Host determinants of infectiousness in smear-positive patients with pulmonary tuberculosis
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/116756 |
Resumo: | Background Epidemiologic data suggests that only a minority of tuberculosis (TB) patients are infectious. Cough aerosol sampling is a novel quantitative method to measure TB infectiousness. Methods We analyzed data from three studies conducted in Uganda and Brazil over a 13-year period. We included sputum acid fast bacilli (AFB) and culture positive pulmonary TB patients and used a cough aerosol sampling system (CASS) to measure the number of colony-forming units (CFU) of Mycobacterium tuberculosis in cough-generated aerosols as a measure for infectiousness. Aerosol data was categorized as: aerosol negative (CFU = 0) and aerosol positive (CFU > 0). Logistic regression models were built to identify factors associated with aerosol positivity. Results M. tuberculosis was isolated by culture from cough aerosols in 100/233 (43%) TB patients. In an unadjusted analysis, aerosol positivity was associated with fewer days of antituberculous therapy before CASS sampling (p = .0001), higher sputum AFB smear grade (p = .01), shorter days to positivity in liquid culture media (p = .02), and larger sputum volume (p = .03). In an adjusted analysis, only fewer days of TB treatment (OR 1.47 per 1 day of therapy, 95% CI 1.16-1.89; p = .001) was associated with aerosol positivity. Conclusion Cough generated aerosols containing viable M. tuberculosis, the infectious moiety in TB, are detected in a minority of TB patients and rapidly become non-culturable after initiation of antituberculous treatment. Mechanistic studies are needed to further elucidate these findings. |
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Host determinants of infectiousness in smear-positive patients with pulmonary tuberculosisInfectious DiseasesEpidemiologySDG 3 - Good Health and Well-beingBackground Epidemiologic data suggests that only a minority of tuberculosis (TB) patients are infectious. Cough aerosol sampling is a novel quantitative method to measure TB infectiousness. Methods We analyzed data from three studies conducted in Uganda and Brazil over a 13-year period. We included sputum acid fast bacilli (AFB) and culture positive pulmonary TB patients and used a cough aerosol sampling system (CASS) to measure the number of colony-forming units (CFU) of Mycobacterium tuberculosis in cough-generated aerosols as a measure for infectiousness. Aerosol data was categorized as: aerosol negative (CFU = 0) and aerosol positive (CFU > 0). Logistic regression models were built to identify factors associated with aerosol positivity. Results M. tuberculosis was isolated by culture from cough aerosols in 100/233 (43%) TB patients. In an unadjusted analysis, aerosol positivity was associated with fewer days of antituberculous therapy before CASS sampling (p = .0001), higher sputum AFB smear grade (p = .01), shorter days to positivity in liquid culture media (p = .02), and larger sputum volume (p = .03). In an adjusted analysis, only fewer days of TB treatment (OR 1.47 per 1 day of therapy, 95% CI 1.16-1.89; p = .001) was associated with aerosol positivity. Conclusion Cough generated aerosols containing viable M. tuberculosis, the infectious moiety in TB, are detected in a minority of TB patients and rapidly become non-culturable after initiation of antituberculous treatment. Mechanistic studies are needed to further elucidate these findings.Instituto de Higiene e Medicina Tropical (IHMT)Individual Health Care (IHC)Global Health and Tropical Medicine (GHTM)RUNAcuña-Villaorduña, CarlosAyakaka, IreneSchmidt-Castellani, Luiz GuilhermeMumbowa, FrancisMarques-Rodrigues, PatriciaGaeddert, MaryWhite, Laura F.Palaci, MoisesEllner, Jerrold J.Dietze, ReynaldoJoloba, MosesFennelly, Kevin P.Jones-López, Edward C.2021-05-02T22:51:52Z2019-06-032019-06-03T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/116756eng2328-8957PURE: 27541062https://doi.org/10.1093/ofid/ofz184info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:59:30Zoai:run.unl.pt:10362/116756Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:43:15.942524Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Host determinants of infectiousness in smear-positive patients with pulmonary tuberculosis |
