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Диагноз туберкулеза у госпитализированных ВИЧ-инфицированных лиц, которые не могут произвести слюну: проверяет ли моча липоарабинонан?

КОЛИЧЕСТВО: До одной трети ВИЧ-инфицированных лиц, предположительно больных туберкулезом, страдают от опухоли. Для диагностики туберкулеза у ВИЧ-инфицированных пациентов с продвинутой иммуноусилительной системой можно использовать тест на боковую полосу потока Alere FormTM TBL LAM Ag. Однако вопрос о том, каким образом результаты анализа мочи должны быть включены в алгоритмы тестирования и в конкретные подгруппы пациентов, остается неясным. МЕТОДЫ: Настоящее исследование представляет собой постспециальный подгрупповый анализ данных, полученных в результате случайного исследования с участием не

Совпадение в аннотации оригинала
BACKGROUND: Up to one third of HIV-infected individuals with suspected TB are sputum-scarce. The Alere Determine™ TB LAM Ag lateral flow strip test can be used to diagnose TB in HIV-infected patients with advanced immunosuppression. However, how urine LAM testing should be incorporated into testing algorithms and in the context of specific patient sub-groups…

Household symptomatic contact screening of newly diagnosed sputum smears positive tuberculosis patients - An effective case detection tool.

OBJECTIVES: Primary objective was to assess the prevalence of tuberculosis (TB) among household contacts of newly diagnosed sputum smear (SS) positive TB index cases. Secondary objectives were the evaluation of risk factors in household contacts for acquiring TB disease; and the evaluation of various characteristics of index cases which influence the transmission of disease to household contacts. SETTINGS AND DESIGN: This exploratory cohort study included 521 household contacts of 133 newly diagnosed SS positive TB patients who were registered under the Revised National Tuberculosis Control P…

Prospective evaluation of RT-PCR on sputum versus culture, urinary antigens and serology for Legionnaire's disease diagnosis.

OBJECTIVES: Legionnaires' disease (LD) is a severe disease associated with community and hospital-acquired pneumonia, frequently under diagnosed. The main aim of our study was to determine the value of PCR for the diagnosis of LD in routine clinical practice. METHODS: In a prospective study, from March 2007 to April 2010, the value of PCR on non-invasive respiratory specimens (NIRS) was compared to those of the other available tools for LD diagnosis in patients hospitalized for pneumonia. RESULTS: Among 254 consecutive cases of pneumonia included, 24 cases were LD (19 confirmed and 5 probabl

Transportation of sputum samples in cetylpyridinium chloride for drug resistance studies from remote areas of Odisha, India.

INTRODUCTION: Antimicrobial susceptibility testing of Mycobacterium tuberculosis is required for successful treatment of patients, mainly in retreatment cases which necessitate isolation of mycobacteria from sputum samples within 24-48 hours. In situations where transportation of sputum is required, the use of cetylpyridinium chloride (CPC) effectively sustains the viability of mycobacteria up to two weeks. METHODOLOGY: Sputum samples were collected from pulmonary TB patients attending designated microscopy centres (DMC), stored in CPC solution and transported to a culture drug susceptibility…

Whole blood interferon-γ release assay is insufficient for the diagnosis of sputum smear negative pulmonary tuberculosis.

PURPOSE: We investigated the value of an interferon-γ release assay (IGRA) for the diagnosis of active pulmonary tuberculosis (PTB) among sputum smear negative PTB suspects in an environment with intermediate burden of PTB and high Bacillus Calmette-Guerin (BCG) vaccination rate. MATERIALS AND METHODS: We retrospectively reviewed IGRA, medical records, chest PA and CT scan of PTB suspects seen at Gangnam Severance Hospital, Seoul, Korea from Oct. 2007 to Apr. 2013. "Active PTB" was diagnosed when 1) M. tuberculosis culture positive, 2) confirmation by pathologic examination; or 3) clinical fi…

Diagnostic yield of broncho-alveolar lavage fluid and postbronchoscopic sputum cytology in endoscopically non-visible lung cancers.

