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Concordance between upper and lower airway microbiota in children with cystic fibrosis.

Introduction. Sputum is the most used sample type to monitor the lower respiratory tract microbiota in cystic fibrosis (CF), but young patients often cannot expectorate.Hypothesis. We hypothesized that throat swabs could reflect lower airway colonization and assessed the concordance of bacterial community composition between paired sputum and throat swab samples from children with CF.Aim. We aimed to compare bacterial community diversity and composition between sputum and throat swabs in the full cohort and in patients with paired samples from the same visit.Methodology. The prospective longit…

Airway Inflammation in Children with Primary Ciliary Dyskinesia.

Rationale: The role of airway inflammation in disease pathogenesis in children with primary ciliary dyskinesia (PCD) is poorly understood. Objectives: We investigated relationships between sputum inflammation measurements, age, lung function, bronchiectasis, airway infection, and ultrastructural defects in children with PCD. Methods: Spontaneously expectorated sputum was collected from clinically stable children and adolescents with PCD ages 6 years and older participating in a multicenter, observational study. Sputum protease and inflammatory cytokine concentrations were correlated with age, …

Evaluation of molecular tools for detection and drug susceptibility testing of Mycobacterium tuberculosis in stool specimens from patients with pulmonary tuberculosis.

Pulmonary tuberculosis diagnosis is difficult when patients cannot produce sputum. Most sputum is swallowed, and tuberculosis DNA can survive intestinal transit. We therefore evaluated molecular testing of stool specimens for detecting tuberculosis originating from the lungs. Paired stool and sputum samples (n=159) were collected from 89 patients with pulmonary tuberculosis. Control stool samples (n=47) were collected from patients without tuberculosis symptoms. Two techniques for DNA extraction from stool samples were compared, and the diagnostic accuracy of the PCR in stool was compared with…

Chronic cough: eosinophilic bronchitis without asthma.

Sputum cell-counts were studied in 7 non-smokers with corticosteroid-responsive chronic cough productive of sputum and 8 smokers with a clinical diagnosis of chronic bronchitis, all of whom had normal lung function tests and methacholine airway responsiveness, and in 10 non-smokers with asthma, examined during an exacerbation. Sputum from asthmatic patients and subjects with corticosteroid-responsive cough contained eosinophils and metachromatic cells. Macrophages were by far the dominant cell type in sputum from subjects with chronic bronchitis. Airway inflammation with eosinophils and metach…

Feasibility and Sensitivity of Saliva GeneXpert MTB/RIF Ultra for Tuberculosis Diagnosis in Adults in Uganda.

The objective of this prospective observational study carried out at China-Uganda Friendship Hospital-Naguru in Kampala, Uganda, was to determine the performance of GeneXpert MTB/RIF Ultra (Xpert Ultra) molecular testing on saliva for active tuberculosis (TB) disease among consecutive adults undergoing TB diagnostic evaluation who were Xpert Ultra positive on sputum. We calculated sensitivity to determine TB diagnostic performance in comparison to a composite reference standard of Mycobacterium tuberculosis liquid and solid cultures on two spot sputum specimens. Xpert Ultra on a single saliva …

Value of refined care in patients with acute exacerbation of chronic obstructive pulmonary disease.

BACKGROUND: Under physiological conditions, sputum produced during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can move passively with the cilia in the airway; the sputum is gradually excreted from the depth of the airways through the stimulation of the coughing reflex on the sensory nerve on the surface of the airway. However, when the sputum is thick, the cough is weak, or the tracheal cilia are abnormal, sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung. Furthermore, the presence of pathogenic microorganisms in sputum may…

L-ornithine derived polyamines in cystic fibrosis airways.

Increased arginase activity contributes to airway nitric oxide (NO) deficiency in cystic fibrosis (CF). Whether down-stream products of arginase activity contribute to CF lung disease is currently unknown. The objective of this study was to test whether L-ornithine derived polyamines are present in CF airways and contribute to airway pathophysiology. Polyamine concentrations were measured in sputum of patients with CF and in healthy controls, using liquid chromatography-tandem mass spectrometry. The effect of spermine on airway smooth muscle mechanical properties was assessed in bronchial segm…

Prevalence and risk factors for transmission of infection among children in household contact with adults having pulmonary tuberculosis.

