Cases Of Tuberculosis Patients Research Articles

Anti-tubercular therapy (ATT) induced exfoliative dermatitis–A case series

Tuberculosis is a serious contagious disease mainly affecting the lungs and is common in the developing countries. The essential component of all antitubercular regimens include Isoniazid, pyrazinamide as first-line drugs. A serious cutaneous adverse drug reaction namely exfoliative dermatitis (erythroderma) is associated with isoniazid use though uncommon but is common among pyrazinamide users. Here we report 3 cases of tuberculosis patients on antitubercular therapy (ATT) for 8 weeks, came to hospital OP (outpatient) with severe generalized redness and scaling with itching distributed all over the body and trunk. Immediately ATT was discontinued and all the three patients were administered antihistaminic and corticosteroid. The patients recovered within 3 weeks. To confirm ATT induced erythroderma and narrow down the offending agents, sequential rechallenge with ATT was done and again these patients had similar lesions erupt all over the body only with isoniazid and pyrazinamide. Antihistamine, steroids were started and the symptoms resolved and completely recovered within 3 weeks. Prompt withdrawal of the culprit drug along with appropriate medications and supportive measures is necessary for good prognosis. Physicians must be judicious while prescribing ATT especially, isoniazid and pyrazinamide as these can precipitate fatal cutaneous adverse reactions. Strict vigilance may help in early detection of this type ADR and timely management.

Epidemiological characteristics of pulmonary tuberculosis in Anhui Province, Eastern China from 2013 to 2018.

ObjectivePulmonary tuberculosis (TB) is a severe infectious respiratory disease, the burden of which remains high in China. To provide scientific evidence for developing more targeted prevention and control strategies, this study aimed to determine the incidence trends and explore the epidemiological characteristics of pulmonary TB in Anhui Province, Eastern China between 2013 and 2018.MethodsThe retrospective study analyzed information regarding pulmonary TB cases reported by the National Infectious Disease Reporting System and census data collected from the Anhui Provincial Bureau of Statistics.ResultsOverall, 211,892 cases of TB patients were reported in Anhui Province, China between 2013 and 2018, with an average annual reported incidence rate of 57.7 per 100,000 persons. A significant decrease in the incidence rate of pulmonary TB (p < 0.001) was observed during the study period. Men had a higher incidence rate of pulmonary TB than women (p < 0.001). The highest annual average reported incidence rate was 204.2 per 100,000 persons in those aged 70–74 years. The number of farmers with pulmonary TB, i.e., 155,415, accounted for 73.4% of all cases. Moreover, the peak period of reported cases was from January to March. Four cities along the Yangtze River—Anqing, Tongling, Chizhou, and Wuhu—reported significantly higher incidence rates of pulmonary TB than other cities (p < 0.001).ConclusionsFrom 2013 to 2018, there was a significant decline in the incidence rate of pulmonary TB in Anhui Province, with peaks occurring from January to March. Prevention and control strategies targeting men, people aged 70–74 years, farmers, and the four cities along the Yangtze River should be strengthened.

Analysis of Cases of Tuberculosis Related to Diabetes Patients and the Concurrent Use of Licit and Ilicit Drugs in the State of Pernambuco