Diagnostic yield of broncho-alveolar lavage (BAL) fluid and postbronchoscopic sputum (PBS) cytology is very high in endoscopically visible bronchogenic carcinoma, but they are also helpful in diagnosis of those lung cancers which are not visible bronchoscopically. Objective of this prospective study is to analyse the diagnostic yield of BAL fluid and PBS cytology in endoscopically non-visible lung cancer. Thirty patients with chest radiographic abnormality suspicious of lung cancer without endobronchial abnormality underwent BAL fluid and PBS cytology examination in the department of respirato…

[Sputum smear conversion during intensive TB treatment phase according to HIV status, in hospitalised patients in Togo].

METHOD: We prospectively studied patients with pulmonary TB, with or without HIV-1 co-infection, from December 1, 2007 to December 1, 2008. … 35.75% patients were HIV co-infected with a median CD4 count at 157 cells per millimeter cube. The sputum smear conversion was obtained for more than 87.5% of patients in group A and 24.56% in group B at two weeks; 94% of patients in group A and 61.83% in group B at four weeks; 100% of patients in group A and 87.33% in group B at six weeks, and 100% of …

Comparative evaluation of two polymerase chain reactions targeting different genomic regions to detect Mycobacterium tuberculosis in sputum.

PURPOSE: Tuberculosis remains an important health problem all over the world, especially in resource poor settings like India. The Ziehl-Neelsen (ZN) staining of sputum smear is still the method of choice in the diagnosis of tuberculosis in spite of its low sensitivity and specificity. This paper evaluates comparison of two different polymerase chain reaction (PCR) assays with sputum smear findings to detect Mycobacterium tuberculosis. MATERIALS AND METHODS: A total of 191 sputum samples were collected from 84 patients attending a tertiary care hospital, who were suspected of having pulmonary…

Ex vivo sputum analysis reveals impairment of protease-dependent mucus degradation by plasma proteins in acute asthma.

RATIONALE: Airway mucus plugs, composed of mucin glycoproteins mixed with plasma proteins, are an important cause of airway obstruction in acute severe asthma, and they are poorly treated with current therapies. OBJECTIVES: To investigate mechanisms of airway mucus clearance in health and in acute severe asthma. METHODS: We collected airway mucus from patients with asthma and nonasthmatic control subjects, using sputum induction or tracheal aspiration. We used rheological methods complemented by centrifugation-based mucin size profiling and immunoblotting to characterize the physical propert…

Chronic pulmonary histoplasmosis with declining complement fixation titers and persistence of positive sputum culture. A case report.

A patient with culturally proved chronic pulmonary histoplasmosis was treated with amphotericin B. Complement fixation titers decreased but sputum cultures remained positive for Histoplasma capsulatum 5 months after original therapy. Lobectomy and a subsequent course of amphotericin B were necessary. Exceeding the minimal inhibitory concentrations of amphotericin B did not eradicate the organism and declining complement fixation titers failed to have prognostic significance.

Detection of unamplified mycobacterium tuberculosis genomic DNA in sputum samples using a metal-enhanced fluorescence-based biosensor.

Mycobacterium tuberculosis the development of a metal-enhanced fluorescence (MEF)-based biosensor in this study enabled the detection of Mycobacterium tuberculosis DNA extracted from sputum samples with high sensitivity and without the need for DNA amplification. The detection process involved the utilization of silver dendritic nanostructures, which were grown on the surface of silicon wafers and subsequently modified with a probe that was designed to target the specific DNA Insertion Element 6110 (IS6110) gene of M. tuberculosis. A comparison was made between the performance of the developed…

Draft genome sequence of the mucoralean fungus Syncephalastrum contaminatum strain 142427, isolated from a human sputum specimen.

Syncephalastrum contaminatum is a recently described mucoralean fungus with limited genome representation. We report the 26.77 Mb draft genome of strain 142427, isolated from the sputum of a female patient with a lung infection in China. This clinical-source genome supports comparative studies of Syncephalastraceae.

Clinical factors associated with rescue bronchoscopic sputum suction after minimally invasive esophagectomy: A single-center retrospective study.

PURPOSE: Postoperative sputum retention after minimally invasive esophagectomy may require bronchoscopic sputum suction when conservative airway clearance is insufficient. However, the clinical features associated with this intervention remain unclear. METHODS: We retrospectively reviewed the data of 145 patients who underwent minimally invasive esophagectomy for thoracic esophageal cancer. Patients were divided into those who required postoperative bronchoscopic sputum suction and those who did not. Clinicopathological factors, surgical outcomes, Brinkman Index, pulmonary function, and posto…

Impact of sputum quality on Xpert MTB/RIF Ultra test results for tuberculosis: A multi-country study.