AIMS: To study the prevalence of tuberculosis infection among children in household contact with adults having pulmonary tuberculosis, and identify the possible risk factors. METHODS: Children under the age of 5 years who were in household contact with 200 consecutive adults with pulmonary tuberculosis underwent tuberculin skin testing. Transverse induration of greater than 10 mm was defined as positive tuberculin test suggestive of tubercular infection. Infected children underwent chest radiography and analysis of gastric lavage fluid or induced sputum for detection of acid fast bacilli. RE…

Doxycycline in serum and bronchial secretions.

The concentration of doxycycline hydrochloride was measured in serum and bronchial secretions in five patients with chronic bronchitis recei … re was considerable individual variability and a wide range of concentrations of doxycycline in the sputum (0-07 to 2-10 mug/ml, mean 0-34 mug/ml). During the course of treatment there was a progressive increase in sputum levels and sputum/serum concentration ratios. There was no correlation between sputum concentration and degree of purulence. The clini …

Assessment of the Xpert MTB/RIF assay for diagnosis of tuberculosis with gastric lavage aspirates in children in sub-Saharan Africa: a prospective descriptive study.

BACKGROUND: Rapid and accurate diagnosis of pulmonary tuberculosis in children remains challenging because of difficulties in obtaining sputum samples and the paucibacillary nature of the disease. The Xpert MTB/RIF assay is useful for rapid diagnosis of childhood tuberculosis with sputum and nasopharyngeal samples. We assessed this assay for the detection of tuberculosis and multidrug resistant (MDR) tuberculosis with gastric lavage aspirate (GLA) samples in children admitted to hospital. METHODS: We did a prospective study to assess the sensitivity and specificity of the Xpert MTB/RIF assay …

Aerosolized dornase alpha (rhDNase) in cystic fibrosis.

Advances in the treatment and management of respiratory and pancreatic disorders has increased the life expectancy of patients with cystic f … an DNA (3-8). This high DNA concentration causes two problems. First, it increases the viscosity of sputum. This, in conjunction with reduced mucociliary clearance, decreases the removal of sputum. Second, the DNA binds to aminoglycosides, which decreases their antimicrobial efficacy (9, 10). Until recently there was no effective drug to decrease the vis …

The impact of non-TB mycobacterial co-isolation in patients with pulmonary TB.

BACKGROUND: Pulmonary TB is diagnosed by isolating Mycobacterium tuberculosis from sputum. Culture conversion, defined as two consecutive negative sputum cultures, guides treatment duration. Non-TB mycobacteria (NTM) species are common in the environment but only cause pulmonary disease in certain patients, and the significance of co-isolation of NTM during TB treatment is unclear. We aimed to assess if NTM co-isolation impacts sputum conversion, treatment duration, or outcomes. METHODS: We conducted a retrospective study of pulmonary TB patients treated at West Park Healthcare Centre between…

Xpert MTB/RIF на образцах мочи в целях повышения диагноза туберкулеза у ВИЧ-инфицированных в Гвинее-Бисау.

ЦЕЛИ: Мы изучили вопрос о том, не повышает ли анализ Xpert MTB/RIF (Xpert) на образцах мочи среди недавно диагностированных пациентов, инфицированных ВИЧ, в качестве предохранительного теста на Xpert тест на слюну. Мы пытались определить подгруппы пациентов, для которых тесты с помощью любого теста являются особенно выгодными. МЕТОДЫ: Мы включили пациентов >15 лет, недавно диагностировавших ВИЧ, которые в день диагностики ВИЧ-инфекции доставили образец мочи в крупнейшую клинику по ВИЧ в Гвинее-Бисау в период с 5 сентября 2016 года по 13 октября 2017 года, в перекрестное исследование. Пациентам

Совпадение в аннотации оригинала
OBJECTIVES: We investigated if Xpert MTB/RIF (Xpert) testing on urine samples among newly diagnosed HIV-patients as an adjunctive test to Xpert testing on sputum increases diagnosis. We sought to define subgroups of patients, for whom testing with either test is especially advantageous. METHODS: We included patients >15 years, newly diagnosed with HIV, that…

Diagnosing eosinophilic asthma using a multivariate prediction model based on blood granulocyte responsiveness.