INTRODUCTION: Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis. In Brazil, TB is considered a public health problem due to the high rate of cases, ranking 20th in the notified cases ranking. The transmission of the disease is related to some lifestyles, since there is a higher incidence in patients with diabetes Who use illicit and licit drugs such as tobacco and alcohol. Factors such as diabetes, alcoholism, smoking and illicit drugs favor the spread of the disease and may shift from latent to active tuberculosis. OBJECTIVE: Given the above, the objective of this study was to verify the cases of tuberculosis related to patients with diabetes and the use of licit and illicit drugs in the state of Pernambuco from 2015 to 2018. METHODS: This is a descriptive study with approach. To verify the incidence of tuberculosis in a given group. For this data were obtained from the SINAM / DATASUS database. The variables used were: diabetes, alcoholism, smoking and illicit drugs. RESULTS: From 2015 to 2018, 19,733 cases of tuberculosis patients were reported. Of these 1,890 (10%) were affected by diabetes, and in 2017 the most affected with (26.5%). Greater susceptibility to develop tuberculosis due to hyperglycemia, leading to insulin dependence which generates indirect cellular effects. It was observed that of the notified by tuberculosis about 4,584 (23%) stated to use alcohol. Alcohol is also considered a risk factor as it alters the immune response due to liver damage, thus leading to an increase to develop TB with an increase of (26.6%) in 2017. TB involvement in patients who have tobacco use was 4,258 (22.1%) with an increase of (31.5%) in 2018, the tobacco is a risk factor because it has reduced immune response due to ciliary dysfunction, developed by cigarette smoke . Given the use of Illicit Drugs, it was seen that 2,229 (11.8%) were using these drugs when affected by tuberculosis. CONCLUSION: In summary, it was observed that according to the lifestyle of people with tuberculosis, those who use alcohol are the most affected by the disease, so it is necessary that good follow up of these patients, as alcohol is considered as a licit drug. Knowledge of the profile of notified TB patients contributes to the planning and execution of actions aimed at serving the human being with quality.

Tuberculosis infection and epidemiological characteristics in Haidian District, Beijing, 2005\u20132018

BackgroundThis study was aimed to investigate the epidemiological characteristic of pulmonary tuberculosis (PTB) in Haidian District, Beijing from 2005 to 2018 and to provide suggestions for controlling tuberculosis (TB) development.MethodsEpidemiological data about TB were obtained by the Infectious Disease Reporting System at different levels of medical institutions in Haidian District of Beijing from 2005 to 2018. The epidemiological methods combined with χ2 test were used to analyze the distribution of TB in population, time, region and TB diagnosis.ResultsIn total, 14,449 cases of TB patients were reported in Haidian District from 2005 to 2018 and the average annual morbidity was 31.67/10,000. Of the total cases, housework and unemployed people (20.73%; 2996/14,449) accounted for the highest proportion of occupational distribution, followed by students, accounting for 17.18% (2482/14,449). 2433 patients with the age of 65 years and over accounting for 16.83% (2433/14,449); Laboratory confirmed diagnosis of TB was 26.60% and the diagnostic delays accounted for 54.96%.ConclusionsFrom 2005 to 2018, TB incidence was falling gradually in Haidian District. However, particular attention should be paid to the elderly and student groups, and the policy publicity and education should be strengthened to reduce the diagnosis delay of TB.

NAT2 Involed in the Susceptibility to Antituberculosis Drug-Induced Liver Injury

Objective: To investigate whether the N-acetyltransferase 2 (NAT2) gene is involved in the development of susceptibility to antituberculosis drug-induced liver damage (ATDLI) in patients with pulmonary tuberculosis in the Han nationality. Methods: We retrospectively analyzed 300 cases of tuberculosis patients without liver damage (control group) and 221 cases of tuberculosis patients with liver damage after antituberculosis treatment (case group). After antituberculosis treatment, genetic polymorphisms of NAT2 were analyzed in those patients using MassARRAY method. Results: Of the 10 tagged SNPs selected, In the promoter area of NAT2, the frequencies of T allele in rs4646243 and A allele in rs4646246 were signifcantly higher in the patients with ATDLI than controls (0.569 vs. 0.483, p=0.0062 and 0.567 vs 0.487, p=0.0103). The A allele of rs1115784 in the intron area showed a significant association with the development of ATDLI (0.389 vs 0.305, p = 0.0043). The frequencies of the mutated genes T and A in rs1041983 and rs1799930 in the second exon region were significantly higher than those in the control group (0.491 vs 0.360, p&lt;0.00001 and 0.336 vs 0.212, respectively; p&lt;0.00001). Two monomer domains were found in the 10 tag SNP sites, haplotype ht [TGAA] in monomeric domain 1 and haplotype ht [TAG] in monomeric domain 2, both were signifcantly more likely to be detected in the liver injury group than in the control group(p=0.0038, p&lt;0.001, respectively). Two haplotypes were also found on the NAT2 gene: haplotype ht [CGGG] in monomeric domain 1 and ht [CGG] in block 2, and their presence means a lower risk of liver damage. Conclusion: NAT2 genotypes might have signifcant association with the risk of ATDLI in the Chinese Han nationality. By detecting the NAT2 gene and its haplotype, we can screen patients with a higher risk of liver damage before anti-TB treatment and take measures for the protection of patients.

