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia

Matched MeSH terms: Tuberculin Test*
Fulltext Close contact investigation of TB in high-burden, low- and middle-income countries

Pang YK

Malays Fam Physician, 2014;9(2):11-17.
PMID: 25893066 MyJurnal

Tuberculosis (TB) remains a very common disease in most of the low- and middle-income countries. As a result of high disease burden, TB control measures in these countries are usually concentrated on intensifying active disease case-finding and early treatment of infectious TB. On the contrary, in countries with low disease burden, the focus is on contact investigation to identify latently infected individuals and prophylactically treating them to prevent disease reactivation and transmission. These two strategies are deemed important for the effective TB control. Nonetheless, WHO cautions that targeted contact investigation and latent TB infection (LTBI) treatment should only be undertaken by countries that have the operational capacity/ resources and have achieved ≥ 85% treatment success rate of active TB. The screening of LTBI is further challenged by the lack of a “gold standard” test to identify and validate individuals with this condition. Tuberculin skin test (TST) is still the preferred investigation as it is cheap, widely available and validated in many trials. The sensitivity and specificity of the newer test—interferon gamma release assay (IGRA) for LTBI screening has been encouraging in low prevalence countries. However, the evidence supporting such usage remains uncertain in high burden settings. Diagnosis of LTBI should adhere to the strict criteria outlined in the guidelines to avoid misdiagnosing active TB as LTBI. The treatment of the latter involved only one or two anti-TB drugs. It has been demonstrated that in the properly conducted contact screening and LTBI treatment, chances of the emergence of multi-drug-resistant TB is very low.

Matched MeSH terms: Tuberculin Test
Effect of delay in diagnosis on the rate of tuberculosis among close contacts of tuberculosis patients

Aldhubhani AH, lzham MI, Pazilah I, Anaam MS

East Mediterr Health J, 2013 Oct;19(10):837-42.
PMID: 24313146

Few studies have explored diagnosis delay by tuberculosis (TB) patients and its effects on the rate of infection among their close contacts. A cross-sectional study of the close contacts of 505 newly diagnosed TB patients was conducted in a TB referral centre in Sana'a, Yemen from 2008 to 2010. Only the close contacts of 89 new TB patients agreed to participate and completed the tuberculin skin test (TST). Of the 239 close contacts investigated, 133 (55.6%) had a positive TST result. Index patients were classified as long or short diagnosis delay (above or below the median). There was no significant difference in the number of infected close contacts between long and short delay index patients (Mann-Whitney U-test). A larger sample size, with more incentives for patients to participate and the use of other investigative tools could provide a better picture of the pattern of TB transmission among all contacts.

Matched MeSH terms: Tuberculin Test
Fulltext Effects of repeated comparative intradermal tuberculin testing on test results: a longitudinal study in TB-free red deer

Che-Amat A, Risalde MÁ, González-Barrio D, Ortíz JA, Gortázar C

BMC Vet Res, 2016 Sep 05;12(1):184.
PMID: 27596591 DOI: 10.1186/s12917-016-0825-2

Diagnosing tuberculosis (TB) in farmed red deer (Cervus elaphus) is challenging and might require combining cellular and humoral diagnostic tests. Repeated skin-testing with mycobacterial purified protein derivatives (PPDs) might sensitize or desensitize the subjects to both kinds of diagnostic tools. We evaluated the effect of repeated (every 6 months) comparative tuberculin skin testing on skin test and ELISA responsiveness in farmed red deer hinds from a TB-free herd. Eighteen 8-month old hinds were inoculated with bovine and avian PPDs and the mitogen phytohaemagglutinin (PHA), as positive control and concurrently tested by ELISA for antibodies against avian (avian PPD, aPPD and protoplasmatic antigen 3, PPA3) and bovine antigens (bPPD and MPB70). Blood serum was also sampled three weeks after each skin testing round and tested for antibodies against aPPD and bPPD, in order to detect eventual antibody level boosts. Testing took place every six months from winter 2012 until winter 2015.

Matched MeSH terms: Tuberculin Test/veterinary*
Fulltext Epidemiology of latent tuberculosis infection among patients with and without diabetes mellitus

Swarna Nantha Y, Puri A, Mohamad Ali SZ, Suppiah P, Che Ali SA, Ramasamy B, et al.

Fam Pract, 2017 09 01;34(5):532-538.
PMID: 28369346 DOI: 10.1093/fampra/cmx017

Background: Individuals with type 2 diabetes mellitus (DM) are at a greater risk of tuberculosis (TB) reactivation. There is a paucity of information about the risk factors associated with latent tuberculosis infection (LTBI) in patients with diabetes.

Objective: We conducted an observational study to compare the prevalence and risk factors associated with LTBI factors in Malaysian adults with and without DM.

