Mycobacterium Tuberculosis Co-infection Research Articles

Co-infection with Mycobacterium tuberculosis and Mycobacterium avium in an HIV-positive patient – Case Report

Abstract Introduction: The association between Mycobacterium tuberculosis and the Human Immunodeficiency Virus can accelerate the deterioration of immunological functions. The risks are even more accentuated in the situation of a Non-tuberculous Mycobacterium and Mycobacterium tuberculosis co-infection. Case presentation: We present the case of a 59-year-old male patient, who was admitted at the hospital with non-specific symptoms. Further investigations reveal a remarkable particularity about the case: The infection with Mycobacterium tuberculosis was urogenital, whereas the one with Non-tuberculous mycobacteria was pulmonary. Conclusion: Both Mycobacterium tuberculosis and Non-tuberculous strains can exist within the same infection, posing great difficulties for diagnosis, as well as the treatment scheme.

Mycobacterium tuberculosis and human immunodeficiency virus co-infection and associated variables among presumptive pulmonary tuberculosis patients in Ethiopia; a health institution based cross-sectional study

BackgroundCo-infection of Mycobacterium tuberculosis (MTB) and the Human Immunodeficiency Virus (HIV) is a major global public health issue, particularly in border areas of resource-limited nations, including Ethiopia. ObjectiveTo explore the prevalence and associated variables of MTB/HIV co-infection among PTB presumptive patients in Northwest Ethiopia. MethodsFrom February to August 2021, a cross-sectional institutional investigation was conducted at the Metema and Abrehajira hospitals. Semi-structured questionnaires were used to collect socio-demographic and clinical data. The MTB/RIF Xpert assay was used to process sputum, and 3 ml of veins blood was collected for HIV rapid test (STAT-PAK, ABON, and SD BIOLINE HIV test algorithm) following the Ethiopian National HIV test algorithm. The Gene Xpert assay's sample processing control was checked to ensure data quality. Data entered into Epi-Data were exported to SPSS version 20 for analysis. Statistically significant variables (p-value ≤0.2) from bivariable analysis were included in multivariable analysis. A p-value ≤ 0.05 was judged statistically significant. ResultsThis study included 314 PTB presumptive patients with a median age of 35.0 years, of which 178 (56.69 %) were males. Among all patients, 40(12.7 %) and 51(16.2 %) were PTB, and HIV seropositivity, respectively. Of the PTB patients, 14/40 (35 %) (95 % CI: 24.4–45.6) were co-infected with HIV/AIDS. Married patients were 70 % less likely than unmarried individuals (AOR = 0.3 CI; 0.07–0.98) to have MTB/HIV co-infection. Patients who had contact history with MDR-TB patients (AOR = 5 CI; 1.37–18.00), and those who had a history of alcohol use (AOR = 12.2 CI; 2.56–57.8) were more likely to have MTB-HIV co-infection than their peers. ConclusionOur findings showed that MTB-HIV co-infection is one of the most important community health concerns in the study area. Therefore, MTB/HIV cooperation activities should be fully in place to prevent co-infection and its impact on the population.

Two Difficult Pandemics: Tuberculosis and COVID-19.

The coinfection of Mycobacterium tuberculosis and SARS-CoV-2 is called tuberculosis and COVID-19 coinfection (TB-COVID-19). We aimed to share the clinical, radiological, and laboratory findings and treatment processes of our patients with TB-COVID-19 coinfection in our tertiary reference hospital. Patients aged 18 years and over and hospitalized in the tuberculosis service between March 2020 and September 2022 were included. All coinfected patients whose COVID-19 polymerase chain reaction results were positive while receiving tuberculosis treatment or who were diagnosed with tuberculosis while receiving treatment for COVID-19 were included. The number of patients was 39; 61.6% of males; the mean age was 52 ± 17.1 years; 20% were foreign nationals; 92.5% were Asian; 69.5% had a bacteriological diagnosis; 84.6% had pulmonary tuberculosis; 10% had received antituberculosis treatment before; and 87.5% were sensitive to the first-line antituberculosis drugs. The most common comorbidities were diabetes and hypertension. 87.5% of the patients were diagnosed with tuberculosis and were superinfected with COVID-19 while receiving tuberculosis treatment. 49.5% of patients had received at least one dose of COVID-19 vaccine. The most common presenting symptom was cough and sputum; the prominent laboratory parameter was C-reactive protein increase, and thorax computed tomography finding was consolidation, tree-in-bud, and cavitation. While 45.9% of the patients were still under treatment, 1 (2.5%) patient also resulted in mortality. In this study, attention was drawn to two infectious diseases seen with respiratory tract symptoms. The mortality rate was found to be low. Neither disease was found to be a factor aggravating the course of each other.