Evaluation of TNF-alpha gene (G308A) and MBL2 gene codon 54 polymorphisms in Turkish patients with tuberculosis.

MBL acts as a binding protein that enables uptake of mycobacteria into macrophages. And, TNF-alpha is an important cytokine that is involved in control of mycobacterial infections both in-vivo and in-vitro. A large number of genetic factors exerting susceptibility to tuberculosis has been identified, among which mannose-binding lectin and tumor necrosis factor-alpha call attention. The objective of this study is to compare the frequency of TNF-alpha and MBL gene polymorphisms between patients diagnosed with tuberculosis and healthy volunteers in Turkey, and determine the association between tuberculosis and TNF-alpha gene (G308A) and MBL2 gene codon 54 polymorphisms. The study included 69 patients who were diagnosed with tuberculosis and 70 control subjects. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect TNF-alpha (G308A) gene and MBL2 gene codon 54 polymorphisms. For statistical analysis, the significance level was determined as p<0.05. A comparison between patient and control groups in TNF-alpha (G308A) gene and MBL2 gene codon 54 polymorphisms showed no statistically significant difference (p>0.05). However, a comparison of mean body mass index (BMI) and smoking status showed a statistically significant difference between the tuberculosis and control groups (p=0.01 and p=0.009, respectively). Our results suggest that the MBL2 gene Codon 54 and TNF-alpha gene G308A polymorphisms are not associated with an increased risk for development of tuberculosis in our patients. Further studies are required including more cases of tuberculosis patients and other potentially relevant gene polymorphisms.

Impact of diabetes mellitus on tuberculosis drug resistance in new cases of tuberculosis

Background and objectiveDiabetes mellitus (DM) has an effect on many aspects of tuberculosis (TB). The aim of this study is to determine the impact of DM on anti-tuberculosis drug resistance in new cases of TB patients. Materials and methodsA case-control study was conducted on all newly diagnosed pulmonary TB adult patients with DM as cases and without DM as controls who were hospitalized and treated at the National Research Institute of Tuberculosis and Lung Disease (NRITLD) from May 2013 to October 2013. A molecular resistance test for rapid detection of resistance to isoniazid and rifampin was done for all smear-positive TB patients. A multivariate analysis was performed to determine the impact of DM on any anti-TB drug resistance. Results45TB cases with DM and 45TB cases without DM were included. TB cases with DM were more likely to be older (61 vs. 47years, p=0.001). Two TB–DM patients had multidrug-resistant TB (MDR-TB) (4.4%) compared with zero cases of MDR-TB in the control group, and TB–DM cases were resistant to at least one drug (11.1% vs. 4.4%, p=0.43). DM remained significantly associated with any drug resistance (OR: 6.32, 95% CI: 1–40.72) in multivariate analysis. ConclusionNew TB patients with DM are at increased risk of anti-TB drug resistance. More studies are needed to confirm these results.

