MyMedR

Chin CS, Ong SC

Med J Malaysia, 1979 Jun;33(4):326-30.

Matched MeSH terms: Sputum/microbiology*

Intensified pulmonary tuberculosis case finding among HIV-infected new entrants of a prison in Malaysia: implications for a holistic approach to control tuberculosis in prisons

Al-Darraji H, Hill P, Sharples K, Altice FL, Kamarulzaman A

Int J Prison Health, 2023 Jan 11.

PMID: 36622107 DOI: 10.1108/IJPH-01-2022-0001

PURPOSE: This intensified case finding study aimed to evaluate the prevalence of tuberculosis (TB) disease among people with HIV entering the largest prison in Malaysia.

DESIGN/METHODOLOGY/APPROACH: The study was conducted in Kajang prison, starting in July 2013 in the men's prison and June 2015 in the women's prison. Individuals tested positive for HIV infection, during the mandatory HIV testing at the prison entry, were consecutively recruited over five months at each prison. Consented participants were interviewed using a structured questionnaire and asked to submit two sputum samples that were assessed using GeneXpert MTB/RIF (Xpert) and culture, irrespective of clinical presentation. Factors associated with active TB (defined as a positive result on either Xpert or culture) were assessed using regression analyses.

FINDINGS: Overall, 214 incarcerated people with HIV were recruited. Most were men (84.6%), Malaysians (84.1%) and people who inject drugs (67.8%). The mean age was 37.5 (SD 8.2) years, and median CD4 lymphocyte count was 376 cells/mL (IQR 232-526). Overall, 27 (12.6%) TB cases were identified, which was independently associated with scores of five or more on the World Health Organization clinical scoring system for prisons (ARR 2.90 [95% CI 1.48-5.68]).

ORIGINALITY/VALUE: Limited data exists about the prevalence of TB disease at prison entry, globally and none from Malaysia. The reported high prevalence of TB disease in the study adds an important and highly needed information to design comprehensive TB control programmes in prisons.

Matched MeSH terms: Sputum/microbiology

Fulltext Pulmonary tuberculosis--a review of clinical features and diagnosis in 232 cases

Ismail Y

Med J Malaysia, 2004 Mar;59(1):56-64.

PMID: 15535337

The diagnosis of pulmonary tuberculosis is often delayed due to atypical clinical features and difficulty in obtaining positive bacteriology. We reviewed 232 cases of pulmonary tuberculosis diagnosed in Kedah Medical Centre, Alor Setar from January 1998 to December 2002. All age groups were affected with a male predominance (Male:Female ratio = 60:40). Risk factors include underlying diabetes mellitus (17.7%), positive family history (16.8%) and previous tuberculosis (5.2%). Nearly half (45.3%) of patients had symptoms for more than one year. Only 22% of patients had typical symptoms of tuberculosis (prolonged recurrent fever, cough, anorexia and weight loss), whilst others presented with haemoptysis, chronic cough, COPD, bronchiectasis, general ill-health, pyrexia of unknown origin or pleural effusion without other systemic symptoms. Fifteen percent of the patients presented with extrapulmonary diagnosis. Ninety percent of the patients had previous medical consultations but 40% had no chest radiograph or sputum examination done. The chest radiographs showed 'typical' changes of tuberculosis in 62% while in the other 38% the radiological features were 'not typical'. Sputum direct smear was positive for acid-fast bacilli in only 22.8% of patients and 11.2% were diagnosed base on positive sputum culture. Sputum may be negative even in patients with typical clinical presentations and chest radiograph changes. Bronchial washing improved the diagnosis rate being positive in 49.1% of cases (24.1% by direct smear and the other 25.0% by culture). In 16.8% of cases, the diagnosis was based on a good response to empirical anti-tuberculosis therapy in patients with clinical and radiological features characteristic of tuberculosis. In conclusions, the clinical and radiological manifestations of pulmonary tuberculosis may be atypical. Sputum is often negative and bronchoscopy with washings for Mycobacterium culture gives a higher yield for diagnosis. In highly probable cases, empirical therapy with antituberculosis drugs should be considered because it is safe and beneficial.

Matched MeSH terms: Sputum/microbiology

Diagnostic accuracy of the Xpert® MTB/RIF cycle threshold level to predict smear positivity: a meta-analysis

Lange B, Khan P, Kalmambetova G, Al-Darraji HA, Alland D, Antonenka U, et al.

Int J Tuberc Lung Dis, 2017 05 01;21(5):493-502.