T Cell Response in Tuberculosis-Infected Patients Vaccinated against COVID-19.

Many studies have focused on SARS-CoV-2 and Mycobacterium tuberculosis (Mtb) co-infection consequences. However, after a vaccination plan against COVID-19, the cases of severe disease and death are consistently controlled, although cases of asymptomatic and mild COVID-19 still happen together with tuberculosis (TB) cases. Thus, in this context, we sought to compare the T cell response of COVID-19-non-vaccinated and -vaccinated patients with active tuberculosis exposed to SARS-CoV-2 antigens. Flow cytometry was used to analyze activation markers (i.e., CD69 and CD137) and cytokines (IFN-γ, TNFα, IL-17, and IL-10) levels in CD4+ and CD8+ T cells upon exposure to SARS-CoV-2 peptides. The data obtained showed that CD8+ T cells from non-vaccinated TB patients present a high frequency of CD69 and TNF-α after viral challenge compared to vaccinated TB donors. Conversely, CD4+ T cells from vaccinated TB patients show a high frequency of IL-10 after spike peptide stimulus compared to non-vaccinated patients. No differences were observed in the other parameters analyzed. The results suggest that this reduced immune balance in coinfected individuals may have consequences for pathogen control, necessitating further research to understand its impact on clinical outcomes after COVID-19 vaccination in those with concurrent SARS-CoV-2 and Mtb infections.

Suppressive myeloid cells in SARS-CoV-2 and Mycobacterium tuberculosis co-infection.

Epidemiologic data show that both current and previous tuberculosis (TB) increase the risk of in-hospital mortality from coronavirus disease-2019 (COVID-19), and there is a similar trend for poor outcomes from Mycobacterium tuberculosis (Mtb) infection after recent SARS-CoV-2. A shared dysregulation of immunity explains the dual risk posed by co-infection, but the specific mechanisms are being explored. While initial attention focused on T cell immunity, more comprehensive analyses revealed a dysfunctional innate immune response in COVID-19, characterized by reduced numbers of dendritic cells, NK cells and a redistribution of mononuclear phagocytes towards intermediate myeloid subsets. During hyper- or chronic inflammatory processes, activation signals from molecules such as growth factors and alarmins lead to the expansion of an immature population of myeloid cells called myeloid-deprived suppressor cells (MDSC). These cells enter a state of pathological activation, lose their ability to rapidly clear pathogens, and instead become broadly immunosuppressive. MDSC are enriched in the peripheral blood of patients with severe COVID-19; associated with mortality; and with higher levels of inflammatory cytokines. In TB, MDSC have been implicated in loss of control of Mtb in the granuloma and ineffective innate and T cell immunity to the pathogen. Considering that innate immune sensing serves as first line of both anti-bacterial and anti-viral defence mechanisms, we propose MDSC as a crucial mechanism for the adverse clinical trajectories of TB-COVID-19 coinfection.

Antimycobacterial activity of scopoletin from ethanolic extract of Hymenodictyon floribundum (Hochst. & Steud.) B.L.Rob. Stem bark

The available tuberculosis (TB) therapies are taken for long time with complex regimens associated with adverse effects and drug-drug interactions. The emergence of multidrug resistant (MDR) and extensively drug resistant (XDR) strains of Mycobacterium tuberculosis and HIV co-infections necessitates the need for continued search for new effective anti-TB alternative leads with different mechanisms of action and safety profile. The aim of this study was to isolate and characterize antimycobacterial compounds from Hymenodictyon floribundum (Hochst. & Steud.) B.L.Rob. a plant used traditionally in the management of HIV/AIDS-related conditions. Antimycobacterial activity of the plant extracts and its constituents against Mycobacterium indicus pranii (MIP) and Mycobacterium madagascariense (MM) was tested using a twofold broth micro-dilution technique. Bioassay-guided isolation was used to isolate active compounds. Isolated compounds were also tested for activity against clinical isolates of Mycobacterium tuberculosis (Mtb). The crude plant extract had antimycobacterial activity and its ethyl acetate fraction was the most active with minimum inhibitory concentration (MIC) values of 97 µg/ml and 197 µg/ml against MIP and MM respectively. Three compounds were isolated from the ethyl acetate fraction; 7‑hydroxy-6-methoxycoumarin (1), 7,7′-dihydroxy-6,6′-dimethoxy-3,3′-biscoumarin (2) and 7,7′-dihydroxy-6,6′-dimethoxy-8,8′-biscoumarin (3). Compound 1 had growth inhibitory activity against MIP, MM and Mtb with MIC values of 0.2 M against MIP, 0.41 M against MM, 0.78 M against Mtb1 and 1.63 M against Mtb2. In conclusion, 7-Hydroxy-6- methoxycoumarin exhibited moderate antimycobaterial activity. The findings from this study support the use of H. floribundum by traditional health practitioners for treatment of HIV and AIDS-related conditions.