A study of 9 cases of cervical tuberculous lymphadenitis with the diagnosis of cervical tuberculous lymphadenitis

The incidence of tuberculosis patients is high in Japan compared with the other developed countries. The ratio of extrapulmonary tuberculosis patients, for example cervical tuberculous lymphadenitis, tends to increase. In otolaryngology, the number of tuberculosis patients (especially those with cervical tuberculous lymphadenitis) is high and followed by pleuritis patients in extrapulmonary tuberculosis. Although otolaryngologists often diagnose extrapulmonary tuberculosis, it is difficult for them to diagnose appropriately because of various clinical features. Thus, we examined and presented the clinical history of 9 cases of tuberculosis patients in our Otolaryngology department and added a review of the related literature. We diagnosed 9 patients as having cervical tuberculous lymphadenitis from April 2002 to December 2012. They were 30 to 90 years old (mean 57.9 years old), and the male/female ratio was 3 : 6. Five cases were diagnosed as the abscess types and 4 were the swelling types based on the imaging analysis of cervical tuberculous lymphadenitis. Four cases showed multiple lymphadenopathy and 5 showed a solitary involvement. Five sputum and 7 gastric fluid cultures were all negative, whereas 4 QuantiFERON tests were all positive. Fine-needle aspiration cytology was performed in 8 patients, and epithelioid cells were seen in 4 cases. Because tuberculosis presents various clinical features, if we obtained the atypical findings from those patients, it is important in the first instance to suspect tuberculosis. Based on the viewpoint for preventing the spread of infection, we should perform cellular analysis using ultrasound-guided fine needle aspiration after sufficient assessment of the spreading risk by sputum, gastric fluid culture and TB-PCR and QuantiFERON tests, and if a diagnosis remains difficult, the lymph node open biopsy need to be considered.

Analysis of pulmonary tuberculosis patients in floating popoulations

Objective To analyze the clinical features and evaluate outcomes of active pulmonary tuberculosis(TB)patients in floating population.Methods Retrospectively analyzed the clinical data of 68 active pulmonary TB patients in floating population,in comparison with 123 cases of TB patients of local which was treated as control group.Evaluated the outcomes by analyzing the composition of sex and age,tuberculosis type,positive phlegm germ.males and 33 females;so the male to female ratio was 2.73:1,the difference between two groups was statistically significant(x2=3.37,P＜0.05).The age in study group ranged from 18 to 62,the average was(30.23±18.52),and it ranged from 18 to 70 in control group,the average was(46.46±31.50),the difference between two groups was statistically significant(t=25.14,P＜0.05).Among those aged 21 to 30,the incidence in study group was 44.11%(30/68),and in control group it was 24.39%(30/123),the difference between two groups had statistical significance(x2=9.91,P＜0.05).In study group,there were 68 sputum smears,47 of them were positive,and the proportion was 69.11%;In control group,there were 123 sputum smears,70 of them were positive,and the proportion was 56.91%.The difference between two groups had statisticall significance.In study group.there were 22 patients who stopped by themselves accepting treatment,accounting for 34.92%;At same time,in control group,there were 23 patients who stopped by themselves accepting treatment,accounting for 18.67%.The difference of treatment compliance between two groups had statistical significance(x2=6.890,P＜0.05).After 6 months treatment,41 cases were treated in study group,of them 37 cases sputum bacterium turns negative,accounting for 90.24%;the same time 100 cases were treated in control group,of them 92 cases sputum bacterium turns negative,accounting for 92.00%.The difference of sputum bacterium conversion rate in two groups had no statistical significance(x2=0.1 10,P＞0.05).Conclusion The incidence rate of tuberculosis was high in floating population of Pinghu City.The TB patients in floating population could receive the same treatment as those in local population through DOTS treatment. Key words: Tuberculosis,pulmonary; Population

The research of MPT64 antibodies aptamer of Mycobacterium tuberculosis in the serological diagnosis