PMID: 28399963 DOI: 10.5588/ijtld.16.0702

SETTING: Xpert® MTB/RIF is the most widely used molecular assay for rapid diagnosis of tuberculosis (TB). The number of polymerase chain reaction cycles after which detectable product is generated (cycle threshold value, CT) correlates with the bacillary burden.OBJECTIVE To investigate the association between Xpert CT values and smear status through a systematic review and individual-level data meta-analysis.

DESIGN: Studies on the association between CT values and smear status were included in a descriptive systematic review. Authors of studies including smear, culture and Xpert results were asked for individual-level data, and receiver operating characteristic curves were calculated.

RESULTS: Of 918 citations, 10 were included in the descriptive systematic review. Fifteen data sets from studies potentially relevant for individual-level data meta-analysis provided individual-level data (7511 samples from 4447 patients); 1212 patients had positive Xpert results for at least one respiratory sample (1859 samples overall). ROC analysis revealed an area under the curve (AUC) of 0.85 (95%CI 0.82-0.87). Cut-off CT values of 27.7 and 31.8 yielded sensitivities of 85% (95%CI 83-87) and 95% (95%CI 94-96) and specificities of 67% (95%CI 66-77) and 35% (95%CI 30-41) for smear-positive samples.

CONCLUSION: Xpert CT values and smear status were strongly associated. However, diagnostic accuracy at set cut-off CT values of 27.7 or 31.8 would not replace smear microscopy. How CT values compare with smear microscopy in predicting infectiousness remains to be seen.

Matched MeSH terms: Sputum/microbiology*

Fulltext Monitoring treatment response in sputum smear positive pulmonary tuberculosis patients: comparison of weight gain, sputum conversion and chest radiograph

How SH, Kuan YC, Ng TH, Razali MR, Fauzi AR

Malays J Pathol, 2014 Aug;36(2):91-6.

PMID: 25194531 MyJurnal

Monitoring treatment response to anti-tuberculous therapy remains unsatisfactory in resource-limited countries where sophisticated and expensive tests are not readily available. Sputum culture for mycobacterium is desirable, but not obtainable in many developing countries. Sputum acid-fast bacilli (AFB) smear alone can be misinterpreted in the presence of unviable bacilli or non-tuberculous mycobacteria. Hence the search for a cheaper but reliable monitoring tool, or a combination of several tools, continues. Interesting reports from studies in third world nations have considered weight gain/loss as one such monitoring tool. Since pulmonary tuberculosis is endemic in this country, we take the opportunity to evaluate weight gain and chest radiograph, compared to sputum AFB smear in monitoring patient's response.

Matched MeSH terms: Sputum/microbiology*

A prospective study of mycobacterial viability in refrigerated, unpreserved sputum batched for up to 8 weeks

Rashid Ali MR, Parameswaran U, William T, Bird E, Wilkes CS, Lee WK, et al.

Int J Tuberc Lung Dis, 2015 May;19(5):620-1.

PMID: 25868033 DOI: 10.5588/ijtld.14.0938

Matched MeSH terms: Sputum/microbiology*

Fulltext Exposure to sputum positive cases of tuberculosis in a government hospital

Jeyakumar D

Med J Malaysia, 1998 Dec;53(4):354-7.

PMID: 10971977

A retrospective study was carried out to ascertain the degree of exposure to the tubercle bacillus within Ipoh Hospital. This study reveals that, over a one year period, 92 sputum positive cases were admitted to the general wards. In 11 of these cases, drug resistance was considered to be possible. The mean time from admission to the commencement of treatment was seven days for the newly diagnosed cases. This study thus documents a significant degree of in-hospital exposure to the tubercle bacillus.

Matched MeSH terms: Sputum/microbiology*

Detection of Mycobacterium tuberculosis in bronchoalveolar lavage from patients with sputum smear-negative pulmonary tuberculosis using a polymerase chain reaction assay

Liam CK, Chen YC, Yap SF, Srinivas P, Poi PJ

Respirology, 1998 Jun;3(2):125-9.

PMID: 9692522

The objective of this study was to evaluate the utility of a polymerase chain reaction (PCR) assay in detecting Mycobacterium tuberculosis in bronchoalveolar lavage (BAL) specimens of patients suspected of having active pulmonary tuberculosis (TB) but who were sputum smear-negative. Patients undergoing investigation for suspected pulmonary TB at the University Hospital, Kuala Lumpur, and who were sputum smear-negative underwent fibreoptic bronchoscopy and BAL. One portion of each lavage specimen was submitted for smear examination for acid-fast bacilli and mycobacterial culture and the other portion assayed by PCR for the presence of a 562-base pair DNA segment belonging to the insertion sequence IS986, unique to the M. tuberculosis complex. As controls, lavage specimens from patients with other lung lesions were also similarly tested. The PCR assay gave a positivity rate of 80.9% (55 of 68) compared with 8.8% of smear examination and 7.4% of culture for detecting M. tuberculosis in BAL specimens. The assay was positive in two of 45 BAL specimens from 35 control subjects. The PCR assay was more sensitive than smear and culture in detecting M. tuberculosis in BAL specimens of patients with sputum smear-negative pulmonary TB.