Antimicrobial peptides as drugs with double response against Mycobacterium tuberculosis coinfections in lung cancer.

Tuberculosis and lung cancer are, in many cases, correlated diseases that can be confused because they have similar symptoms. Many meta-analyses have proven that there is a greater chance of developing lung cancer in patients who have active pulmonary tuberculosis. It is, therefore, important to monitor the patient for a long time after recovery and search for combined therapies that can treat both diseases, as well as face the great problem of drug resistance. Peptides are molecules derived from the breakdown of proteins, and the membranolytic class is already being studied. It has been proposed that these molecules destabilize cellular homeostasis, performing a dual antimicrobial and anticancer function and offering several possibilities of adaptation for adequate delivery and action. In this review, we focus on two important reason for the use of multifunctional peptides or peptides, namely the double activity and no harmful effects on humans. We review some of the main antimicrobial and anti-inflammatory bioactive peptides and highlight four that have anti-tuberculosis and anti-cancer activity, which may contribute to obtaining drugs with this dual functionality.

Necrotising pneumonia caused by Curvularia hawaiiensis (syn. Bipolaris hawaiiensis) and Mycobacterium tuberculosis coinfection in a patient with ascariasis: a case report and review

IntroductionCurvularia hawaiiensis (formerly Bipolaris hawaiiensis) is a plant pathogen often isolated from soil and vegetative material. However, only a few cases of opportunistic invasive infections in humans have been described.CaseA 16-year-old female patient without comorbidities was admitted to the emergency department because of fever and chest pain. We described the first coinfection of Curvularia hawaiiensis and Mycobacterium tuberculosis necrotising pneumonia.DiscussionMultiple infections can alter immune responses. However, immunosuppression is the most critical risk factor for infection with species of the genus Curvularia. Therefore, it is crucial to carefully examine patients with tuberculosis, as they may rarely be coinfected with unusual fungi.

Kinetics of a Reaction-Diffusion Mtb/SARS-CoV-2 Coinfection Model with Immunity

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Mycobacterium tuberculosis (Mtb) coinfection has been observed in a number of nations and it is connected with severe illness and death. The paper studies a reaction–diffusion within-host Mtb/SARS-CoV-2 coinfection model with immunity. This model explores the connections between uninfected epithelial cells, latently Mtb-infected epithelial cells, productively Mtb-infected epithelial cells, SARS-CoV-2-infected epithelial cells, free Mtb particles, free SARS-CoV-2 virions, and CTLs. The basic properties of the model’s solutions are verified. All equilibrium points with the essential conditions for their existence are calculated. The global stability of these equilibria is established by adopting compatible Lyapunov functionals. The theoretical outcomes are enhanced by implementing numerical simulations. It is found that the equilibrium points mirror the single infection and coinfection states of SARS-CoV-2 with Mtb. The threshold conditions that determine the movement from the monoinfection to the coinfection state need to be tested when developing new treatments for coinfected patients. The impact of the diffusion coefficients should be monitored at the beginning of coinfection as it affects the initial distribution of particles in space.

Knowledge domain and emerging trends in HIV-MTB co-infection from 2017 to 2022: A scientometric analysis based on VOSviewer and CiteSpace.