Methods: Four hundred and four patients with DM and 359 patients with non-DM at a regional primary care clinic were recruited as participants in this case-control study. The tuberculin sensitivity test (TST) was performed. The presence of LTBI was defined by a TST value of 10 mm in DM patients and 10 mm in the non-DM group. A logistic regression model was used to identify variables associated with LTBI.

Results: There was no statistical significant difference in the prevalence rates seen between the DM and non-DM group of the study. LTBI prevalence among patients with DM was 28.5%. The proportion of patients in the non-DM group with LTBI was 29.2%. When a critical cut-off of 8 mm was used, the adjusted odds ratio of LTBI in DM patients was 1.88 (95% confidence interval: 1.22-2.82). Smoking was an independent risk factor for LTBI regardless of DM status. HbA1c levels or anthropometric measurements were not associated with LTBI in diabetic patients.

Conclusions: There is no significant risk of contracting LTBI in DM patients using the standard 10-mm TST cut-off. Nonetheless, using lower cut-offs in a DM population appear valid. Smoking is an important predictor of LTBI.

Matched MeSH terms: Tuberculin Test
Fulltext First evaluation of the performance of portable IGRA, QIAreach® QuantiFERON®-TB in intermediate TB incidence setting

Aziz ZA, Noordin NM, Wan Mohd WM, Kasim MA

PLoS One, 2023;18(2):e0279882.
PMID: 36763619 DOI: 10.1371/journal.pone.0279882

Diagnosis and treatment of tuberculosis infection (TBI) are the core elements of tuberculosis elimination. Interferon gamma release assays have advantages over the tuberculin skin test, although their implementation in low-resource settings is challenging. The performance of a novel digital lateral flow assay QIAreach® QuantiFERON®-TB (QIAreach QFT) against the QuantiFERON®-TB Gold Plus (QFT-Plus) assay was evaluated in an intermediate incidence setting (Malaysia) according to the manufacturer's instructions. Individuals aged 4-82 years, who were candidates for TB infection screening for contact investigation were prospectively recruited. On 196 samples, the QIAreach-QFT showed a positive percent agreement (sensitivity) was 96.5% (CI 87.9-99.6%), a negative percent agreement (specificity) 94.2% (CI 88.4% to 97.6%) and an overall percentage of agreement was 94.9% (95% CI 90.6-97.6%) with a Cohen's κ of 0,88. Out of 196, 5.6% (11/196) samples gave an error result on QIAreach-QFT and 4.1% (8/196) samples gave indeterminate result on QFT-plus. The TTR for QIAreach QFT positive samples varied from 210-1200 seconds (20 min) and significantly correlated with IFN-γ level of QFT-Plus. QIAreach QFT could be considered an accurate and reliable point-of-need test to diagnose TB infection helping to achieve the WHO End TB programme goals even in decentralised settings where laboratory expertise and infrastructure may be limited.

Matched MeSH terms: Tuberculin Test
Fulltext Giant reactions to tuberculin in lepromatous leprosy patients

Waters MFR, Stanford JL

Int. J. Lepr. Other Mycobact. Dis., 1985 Dec;53(4):546-53.
PMID: 4086918

A detailed account and definition is given of the previously inadequately described "giant reactions" to tuberculin occasionally seen in leprosy patients. The reaction is an accelerated and exaggerated response to species-specific antigens of Mycobacterium tuberculosis found in both PPD and New tuberculin. Our studies were performed in Malaysia, Uganda, Spain, and England. There was a significantly higher incidence of the phenomenon in Malaysia than in the other centers, but this may have been because there alone previously untreated lepromatous (LL and BL) patients were serially tested for up to three years after starting chemotherapy. Of the 28 patients exhibiting giant reactions, 27 occurred among lepromatous patients (24 LL and 3 BL), of which only 3 (1 LL and 2 BL) were untreated. One treated BL patient had developed, and one untreated BL patient was a family contact of, active tuberculosis. Giant reactions are uncommon in untreated and in very long-term treated LL patients, but may occur in up to a fifth of those receiving their first 1-3 years of chemotherapy. Although the mechanism is not yet understood, it appears to be a coincidence of delayed hypersensitivity of the tuberculin type and a less-delayed phenomenon of excessive local edema associated with local lymphadenopathy and short-lasting symptoms of malaise and pyrexia. It is suggested that the majority of giant reactions occur during a period of temporary lack of immune regulation associated with changing levels of antigenic load.