Matched MeSH terms: Sputum/microbiology

The role of 67gallium scintigraphy and high resolution computed tomography as predictors of disease activity in sputum smear-negative pulmonary tuberculosis

Lai FM, Liam CK, Paramsothy M, George J

Int J Tuberc Lung Dis, 1997 Dec;1(6):563-9.

PMID: 9487455

University Hospital, Kuala Lumpur, Malaysia.

Matched MeSH terms: Sputum/microbiology*

Enterotoxin production by Staphylococcus aureus strains isolated from humans, foods and animals in Malaysia

Lim YS, Jegathesan M, Koay AS

Southeast Asian J. Trop. Med. Public Health, 1982 Mar;13(1):133-7.

PMID: 7112212

Enterotoxin production by strains of Staphylococcus aureus isolated from human, food and animal sources was investigated. Of the 130 isolates studied, 27 (20.8%) were found to be enterotoxigenic. The most common enterotoxin detected from human sources was enterotoxin C whereas enterotoxin B occurred more frequently in staphylococcal strains of food origin. The 2 enterotoxigenic strains, from animals isolated from a dog and a goat, produced enterotoxins A and C, respectively. Enterotoxin E was not detected alone from any of the enterotoxigenic strains studied, but occurred together with other enterotoxins. The need to detect enterotoxin in staphylococcal strains and in suspected foods for the confirmation of staphylococcal food poisoning is discussed.

Matched MeSH terms: Sputum/microbiology

Pulmonary aspergilloma. Case reports from Malaysia

Arianayagam S, Jayalakshmi P, Tuck Soon SH

Mycopathologia, 1986 Mar;93(3):151-3.

PMID: 3520330

Pulmonary aspergilloma is by no means uncommon in Malaysia. The lack of documentation of its occurrence in Malaysia, is mainly due to the lack of clinical awareness, and the absence of facilities for the proper diagnosis of the infection.

Matched MeSH terms: Sputum/microbiology

The pattern of bacteriological cultures in a state laboratory

Lim Swee Eng, Bin Mohamed Hussain AH

Med J Malaysia, 1973 Dec;28(2):103-8.

PMID: 4276266

Matched MeSH terms: Sputum/microbiology

Proceedings: Modern methods of case finding (who)

Toman K

Bull Int Union Tuberc, 1974 Aug;49 suppl 1:62-3.

PMID: 4468042

Matched MeSH terms: Sputum/microbiology

Treatment of 164 patients with chronic pulmonary tuberculosis by pneumonectomy in a developing country

Snelling MR, Kam CM

Tubercle, 1968 Jun;49(2):187-91.

PMID: 5664317

Matched MeSH terms: Sputum/microbiology

A case of pulmonary tuberculosis masquerading as lung carcinoma

Tan KT, Kannan SK, Rajahram GS

Med J Malaysia, 2019 12;74(6):547-548.

PMID: 31929486

Tuberculosis is a nimble chameleon. It can manifest itself in various ways with atypical clinical and radiographic findings. In this report we discuss the importance of radiographic findings (nodular or mass-like forms) requiring a correlation with microbiological and histopathological results to differentiate lung cancer from TB.

Matched MeSH terms: Sputum/microbiology*

Fulltext Genomic analysis of Mycobacterium abscessus strain M139, which has an ambiguous subspecies taxonomic position

Ngeow YF, Wee WY, Wong YL, Tan JL, Ongi CS, Ng KP, et al.

J Bacteriol, 2012 Nov;194(21):6002-3.

PMID: 23045507 DOI: 10.1128/JB.01455-12

Mycobacterium abscessus is a ubiquitous, rapidly growing species of nontuberculous mycobacteria that colonizes organic surfaces and is frequently associated with opportunistic infections in humans. We report here the draft genome sequence of Mycobacterium abscessus strain M139, which shows genomic features reported to be characteristic of both Mycobacterium abscessus subsp. abscessus and Mycobacterium abscessus subsp. massiliense.