Co-infection with Mycobacterium tuberculosis (MTB) in human immunodeficiency virus (HIV)-infected individuals is one of the leading causes of death. Also, research on HIV and MTB (HIV-MTB) co-infection was found to have a downward trend. In this work, we performed the knowledge domain analysis and visualized the current research progress and emerging trends in HIV-MTB co-infection between 2017 and 2022 by using VOSviewer and CiteSpace. The relevant literatures in this article were collected in the Web of Science (WoS) database. VOSviewer and CiteSpace bibliometric software were applied to perform the analysis and visualization of scientific productivity and frontier. Among all the countries, USA was dominant in the field, followed by South Africa, and England. Among all the institutions, the University of Cape Town (South Africa) had more extensive collaborations with other research institutions. The Int J Tuberc Lung Dis was regarded as the foremost productive journal. Survival and mortality analysis, pathogenesis, epidemiological studies, diagnostic methods, prognosis improvement of quality of life, clinical studies and multiple infections (especially co-infection with COVID-19) resulted in the knowledge bases for HIV-MTB co-infection. The clinical research on HIV-MTB co-infection has gradually shifted from randomized controlled trials to open-label trials, while the cognition of HIV-TB has gradually shifted from cytokines to genetic polymorphisms. This scientometric study used quantitative and qualitative methods to conduct a comprehensive review of research on HIV-MTB co-infection published over the past 5 years, providing some useful references to further the study of HIV-MTB co-infection.

Immunoinformatic-Based Multi-Epitope Vaccine Design for Co-Infection of Mycobacterium tuberculosis and SARS-CoV-2.

(1) Background: Many co-infections of Mycobacterium tuberculosis (MTB) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have emerged since the occurrence of the SARS-CoV-2 pandemic. This study aims to design an effective preventive multi-epitope vaccine against the co-infection of MTB and SARS-CoV-2. (2) Methods: The three selected proteins (spike protein, diacylglycerol acyltransferase, and low molecular weight T-cell antigen TB8.4) were predicted using bioinformatics, and 16 epitopes with the highest ranks (10 helper T lymphocyte epitopes, 2 CD8+ T lymphocytes epitopes, and 4 B-cell epitopes) were selected and assembled into the candidate vaccine referred to as S7D5L4. The toxicity, sensitization, stability, solubility, antigenicity, and immunogenicity of the S7D5L4 vaccine were evaluated using bioinformatics tools. Subsequently, toll-like receptor 4 docking simulation and discontinuous B-cell epitope prediction were performed. Immune simulation and codon optimization were carried out using immunoinformatics and molecular biology tools. (3) Results: The S7D5L4 vaccine showed good physical properties, such as solubility, stability, non-sensitization, and non-toxicity. This vaccine had excellent antigenicity and immunogenicity and could successfully simulate immune responses in silico. Furthermore, the normal mode analysis of the S7D5L4 vaccine and toll-like receptor 4 docking simulation demonstrated that the vaccine had docking potential and a stable reaction. (4) Conclusions: The S7D5L4 vaccine designed to fight against the co-infection of MTB and SARS-CoV-2 may be safe and effective. The protective efficacy of this promising vaccine should be further verified using in vitro and in vivo experiments.

Prevalence and Risk Factors of Mycobacterium tuberculosis and Human immunodeficiency Virus Coinfection Among Patients on Antiretroviral Therapy in a Specialist Hospital, Lokoja

Prevalence and Risk Factors of Mycobacterium tuberculosis and Human immunodeficiency Virus Coinfection Among Patients on Antiretroviral Therapy in a Specialist Hospital, Lokoja

Co-infection by Mycobacterium Tuberculosis And Klebsiella Pneumoniae in an Elderly Male With Multiple Co-morbidities: A Rare Entity With High Mortality

Klebsiella pneumoniae and Mycobacterium tuberculosis coinfection is one of the most lethal combinations with high mortality specially if there is delay in diagnosis and proper management. Patients with uncontrolled diabetes mellitus are prone to develop this type of serious infection.There is a considerable overlap in the clinical presentation of these critical pulmonary infections hence there is need for a high index of clinical suspicion, appropriate judicious investigations, and promt management to improve survivality. Here, we have presented Mycobacterium tuberculosis and Klebsiella pneumonia co-infection presenting as cough, chest pain, and shortness of breath in an elderly male with multiple co-morbidities, like uncontrolled diabetes mellitus, hypertension, prosthetic aortic valve in situ (for aortic stenosis)& previous history of ishchaemic stroke. This combination is rare and to the best of our knowledge not reported in the literature from Bangladesh. Bangladesh J Medicine 2022; 33: 52-57

Treatment outcome and its associated factors among HIV-MTB co-infected patients in Sichuan, China: A retrospective study

