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https://www.readbyqxmd.com/read/27936146/performance-of-clinical-screening-algorithms-for-tuberculosis-intensified-case-finding-among-people-living-with-hiv-in-western-kenya
#1
Surbhi Modi, Joseph S Cavanaugh, Ray W Shiraishi, Heather L Alexander, Kimberly D McCarthy, Barbara Burmen, Hellen Muttai, Chad M Heilig, Allyn K Nakashima, Kevin P Cain
OBJECTIVE: To assess the performance of symptom-based screening for tuberculosis (TB), alone and with chest radiography among people living with HIV (PLHIV), including pregnant women, in Western Kenya. DESIGN: Prospective cohort study. METHODS: PLHIV from 15 randomly-selected HIV clinics were screened with three clinical algorithms [World Health Organization (WHO), Ministry of Health (MOH), and "Improving Diagnosis of TB in HIV-infected persons" (ID-TB/HIV) study], underwent chest radiography (unless pregnant), and provided two or more sputum specimens for smear microscopy, liquid culture, and Xpert MTB/RIF...
2016: PloS One
https://www.readbyqxmd.com/read/27935770/from-breast-cancer-to-antimicrobial-combating-extremely-resistant-gram-negative-superbugs-using-novel-combinations-of-polymyxin-b-with-selective-estrogen-receptor-modulators
#2
Maytham H Hussein, Elena K Schneider, Alysha G Elliott, Meiling Han, Felisa Reyes-Ortega, Faye Morris, Mark A T Blastovich, Raad Jasim, Bart Currie, Mark Mayo, Mark Baker, Matthew A Cooper, Jian Li, Tony Velkov
Novel therapeutic approaches are urgently needed to combat nosocomial infections caused by extremely drug-resistant (XDR) "superbugs." This study aimed to investigate the synergistic antibacterial activity of polymyxin B in combination with selective estrogen receptor modulators (SERMs) against problematic Gram-negative pathogens. In vitro synergistic antibacterial activity of polymyxin B and the SERMs tamoxifen, raloxifene, and toremifene was assessed using the microdilution checkerboard and static time-kill assays against a panel of Gram-negative isolates...
December 9, 2016: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/27934821/drug-susceptibility-of-rapid-and-slow-growing-non-tuberculous-mycobacteria-isolated-from-symptomatics-for-pulmonary-tuberculosis-central-india
#3
B Goswami, P Narang, P S Mishra, R Narang, U Narang, D K Mendiratta
BACKGROUND: Non-tuberculous mycobacteria (NTM) are emerging as important pathogens. Their treatment also differs from that of Mycobacterium tuberculosis. In India, any datum on them is scarce as species identification and drug susceptibility are not performed in most laboratories. Susceptibility also differs from one geographic area to another, and in our country, there are no data even to guide the clinicians to start treatment empirically. METHODOLOGY: The present study endeavours to generate drug susceptibility data on NTM isolated from sputum samples collected and stored from 6445 symptomatics for pulmonary tuberculosis during a prevalence survey and from specimens received from the hospital...
October 2016: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27931692/front-loaded-sputum-microscopy-in-the-diagnosis-of-pulmonary-tuberculosis
#4
Nwachukwu O Ndubuisi, Onyeagba R Azuonye, Nwaugo O Victor, Okonkwo C Robert, Obiekwe Vivian
OBJECTIVE/BACKGROUND: The objectives of this study are to describe the acid-fast bacilli (AFB) yield of a front-loaded scheme in which an additional on-the-spot specimen (Xspot [Xs]) was collected 1h after the first spot specimen and to compare the default rate between the front-loaded and standard schemes. The performance of the front-loaded sputum microscopy was also compared with the standard World Health Organization (WHO) method for the diagnosis of pulmonary tuberculosis (PTB) in Anambra State, Nigeria...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27931681/mycobacterial-contamination-of-bronchoscopes-challenges-and-possible-solutions-in-low-resource-settings
#5
Dania Khalid Saeed, Sadia Shakoor, Seema Irfan, Rumina Hasan
The use of bronchoscopes has increased in tuberculosis (TB) diagnostics to circumvent the diagnostic challenges that are associated with low sputum volume and smear-negative TB. In healthcare facilities situated in low income countries that have a high burden of TB, adequate decontamination of bronchoscopes is a challenge and often overlooked to save on time and costs. This amplifies the risk of outbreaks and pseudo-outbreaks due to Mycobacterium tuberculosis and nontuberculosis mycobacteria. In this minireview, we review published literature of contaminated bronchoscopes causing pseudo-outbreaks of M...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27931345/factors-associated-with-sputum-culture-conversion-in-multidrug-resistant-pulmonary-tuberculosis
#6
B Velayutham, D Nair, T Kannan, C Padmapriyadarsini, K S Sachdeva, J Bency, J S Klinton, S Haldar, A Khanna, S Jayasankar, S Swaminathan
INTRODUCTION: Sputum culture conversion in pulmonary multidrug-resistant tuberculosis (MDR-TB) is important to make treatment-related decisions and prevent transmission of disease. OBJECTIVE: To identify factors associated with sputum culture conversion, and to determine time to culture conversion and the impact of culture conversion on successful treatment outcomes in MDR-/rifampicin (RMP) resistant TB. METHOD: Retrospective analysis of data from treatment cards and registers of MDR-/RMP-resistant patients initiated on treatment under India's Revised National TB Control Programme in Delhi, West Bengal and Kerala from January 2009 to December 2011...