Matched MeSH terms: Sputum/microbiology

Fulltext Genomic Analysis of Mycobacterium massiliense strain M115, an isolate from human sputum

Ngeow YF, Wong YL, Lokanathan N, Wong GJ, Ong CS, Ng KP, et al.

J Bacteriol, 2012 Sep;194(17):4786.

PMID: 22887681 DOI: 10.1128/JB.01104-12

We report the draft genome sequence of a clinical isolate, strain M115, identified as Mycobacterium massiliense, a member of the newly created taxon of Mycobacterium abscessus subspecies bolletii comb. nov.

Matched MeSH terms: Sputum/microbiology*

Fulltext Development of sandwich-form biosensor to detect Mycobacterium tuberculosis complex in clinical sputum specimens

Shojaei TR, Mohd Salleh MA, Tabatabaei M, Ekrami A, Motallebi R, Rahmani-Cherati T, et al.

Braz J Infect Dis, 2014 Nov-Dec;18(6):600-8.

PMID: 25181404 DOI: 10.1016/j.bjid.2014.05.015

Mycobacterium tuberculosis, the causing agent of tuberculosis, comes second only after HIV on the list of infectious agents slaughtering many worldwide. Due to the limitations behind the conventional detection methods, it is therefore critical to develop new sensitive sensing systems capable of quick detection of the infectious agent. In the present study, the surface modified cadmium-telluride quantum dots and gold nanoparticles conjunct with two specific oligonucleotides against early secretory antigenic target 6 were used to develop a sandwich-form fluorescence resonance energy transfer-based biosensor to detect M. tuberculosis complex and differentiate M. tuberculosis and M. bovis Bacille Calmette-Guerin simultaneously. The sensitivity and specificity of the newly developed biosensor were 94.2% and 86.6%, respectively, while the sensitivity and specificity of polymerase chain reaction and nested polymerase chain reaction were considerably lower, 74.2%, 73.3% and 82.8%, 80%, respectively. The detection limits of the sandwich-form fluorescence resonance energy transfer-based biosensor were far lower (10 fg) than those of the polymerase chain reaction and nested polymerase chain reaction (100 fg). Although the cost of the developed nanobiosensor was slightly higher than those of the polymerase chain reaction-based techniques, its unique advantages in terms of turnaround time, higher sensitivity and specificity, as well as a 10-fold lower detection limit would clearly recommend this test as a more appropriate and cost-effective tool for large scale operations.

Matched MeSH terms: Sputum/microbiology*

Fulltext The bacterial aetiology of adult community-acquired pneumonia in Asia: a systematic review

Peto L, Nadjm B, Horby P, Ngan TT, van Doorn R, Van Kinh N, et al.

Trans R Soc Trop Med Hyg, 2014 Jun;108(6):326-37.

PMID: 24781376 DOI: 10.1093/trstmh/tru058

Community-acquired pneumonia (CAP) is a major cause of adult mortality in Asia. Appropriate empirical treatment depends on knowledge of the pathogens commonly responsible. However, assessing the aetiological significance of identified organisms is often difficult, particularly with sputum isolates that might represent contamination with oropharyngeal flora.

Matched MeSH terms: Sputum/microbiology

Rapid detection of Mycobacterium tuberculosis in clinical samples by multiplex polymerase chain reaction (mPCR)

Tang TH, Ahmed SA, Musa M, Zainuddin ZF

World J Microbiol Biotechnol, 2013 Dec;29(12):2389-95.

PMID: 23807412 DOI: 10.1007/s11274-013-1407-0

Although the multi-copy and specific element IS6110 provides a good target for the detection of Mycobacterium tuberculosis complex by PCR techniques, the emergence of IS6110-negative strains suggested that false negative may occur if IS6110 alone is used as the target for detection. In this report, a multiplex polymerase chain reaction (mPCR) system was developed using primers derived from the insertion sequence IS6110 and an IS-like elements designated as B9 (GenBank accession no. U78639.1) to overcome the problem of detecting negative or low copy IS6110 containing strains of M. tuberculosis. The mPCR was evaluated using 346 clinical samples which included 283 sputum, 19 bronchial wash, 18 pleural fluid, 9 urine, 7 CSF, 6 pus, and 4 gastric lavage samples. Our results showed that the sensitivity (93.1 %) and specificity (89.6 %) of the mPCR system exceeds that of the conventional method of microscopy and culture. The mPCR assay provides an efficient strategy to detect and identify M. tuberculosis from clinical samples and enables prompt diagnosis when rapid identification of infecting mycobacteria is necessary.

Matched MeSH terms: Sputum/microbiology

Displaying publications 1 - 20 of 42 in total