Human immunodeficiency virus (HIV)-Mycobacterium tuberculosis (MTB) co-infection has become a pressing global public health problem. Although tuberculosis (TB) is both treatable and curable, it has been exacerbated by the HIV/acquired immune deficiency syndrome (AIDS) epidemic. HIV-MTB co-infected patients have a variety of disease-specific, and treatment-related factors that can adversely affect their treatment outcomes. This study was conducted to assess the outcomes of TB treatment and its associated factors among HIV-MTB co-infected patients in Sichuan, Southwest China. A retrospective study was performed on HIV-MTB co-infected patients who were diagnosed and registered in TB designated hospitals in Sichuan from January 1, 2016, to December 31, 2020. Data were collected from patients' electronic medical records regarding their demographic, clinical, and social support information, and categorical data, such as sex, were reported using numbers and percentages. χ2 and t-tests were conducted to compare groups in relation to different levels of medical institutions. A binary logistic regression model was used to identify the factors associated with unsuccessful TB treatment outcomes. For logistic regression analysis performed using an α of 0.05, odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated for various risk factors. A total of 3677 registered HIV-MTB co-infected patients were enrolled. After adjusting for other variables, male, advanced age, receiving TB treatment at the municipal medical institution, being diagnosed with external pulmonary TB, referral or tracing, being sputum smear positive, not initiating antiretroviral therapy (ART) and not using fixed-dose combinations were the main risk factors for treatment failure of HIV-MTB co-infected patients in Sichuan province. Sex, age, hospital level, patient source, other diagnostic factors (e.g., sputum smear results, anatomical site of TB), and factors of therapeutic schemes (e.g., antiretroviral therapy, fixed-dose combinations) may serve as risk factors to estimate the likely treatment outcome of HIV-TB co-infection.

PULMONARY TB WITH HUMAN PARAINFLUENZA 3 VIRUS PRESENTING AS SEPTIC SHOCK WITH MULTIORGAN SYSTEM FAILURE

SESSION TITLE: Critical Care Presentations of TBSESSION TYPE: Rapid Fire Case ReportsPRESENTED ON: 10/18/2022 12:25 pm - 01:25 pmINTRODUCTION: Septic shock with Multiple Organ System Failure (MOSF) from Mycobacterium tuberculosis (MTB) is an uncommon, yet well-known clinical syndrome with high rate of in-hospital mortality (79.2%). Most Human Parainfluenza Virus (HPIV) in immunocompetent adults are mild or asymptomatic. However, not much is known about MTB co-infection with HPIV causing septic shock with MOSF. To the best of our knowledge, this is the first case of pulmonary MTB with HPIV infection presenting as septic shock with multiorgan failure reported in literature.CASE PRESENTATION: Patient is a 72 yo Spanish speaking male without significant past medical history, visiting from Mexico, who presented to the ED with cough. He was at baseline health until the day prior to the presentation when he noted cough with streaked hemoptysis, nausea, vomiting with fever. While in the ED, patient developed respiratory distress with hypotension, needing intubation, mechanical ventilation and vasopressors. CT of the chest demonstrated extensive right middle and lower lung consolidation, concerning for pneumonia. Respiratory pathogen panel was positive for HPIV, type 3. Pt developed multiorgan failure including renal failure needing CVVH, biventricular heart failure with EF of 15% and shock liver. Sputum culture was positive for MTB. Pt was started on anti-TB treatment with ethambutol, isoniazid, pyrazinamide, and rifampin. He clinically improved and after 2-week course of hospitalization was discharged home with outpatient follow up with Health Department and Infectious disease.DISCUSSION: Septic shock with multiorgan failure from MTB is rare yet known phenomenon with high rate of in-hospital mortality, however, co-infection of MTB with parainfluenza virus is not well described. The role of HPIV infection in causing respiratory tract illness is likely contributing factor making pulmonary MTB infection more complicated that can lead to septic shock with multiorgan failure.CONCLUSIONS: Pulmonary MTB co-infection with HPIV can present with septic shock with multiorgan failure. Further studies are needed to investigate and support significance of HPIV to pulmonary MTB.Reference #1: https://pubmed.ncbi.nlm.nih.gov/23429859/Reference #2: https://pubmed.ncbi.nlm.nih.gov/28283855/DISCLOSURES: No relevant relationships by Dovile BaniulisNo relevant relationships by Dovile CerkauskaiteNo relevant relationships by Momcilo Durdevic SESSION TITLE: Critical Care Presentations of TB SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/18/2022 12:25 pm - 01:25 pm INTRODUCTION: Septic shock with Multiple Organ System Failure (MOSF) from Mycobacterium tuberculosis (MTB) is an uncommon, yet well-known clinical syndrome with high rate of in-hospital mortality (79.2%). Most Human Parainfluenza Virus (HPIV) in immunocompetent adults are mild or asymptomatic. However, not much is known about MTB co-infection with HPIV causing septic shock with MOSF. To the best of our knowledge, this is the first case of pulmonary MTB with HPIV infection presenting as septic shock with multiorgan failure reported in literature. CASE PRESENTATION: Patient is a 72 yo Spanish speaking male without significant past medical history, visiting from Mexico, who presented to the ED with cough. He was at baseline health until the day prior to the presentation when he noted cough with streaked hemoptysis, nausea, vomiting with fever. While in the ED, patient developed respiratory distress with hypotension, needing intubation, mechanical ventilation and vasopressors. CT of the chest demonstrated extensive right middle and lower lung consolidation, concerning for pneumonia. Respiratory pathogen panel was positive for HPIV, type 3. Pt developed multiorgan failure including renal failure needing CVVH, biventricular heart failure with EF of 15% and shock liver. Sputum culture was positive for MTB. Pt was started on anti-TB treatment with ethambutol, isoniazid, pyrazinamide, and rifampin. He clinically improved and after 2-week course of hospitalization was discharged home with outpatient follow up with Health Department and Infectious disease. DISCUSSION: Septic shock with multiorgan failure from MTB is rare yet known phenomenon with high rate of in-hospital mortality, however, co-infection of MTB with parainfluenza virus is not well described. The role of HPIV infection in causing respiratory tract illness is likely contributing factor making pulmonary MTB infection more complicated that can lead to septic shock with multiorgan failure. CONCLUSIONS: Pulmonary MTB co-infection with HPIV can present with septic shock with multiorgan failure. Further studies are needed to investigate and support significance of HPIV to pulmonary MTB. Reference #1: https://pubmed.ncbi.nlm.nih.gov/23429859/ Reference #2: https://pubmed.ncbi.nlm.nih.gov/28283855/ DISCLOSURES: No relevant relationships by Dovile Baniulis No relevant relationships by Dovile Cerkauskaite No relevant relationships by Momcilo Durdevic