Matched MeSH terms: Tuberculin Test*
Hiding in plain sight: Diagnosing pleural tuberculosis using lung ultrasound

Ahmed WAW, Rahim MJC, Mohammad N, Fauzi MH, Wahab SFA

Ultrasound, 2021 May;29(2):123-127.
PMID: 33995559 DOI: 10.1177/1742271X20959761

Introduction: Diagnosing pleural tuberculosis can be difficult in patients with ambiguous presentation, especially in resource-limited health centres. Thus, lung ultrasound had been studied as a novel method in helping clinicians to diagnose this condition.
Case presentation: A 48-year-old woman presented with worsening dyspnoea and orthopnoea for one week. She had also experienced weight loss, minimal dry cough and right-sided pleuritic chest pain for several weeks. A chest radiograph showed a right lower zone pleural effusion with no apparent lung consolidation. Lung ultrasound showed a right apical consolidation and right lower zone septated pleural effusion. Pleural fluid investigations showed exudative features of mixed lymphocytic, mesothelial and neutrophilic cellular components. Tuberculin skin test was strongly positive. She was subsequently treated for pleural tuberculosis. One month after treatment, her symptoms had improved considerably.
Discussion: Lung ultrasound has been found to be more effective than chest radiograph in detecting consolidation and diagnosing pneumonia. The portability and efficacy of today's ultrasound machines, including the handheld types, show that lung ultrasound is a practical, reliable and valuable diagnostic tool in managing pulmonary conditions including tuberculosis, provided that the operators are adequately trained.
Conclusion: Lung ultrasound in tuberculosis is the next frontier for clinicians and researchers.

Matched MeSH terms: Tuberculin Test
Histoplasmosis in Malaya

Ponnampalam JT

Br J Dis Chest, 1964 Apr;58:49-55.
PMID: 14152216

A survey of 227 patients from 5-60 years of age revealed the presence of positive histoplasmin skin tests in 10.5 per cent. and positive complement-fixation tests in 19-8 per cent. Sputum from 13 of the 37 patients who had a positive complement-fixation test were cultured for H. capsulatum but with negative results. Exposure to infection by the fungus is equally distributed among the different race and age groups. A careful and constant watch should be kept for histoplasmosis in all chest hospitals as a certain number of cases may be present. It tends to elude diagnosis unless specially sought as it resembles the clinical picture of tuberculosis or other granulomatous disease. It presents a field for further investigation and research in Malaya.

Matched MeSH terms: Tuberculin Test*
Fulltext Influence of co-morbidity in the interpretation of tuberculin skin reactivity in multi-ethnic adult patients with tuberculosis

Loh LC, Chan SK, Ch'ng KI, Tan LZ, Vijayasingham P, Thayaparan T

Med J Malaysia, 2005 Oct;60(4):426-31.
PMID: 16570703

In the Malaysian setting of multi-ethnicity and high BCG coverage, interpretation of Tuberculin Skin Testing (TST) may be difficult. Between January 2001 and December 2003, a retrospective study on all adult patients with documented TST results treated for tuberculosis (TB) in chest clinics of two government hospitals was conducted to determine the reliability of TST and factors affecting its interpretation. One hundred and three patients [mean age (SD): 43 (17); male: 67%] were eligible for data collection: 72% and 57% of patients had positive TST results based on cut-off points of 10mm and 15mm respectively. The only significant univariate association with TST results was the severity of co-morbidity. A patient with co-morbidity score of 3 defined as those with any cancer, end-stage renal or liver disease, or HIV disease, was more likely to have a negative TST results [10mm cut-off point: Odd Ratio (95% CI) 6.6 (1.82 to 24.35), p = 0.003; 15mm cut-off point: 4.8 (1.21 to 18.95), p = 0.012]. A TST reading of 10mm had a higher sensitivity than 15mm as the cut-off point in diagnosing TB infection. Considering all possible confounding factors like ethnicity, prior BCG vaccination and TB burden in the population, severity of co-morbidity remains strongly predictive of a negative TST. Caution should be exercised in interpreting TST in these patients.
Study site: Chest clinic, Hospital Seremban, Hospital Kuala Pilah, Negeri Sembilan, Malaysia

Matched MeSH terms: Tuberculin Test*
Fulltext Influence of diabetes mellitus and risk factors in activating latent tuberculosis infection: a case for targeted screening in Malaysia

Swarna Nantha Y

Med J Malaysia, 2012 Oct;67(5):467-72.
PMID: 23770860 MyJurnal

A review of the epidemiology of tuberculosis, its contributing risk factors (excluding HIV) and the role of screening latent tuberculosis infection in Malaysia was done. Despite the global and domestic decrease in prevalence rates of tuberculosis in the past decade, there is an alarming increase in the trend of non communicable diseases in the country. High prevalence rates of major risk factors leading to reactivation of tuberculosis were seen within the population, with diabetes mellitus being in the forefront. The rising numbers in the ageing population of Malaysia poses a further threat of re-emergence of tuberculosis in the years to come. Economically, screening of diabetic patients with comorbidities for latent tuberculosis infection (LTBI) using two major techniques, namely tuberculin sensitivity (TST) and Interferon gamma release assay tests (IGRA) could be a viable option. The role of future research in the detection of LTBI in the Malaysian setting might be necessary to gauge the disease reservoir before implementing prophylactic measures for high risk groups involved.