BACKGROUND: The identification of inflammatory asthma phenotypes, using sputum analysis, has proven its value in diagnosis and disease monitoring. However due to technical limitations of sputum analysis, there is a strong need for fast and noninvasive diagnostics. This study included the activation state of eosinophils and neutrophils in peripheral blood to phenotype and monitor asthma. OBJECTIVES: To (i) construct a multivariable model using the activation state of blood granulocytes, (ii) compare its diagnostic value with sputum eosinophilia as gold standard and (iii) validate the model in …

[Clinical predictors of infectious pulmonary tuberculosis.].

INTRODUCTION: The immediate identification of infectious tuberculosis and implementation of effective isolation measures, are a priority of the national policies for disease control. OBJECTIVES: To identify clinical predictor's factors related with sputum smear-positive, in patients with pulmonary tuberculosis diagnosis. POPULATION AND METHODS: This was a retrospective study involving 289 patients admitted consecutively with the diagnosis of tuberculosis (ICD-9-CM: 010-018) through the emergency department of a Central Hospital. The study was conducted from January 1999 to December 2005. RE…

Cytopathologic and genetic diagnosis of pulmonary amebiasis: a case report.

BACKGROUND: Amebiasis is a parasitic infection with Entamoeba histolytica. Pulmonary amebiasis is rare since the infection is commonly manifested as amebic colitis or liver abscess. Most pleuropulmonary amebiasis is seen in patients with amebic liver abscesses. A pulmonary amebic lesion without either a liver abscess or amebic colitis is extremely rare. Thus, reported cases of sputum cytologic diagnosis of a pulmonary amebic lesion from a patient without a liver abscess are also very rare. CASE: A 53-year-old man presented with a dry cough and mild fever. Chest radiography revealed an abnorma…

Feasibility of a streamlined tuberculosis diagnosis and treatment initiation strategy.

OBJECTIVE: To assess the feasibility of a streamlined strategy for improving tuberculosis (TB) diagnostic evaluation and treatment initiation among patients with presumed TB. DESIGN: Single-arm interventional pilot study at five primary care health centers of a streamlined, SIngle-saMPLE (SIMPLE) TB diagnostic evaluation strategy: 1) examination of two smear results from a single spot sputum specimen using light-emitting diode fluorescence microscopy, and 2) daily transportation of smear-negative sputum samples to Xpert® MTB/RIF testing sites. RESULTS: Of 1212 adults who underwent sputum tes…

[Results of treating patients with mycobacterial respiratory infections negative for HIV virus (retrospective study)].

In this study the results of treatment of 37 patients with non-tuberculous mycobacterial disease were analyzed. The responsible strains were indentified as M. kansasi in 16 patients, M. avium-intracellulare in 10 patients, M. avium intracellulare and M. xenopi in 3 patients, M. xenopi and M. chalone in 7 patients. Patients with M. kansasi infection had been treated for 12 months. Sputum culture became negative in all patients after 2 months of treatment mainly with ryfamipcin (R) and etambutol (E). Thirteen patients infected with M. avium-intracellulare or M. avium-intracellulare and M. xenopi…

Near-point-of-care Diagnosis of Tuberculosis With LyocartE MTB Assay: a Multicenter Diagnostic Accuracy Study.

BACKGROUND: Tuberculosis (TB) continues to pose a major threat to global public health. The development of rapid near point-of-care diagnostics utilizing non-sputum specimens is critical for advancing TB control efforts. METHODS: In this multicenter prospective diagnostic accuracy study, 689 consecutive individuals with presumptive TB were enrolled from 3 sites in China. Sputum and tongue swab specimens were collected from all participants for index testing with the LyocartE assay and comparator testing with Xpert Ultra, smear microscopy, and culture. The diagnostic performance of LyocartE fo…

High local type-2 inflammation is linked to response in severe asthma treated with anti-Interleukin-5 receptor.

BACKGROUND: Benralizumab is an anti-IL-5 receptor (IL-5R) therapy linked to a huge improvement of the condition of patients with severe eosi … 0 %). Components of remission were also assessed individually to evaluate the response of patients. Sputum levels of mediators implicated in inflammation and remodeling were measured before treatment. RESULTS: Among the 45 patients, 12 were classified in remission. These patients were younger at baseline, had a lower smoking exposure, better asthma cont …