Trends in the incidence of Rifampicin resistant Mycobacterium tuberculosis infection in northeastern Nigeria

Mycobacterium tuberculosis is a respiratory bacterial pathogen that causes Tuberculosis. About one-quarter of the global population is infected, most of which are asymptomatic with a 5–15% risk of developing active disease across their lifespan. The progression of the disease has been enhanced by HIV coinfection and the emergence of Mycobacterium tuberculosis strains that are resistant to first-line anti-TB drugs, especially Rifampicin. Rifampicin resistance is brought about by mutation in the gene coding for beta-subunit of the enzyme RNA polymerase (rpoB) and is a surrogate marker for multidrug-resistant Tuberculosis (MDR-TB). Herein, using the GeneXpert MTB/RIF molecular technique, we examined the incidence of Mycobacterium tuberculosis infection and evaluate rpoB gene mutation among Mycobacterium tuberculosis isolates identified from presumptive pulmonary tuberculosis (PTB) and extra-pulmonary tuberculosis (EPTB) patients attending the directly observed treatment short-course (DOTS) clinic, University of Maiduguri Teaching Hospital, Nigeria. A total of two thousand four hundred and fifty-one (2451) presumptive TB cases (PTB = 2279, EPTB = 172) were analyzed from January 2018 to July 2019. The incidence of Mycobacterium tuberculosis infection was 22.68% (Mean±S.E = 46.33 ± 15.41). The incidence of Rifampicin-resistant Mycobacterium tuberculosis was 4.50% (Mean±S.E = 2.08 ± 1.02). The incidence of Mycobacterium tuberculosis and HIV co-infection was 16.59%, while the incidence of Rifampicin-resistant Mycobacterium tuberculosis and HIV co-infection was 4.23%. The peak incidence of M. tuberculosis infection was observed during the first quarter of each year and this variation was observed to be statistically significant (f = 9.34606; p < .05; CI95; p = 0.000068). Incidence of Rifampicin-resistant Mycobacterium tuberculosis was observed to be more prevalent among female patients that are 15 years or older (Fischer's exact test = 0.533; p < .05; CI95; p = 0.465348). The incidence rates reported herein are higher than the WHO-reported national average. By this report, it can be affirmed that the incidence of Mycobacterium tuberculosis infection in northeastern Nigeria is increasing and the rate of infection follows a seasonal trend.