RATIONALE: Sputum-based testing using Xpert MTB/RIF Ultra (Xpert) is the most common molecular testing method for diagnosing tuberculosis (TB). OBJECTIVES: To evaluate whether sputum quality influences Xpert positivity and diagnostic accuracy. METHODS: We screened consecutive people for presumptive TB in India, the Philippines, Vietnam, Nigeria, South Africa, Uganda, and Zambia as part of the R2D2 TB Network and ADAPT studies. Participants provided 2-3 sputum samples for Xpert and culture reference testing. The quality of the first sputum sample was graded following standardized procedures b…

Hypoalbuminemia and reduced sputum microbiome diversity associated with antibiotic treatment failure in nursing and healthcare-associated pneumonia.

Nursing and healthcare-associated pneumonia (NHCAP) pose significant challenges in older populations, yet factors predicting antibiotic treatment failure remain elusive. This exploratory secondary analysis of a multicenter phase IV trial aimed to identify the clinical and microbiome predictors of treatment failure in patients with NHCAP treated with lascufloxacin. Among the 56 evaluable patients (median age 86 years; cured n = 44, not cured n = 12), paired sputum and tongue samples were analyzed using 16S ribosomal RNA gene clone library sequencing. Alpha diversity was assessed using the Shann…

Determinants of sputum smear non-conversion after intensive phase treatment among pulmonary TB patients in southern Thailand.

BACKGROUND: Tuberculosis remains a global health challenge, with sputum conversion serving as a critical indicator of treatment success during the intensive phase. This study aimed to identify factors associated with sputum smear non-conversion at the end of intensive phase treatment among patients with pulmonary tuberculosis. METHODOLOGY: This case-control study utilized data from the National Tuberculosis Information Program (NTIP) Registry database between 2014 and 2019. Newly diagnosed pulmonary tuberculosis patients were included. The study comprised 322 cases of sputum smear non-convers…

Clinical Utility of Intracellular Organisms in Gram-Stained Sputum Among Patients With Methicillin-Resistant Staphylococcus aureus Pneumonia.

INTRODUCTION: Sputum cultures may detect bacteria that are not the true causative pathogens of pneumonia. Gram-stained sputum has demonstrated utility in the diagnosis and treatment of pneumonia. Gap statement: However, the clinical significance of intracellular organisms (ICOs) observed in Gram-stained sputum has not been fully elucidated. AIM: This study aimed to evaluate whether the presence of ICOs morphologically consistent with Staphylococcus species in Gram-stained sputum specimens is associated with the diagnosis of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia and the …

Sputum Microbiota Compositions Correlate With Metabolome and Clinical Outcomes of COPD-Bronchiectasis Association: A Prospective Cohort Study.

Bronchiectasis frequently co-exists with chronic obstructive pulmonary disease (COPD-bronchiectasis association [CBA]). We compared the microbiota and metabolome of bronchiectasis with (BO) and without airflow obstruction (BNO), COPD, and CBA. We determined how microbiota compositions correlated with clinical characteristics and exacerbations of CBA. We prospectively recruited outpatients with BNO (n = 104), BO (n = 51), COPD (n = 33), and CBA (n = 70). We sampled at stead-state and exacerbation, and profiled sputum microbiota via 16S rRNA sequencing and metabolome via liquid chromatography/ma…

Comparative analysis of airflow dynamics and sputum expulsion during cough in healthy and bronchial stenosis respiratory tract.

Bronchial stenosis impacts cough mechanisms and respiratory function. This study used MIMICS and Fluent to construct and simulate a 3D airway model of an elderly female patient with bronchial stenosis. Utilizing dynamic mesh and fluid-structure interaction, airflow during coughing was analyzed, including velocity, wall shear stress, and deformation. The Eulerian wall film model quantified sputum dynamics, revealing that stenosis increases shear stress, exacerbates deformation, and reduces sputum expulsion efficiency, particularly for medium to high viscosity sputum. These findings deepen under…