Matched MeSH terms: Tuberculin Test*
Fulltext Latent tuberculosis infection in a Malaysian prison: implications for a comprehensive integrated control program in prisons

Al-Darraji HA, Kamarulzaman A, Altice FL

BMC Public Health, 2014 Jan 10;14:22.
PMID: 24405607 DOI: 10.1186/1471-2458-14-22

Prisons continue to fuel tuberculosis (TB) epidemics particularly in settings where access to TB screening and prevention services is limited. Malaysia is a middle-income country with a relatively high incarceration rate of 138 per 100,000 population. Despite national TB incidence rate remaining unchanged over the past ten years, data about TB in prisons and its contribution to the overall national rates does not exist. This survey was conducted to address the prevalence of latent TB infection (LTBI) in Malaysia's largest prison.

Matched MeSH terms: Tuberculin Test
Fulltext Latent tuberculosis infection screening in foreign-born populations: a successful mobile clinic outreach model

Morano JP, Zelenev A, Walton MR, Bruce RD, Altice FL

Am J Public Health, 2014 Aug;104(8):1508-15.
PMID: 24922157 DOI: 10.2105/AJPH.2014.301897

OBJECTIVES: We evaluated the efficacy of a mobile medical clinic (MMC) screening program for detecting latent tuberculosis infection (LTBI) and active tuberculosis.
METHODS: A LTBI screening program in a MMC in New Haven, Connecticut, used medical surveys to examine risk factors and tuberculin skin test (TST) screening eligibility. We assessed clinically relevant correlates of total (prevalent; n = 4650) and newly diagnosed (incident; n = 4159) LTBI from 2003 to 2011.
RESULTS: Among 8322 individuals, 4159 (55.6%) met TST screening eligibility criteria, of which 1325 (31.9%) had TST assessed. Similar to LTBI prevalence (16.8%; 779 of 4650), newly diagnosed LTBI (25.6%; 339 of 1325) was independently correlated with being foreign-born (adjusted odds ratio [AOR] = 8.49; 95% confidence interval [CI] = 5.54, 13.02), Hispanic (AOR = 3.12; 95% CI = 1.88, 5.20), Black (AOR = 2.16; 95% CI = 1.31, 3.55), employed (AOR = 1.61; 95% CI = 1.14, 2.28), and of increased age (AOR = 1.04; 95% CI = 1.02, 1.05). Unstable housing (AOR = 4.95; 95% CI = 3.43, 7.14) and marijuana use (AOR = 1.57; 95% CI = 1.05, 2.37) were significantly correlated with incident LTBI, and being male, heroin use, interpersonal violence, employment, not having health insurance, and not completing high school were significantly correlated with prevalent LTBI.
CONCLUSIONS: Screening for TST in MMCs successfully identifies high-risk foreign-born, Hispanic, working, and uninsured populations and innovatively identifies LTBI in urban settings.
Study site: Mobile clinic, New Haven, Connecticut, United States

Matched MeSH terms: Tuberculin Test/methods
Microbial biodiversity in the throats of pulmonary tuberculosis patients and tuberculin skin test (TST) positive and negative healthy individuals in Malaysia

Semail N, Suraiya S, Calero R, Mirabal M, Carrillo H, Ezzeddin Kamil MH, et al.

Tuberculosis (Edinb), 2020 09;124:101965.
PMID: 32692651 DOI: 10.1016/j.tube.2020.101965

The purpose of this study was to investigate the composition of throat microbiota in pulmonary tuberculosis patients (PTB) in comparison to healthy tuberculin skin test positive (TSTp) and negative (TSTn) individuals. Throat swabs samples were collected, and the microbiota was characterized. Richer operational taxonomic units (OTUs) were present in PTB group, compared to TSTp and TSTn. Regarding alpha diversity analysis there was a higher community diversity in TSTn compared to TSTp. Beta diversity analysis showed different species composition in TSTp compared to TSTn and PTB. There was higher presence of Firmicutes in PTB and TSTn compared to TSTp group at phylum level. At the genus level, Leuconostoc and Enterococcus were higher in TSTn compared to TSTp and Pediococcus, Chryseobacterium, Bifidobacterium, Butyrivibrio, and Bulleidia were higher in PTB compared to TSTn. Streptococcus was higher in TSTn compared to PTB and Lactobacillus in PTB compared to TSTp. At species level, Streptococcus sobrinus and Bulleidia moorei were higher in PTB compared to TSTn individuals, while Lactobacillus salivarius was higher in PTB compared to TSTp. The differences in the microbiome composition could influence the resistance/susceptibility to Mtb infection.

Matched MeSH terms: Tuberculin Test*

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