title |
Host determinants of infectiousness in smear-positive patients with pulmonary tuberculosis |
spellingShingle |
Host determinants of infectiousness in smear-positive patients with pulmonary tuberculosis Acuña-Villaorduña, Carlos Infectious Diseases Epidemiology SDG 3 - Good Health and Well-being |
title_short |
Host determinants of infectiousness in smear-positive patients with pulmonary tuberculosis |
title_full |
Host determinants of infectiousness in smear-positive patients with pulmonary tuberculosis |
title_fullStr |
Host determinants of infectiousness in smear-positive patients with pulmonary tuberculosis |
title_full_unstemmed |
Host determinants of infectiousness in smear-positive patients with pulmonary tuberculosis |
title_sort |
Host determinants of infectiousness in smear-positive patients with pulmonary tuberculosis |
author |
Acuña-Villaorduña, Carlos |
author_facet |
Acuña-Villaorduña, Carlos Ayakaka, Irene Schmidt-Castellani, Luiz Guilherme Mumbowa, Francis Marques-Rodrigues, Patricia Gaeddert, Mary White, Laura F. Palaci, Moises Ellner, Jerrold J. Dietze, Reynaldo Joloba, Moses Fennelly, Kevin P. Jones-López, Edward C. |
author_role |
author |
author2 |
Ayakaka, Irene Schmidt-Castellani, Luiz Guilherme Mumbowa, Francis Marques-Rodrigues, Patricia Gaeddert, Mary White, Laura F. Palaci, Moises Ellner, Jerrold J. Dietze, Reynaldo Joloba, Moses Fennelly, Kevin P. Jones-López, Edward C. |
author2_role |
author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Instituto de Higiene e Medicina Tropical (IHMT) Individual Health Care (IHC) Global Health and Tropical Medicine (GHTM) RUN |
dc.contributor.author.fl_str_mv |
Acuña-Villaorduña, Carlos Ayakaka, Irene Schmidt-Castellani, Luiz Guilherme Mumbowa, Francis Marques-Rodrigues, Patricia Gaeddert, Mary White, Laura F. Palaci, Moises Ellner, Jerrold J. Dietze, Reynaldo Joloba, Moses Fennelly, Kevin P. Jones-López, Edward C. |
dc.subject.por.fl_str_mv |
Infectious Diseases Epidemiology SDG 3 - Good Health and Well-being |
topic |
Infectious Diseases Epidemiology SDG 3 - Good Health and Well-being |
description |
Background Epidemiologic data suggests that only a minority of tuberculosis (TB) patients are infectious. Cough aerosol sampling is a novel quantitative method to measure TB infectiousness. Methods We analyzed data from three studies conducted in Uganda and Brazil over a 13-year period. We included sputum acid fast bacilli (AFB) and culture positive pulmonary TB patients and used a cough aerosol sampling system (CASS) to measure the number of colony-forming units (CFU) of Mycobacterium tuberculosis in cough-generated aerosols as a measure for infectiousness. Aerosol data was categorized as: aerosol negative (CFU = 0) and aerosol positive (CFU > 0). Logistic regression models were built to identify factors associated with aerosol positivity. Results M. tuberculosis was isolated by culture from cough aerosols in 100/233 (43%) TB patients. In an unadjusted analysis, aerosol positivity was associated with fewer days of antituberculous therapy before CASS sampling (p = .0001), higher sputum AFB smear grade (p = .01), shorter days to positivity in liquid culture media (p = .02), and larger sputum volume (p = .03). In an adjusted analysis, only fewer days of TB treatment (OR 1.47 per 1 day of therapy, 95% CI 1.16-1.89; p = .001) was associated with aerosol positivity. Conclusion Cough generated aerosols containing viable M. tuberculosis, the infectious moiety in TB, are detected in a minority of TB patients and rapidly become non-culturable after initiation of antituberculous treatment. Mechanistic studies are needed to further elucidate these findings. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-06-03 2019-06-03T00:00:00Z 2021-05-02T22:51:52Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/116756 |
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http://hdl.handle.net/10362/116756 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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2328-8957 PURE: 27541062 https://doi.org/10.1093/ofid/ofz184 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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