Objective To establish mixed-sandwich ELISA detection system by screening aptam-ers of MPT64 antibodies with SELEX to detect clinical serum samples, and explore the potential laboratory diagnosis value of this method. Methods To detect the affinity of the final round ssDNA library to MPT64 antibodies inhibited by MPT64 antigen with the competitive ELISA method, optimize the mixed-sandwich ELISA detection method that was aptamer-serum-horseradish peroxidase labeled goat anti-human IgG anti-body detection system to detect 230 cases of clinical serum samples as well as the lowest concentration of MPT64 antibodies and the linear range. Results In competitive ELISA test results, the percentage of inhi-bition effect of MPT64 antigen to final round ssDNA library is from 0.25% to 80% when the MPT64 antigen concentration rised from 2 μg/ml to 256 μg/ml. The Optimized detection system of mixed-sandwich ELISA was constitute of the concentration of ssDNA coated with 0.1μg/hole, serum dilution of 1/200, horseradish peroxidase labeled goat anti-human IgG antibody concentration of 1/40 000. The lowest concentration of MPT64 antibody is 3 mg/L and the linear range is between 10 mg/L and 1000 mg/L. The serum samples of 100 cases of tuberculosis patients, 100 healthy individuals and 30 cases of non-tuberculesis were tested in this system and the test result was analyzed with Graphpad Prism, the difference of tuberculosis group and healthy group was statistically significant (P<0.001 ), the difference of TB group and non-TB control group was also statistically significant (P<0.001). The specificity and the sensitivity was 96.1% and 31.0% re-spectively. Conclusion The aptamer mixed-sandwich ELISA method will play an important role in the sero-logical diagnosis of tuberculosis. Key words: MPT64 antibodies; SELEX; Aptamer; ssDNA; Serological detection

The clinical analysis of Pulmonary tuberculosis with lung cancer

Objective To evaluate the relationship and the clinical characteristics of the pulmonary tuberculosis co-existing lung cancer in the older.Methods Retrospectively analyzed the clinical data of 454 cases of tuberculosis patients(some of them with lung cancer at the same time).Results There were about 68.5% tuberculosis patients with more than 50-year-old;among them there were 32 cases co-existences,and male patients account 78.1 %;87.5% lung cancer occurred with non-active tuherculosis.Conclusions Tuberculosis often occurs in the middle-aged and aged,The risk of male patients with lung tuberculosis to get lung cancer is higher than that of female patients because the clinical features of pulmonary tuberculosis with lung cancer is not typical,it's easy to miss diagnosis,misdiagnosis and easy-to delay treatment,so it should be in a high degree of vigilance and should be rechecked in a timely manner. Key words: Tuberculosis; Lung cancer

Potential challenges to the Stop TB Plan for humans in China; cattle maintain M. bovis and M. tuberculosis

Thirty-eight cows in a herd were determined to be positive for bovine tuberculosis (TB). The bacterial isolation and characterization with multiplex PCR identified six Mycobacterium tuberculosis isolates. The Mycobacterium bovis and M. tuberculosis infection induced comparable pathology in cattle in both gross pathology and histopathology based on the qualitative assessment of the sampled lung tissues. The spoligotyping demonstrated that cow M. tuberculosis isolates belonged to Beijing family strains. Meanwhile, the isolates from tuberculosis patients hospitalized in the local hospitals were assessed. No M. bovis strains were identified in 186 human isolates. Eighty-two percent (153/186) of M. tuberculosis isolates were Beijing-family strains. The 12 loci MIRU genotyping revealed that the first three prevalent patterns were 2232-2517-3533, 2233-2517-3533, and 2223-2517-3533. The bovine M. tuberculosis isolates were the third dominant MIRU pattern. The further 16 loci MIRU-VNTR assay confirmed that the bovine M. tuberculosis strains shared the same pattern suggesting there was a common source causing cow infection and an epidemiological link between cow and human M. tuberculosis infection. On the other hand, the retrospective investigation for the past three years' cases of TB patients from local hospitals revealed 0.34% (17/5011) prevalence of M. bovis infection in local people. In conclusion, in TB high-burden countries like China where bovine and human TB coexists, the fact that cattle maintain both M. bovis and M. tuberculosis would be a potential challenge to both Stop TB Plan of humans and bovine TB eradication scheme.