Mycobacterium Tuberculosis and COVID-19 Co-infection in a Man with Pleural Empyema: A Call for Surveillance

Mycobacterium Tuberculosis and COVID-19 Co-infection in a Man with Pleural Empyema: A Call for Surveillance

Multi Epitope-Based Vaccine Design for Protection Against Mycobacterium tuberculosis and SARS-CoV-2 Coinfection.

BackgroundA prophylactic and immunotherapeutic vaccine for Mycobacterium tuberculosis (MTB) and SARS-CoV-2 coinfection needs to be developed for a proactive and effective therapeutic approach. Therefore, this study aims to use immunoinformatics to design a multi-epitope vaccine for protection against MTB and SARS-CoV-2 coinfection.MethodsThe bioinformatic techniques were used to screen and construct potential epitopes from outer membrane protein A Rv0899 of MTB and spike glycoprotein of SARS-CoV-2 for B and T cells. The antigenicity, allergenicity, and several physiochemical properties of the developed multi-epitope vaccination were then evaluated. Additionally, molecular docking and normal mode analysis (NMA) were utilized in evaluating the vaccine’s immunogenicity and complex stability.ResultsSelected proteins and predicted epitopes suggest that the vaccine prediction can be helpful in the protection against both SARS-CoV-2 and MTB coinfection. Through docking molecular and NMA, the vaccine-TLR4 protein interaction was predicted to be efficient with a high level of IgG, T-helper cells, T-cytotoxic cells, andIFN-γ.ConclusionThis epitope-based vaccine is a potentially attractive tool for SARS-CoV-2 and MTB coinfection vaccine development.

Pathogenesis of SARS-CoV-2 and Mycobacterium tuberculosis Coinfection.

Coronavirus disease-2019 (COVID-19), caused by SARS-CoV-2, is an infectious disease that poses severe threats to global public health and significant economic losses. The COVID-19 global burden is rapidly increasing, with over 246.53 million COVID-19 cases and 49.97 million deaths reported in the WHO 2021 report. People with compromised immunity, such as tuberculosis (TB) patients, are highly exposed to severe COVID-19. Both COVID-19 and TB diseases spread primarily through respiratory droplets from an infected person to a healthy person, which may cause pneumonia and cytokine storms, leading to severe respiratory disorders. The COVID-19-TB coinfection could be fatal, exacerbating the current COVID-19 pandemic apart from cellular immune deficiency, coagulation activation, myocardial infarction, and other organ dysfunction. This study aimed to assess the pathogenesis of SARS-CoV-2-Mycobacterium tuberculosis coinfections. We provide a brief overview of COVID19-TB coinfection and discuss SARS-CoV-2 host cellular receptors and pathogenesis. In addition, we discuss M. tuberculosis host cellular receptors and pathogenesis. Moreover, we highlight the impact of SARS-CoV-2 on TB patients and the pathological pathways that connect SARS-CoV-2 and M. tuberculosis infection. Further, we discuss the impact of BCG vaccination on SARS-CoV-2 cases coinfected with M. tuberculosis, as well as the diagnostic challenges associated with the coinfection.

CD4 Tcells are rapidly depleted from tuberculosis granulomas following acute SIV co-infection.

HIV/Mycobacterium tuberculosis (Mtb) co-infected individuals have an increased risk of tuberculosis prior to loss of peripheral CD4 Tcells, raising the possibility that HIV co-infection leads to CD4 Tcell depletion in lung tissue before it is evident in blood. Here, we use rhesus macaques to study the early effects of simian immunodeficiency virus (SIV) co-infection on pulmonary granulomas. Two weeks after SIV inoculation of Mtb-infected macaques, Mtb-specific CD4 Tcells are dramatically depleted from granulomas, before CD4 Tcell loss in blood, airways, and lymph nodes, or increases in bacterial loads or radiographic evidence of disease. Spatially, CD4 Tcells are preferentially depleted from the granuloma core and cuff relative to B cell-rich regions. Moreover, live imaging of granuloma explants show that intralesional CD4 Tcell motility is reduced after SIV co-infection. Thus, granuloma CD4 Tcells may be decimated before many co-infected individuals experience the first symptoms of acute HIV infection.