December 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27931344/the-clinical-utility-of-xpert-mtb-rif-testing-in-induced-sputum
#7
M Y Chew, J Ng, H-M Cai, T G Lim, T K Lim
We performed a prospective clinical audit in hospitalised patients with suspected pulmonary tuberculosis (PTB) with the objective of evaluating the accuracy and clinical utility of Xpert MTB/RIF in induced sputum in an intermediate-burden setting. Of 450 patients audited, 61 (13.6%) were diagnosed with PTB based on positive culture. The sensitivity, specificity and positive and negative predictive values for Xpert in smear-negative cases for induced sputum were respectively 75%, 99.5%, 94.7% and 97.0%. Xpert in induced sputum may facilitate diagnostic yield and expedite treatment in up to a quarter of PTB patients...
December 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27931343/evaluation-of-omnigenesputum-stabilised-sputum-for-long-term-transport-and-xpert-mtb-rif-testing-in-nepal
#8
B Maharjan, C D Kelly-Cirino, A Weirich, P S Curry, H Hoffman, K Avsar, B Shrestha
SETTING: German Nepal TB Project, National Tuberculosis Reference Laboratory, Kathmandu, Nepal. OBJECTIVE: To evaluate whether transporting samples in OMNIgeneSPUTUM (OM-S) reagent from a peripheral collection site to a central laboratory in Nepal can improve tuberculosis (TB) detection and increase the sensitivity of Xpert MTB/RIF testing. DESIGN: One hundred sputum samples were split manually. Each portion was assigned to the OM-S group (OM-S added at collection, airline-couriered without cold chain, no other processing required) or the standard-of-care (SOC) group (samples airline-couriered on ice, sodium hydroxide + N-acetyl-L-cysteine processing required at the laboratory)...
December 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27931335/clinical-characteristics-and-outcomes-of-tuberculosis-in-douala-cameroon-a-7-year-retrospective-cohort-study
#9
B H Mbatchou Ngahane, F Dahirou, C Tchieche, A Wandji, C Ngni, A Nana-Metchedjin, E Nyankiy, M L Endale Mangamba, C Kuaban
SETTING: Tuberculosis (TB) clinic, Douala Laquintinie Hospital, Douala, Cameroon. OBJECTIVE: To describe the clinical characteristics of TB and to investigate predictors of poor treatment outcomes. DESIGN: A registry-based, retrospective cohort study of all TB cases recorded from 2007 to 2013 was conducted. Multinomial logistic regression models were used to identify predictors of poor outcomes. RESULTS: Of 8902 TB cases included, 5110 (57...
December 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27931331/impact-of-contact-investigation-and-tuberculosis-screening-among-high-risk-groups-in-denmark
#10
S G Jensen, T Lillebaek, T Wilcke, M K Pedersen, P H S Andersen, N W Olsen, N Seersholm
SETTING: The objective of tuberculosis (TB) screening in low-incidence countries is to identify TB patients earlier, ideally to improve health outcomes and reduce Mycobacterium tuberculosis transmission. In this retrospective study, we compare hospitalisation (morbidity) and smear positivity rates (infectiousness) in TB patients identified through active case finding (ACF) with patients identified through passive case finding (PCF). METHODS: ACF patients were identified by screening socially marginalised persons or through contact investigation...
December 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27929242/community-acquired-pneumonia-in-adults-diagnosis-and-management
#11
Alexander Kaysin, Anthony J Viera
Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and lung examination findings. Diagnosis should be confirmed by chest radiography or ultrasonography. Validated prediction scores for pneumonia severity can guide the decision between outpatient and inpatient therapy. Using procalcitonin as a biomarker for severe infection may further assist with risk stratification...
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27925791/reemergence-of-lower-airway-microbiota-in-lung-transplant-patients-with-cystic-fibrosis
#12
Saad A Syed, Fiona J Whelan, Barbara Waddell, Harvey R Rabin, Michael D Parkins, Michael G Surette
RATIONALE: Chronic lung infections are a hallmark of cystic fibrosis; they are responsible for progressive airway destruction and ultimately lead to respiratory death or the requirement for life-saving bilateral lung transplant. Furthermore, recurrent isolation of airway pathogens such as Pseudomonas aeruginosa in the allograft after transplant is associated with adverse outcomes, including bronchiolitis obliterans syndrome and acute infections. Little information exists on the impact of bilateral lung transplant on the lower-airway microbiota...
December 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27925453/chest-computed-tomography-scores-in-patients-with-cystic-fibrosis-colonized-with-methicillin-resistant-staphylococcus-aureus-mrsa
#13
Michal Gur, Elena Spinelli, Glorida Tridello, Susanna Baltieri, Lucia Pinali, Stefania Montemezzi, Lea Bentur, Baroukh Maurice Assael
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in Cystic Fibrosis (CF), with increasing incidence in recent years. We examined the association between bacterial colonization in the sputum (MRSA with or without pseudomonas (PA)) and computed tomography (CT) scores in CF patients. METHODS: MRSA patients were divided according to PA status based on at least three consecutive sputum cultures; controls were patients without MRSA (with or without PA), matched for gender and age at CT...
December 7, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27925430/pulmonary-hypertension-as-estimated-by-doppler-echocardiography-in-adolescent-and-adult-patients-with-cystic-fibrosis-and-their-relationship-with-clinical-lung-function-and-sleep-findings
#14
Bruna Ziegler, Christiano Perin, Fernanda Cano Casarotto, Simone Chaves Fagondes, Sérgio Saldanha Menna-Barreto, Paulo de Tarso Roth Dalcin
BACKGROUND: In cystic fibrosis (CF) patients, end stage of pulmonary disease is characterized by pulmonary hypertension (PH), hypoxemia, decrease in exercise tolerance and sleep quality. OBJECTIVE: To evaluate the association between clinical, lung function, sleep quality and polysomnographic variables with PH in CF patients aged 16 years or older. METHODS: In a cross-sectional study, 51 clinically stable CF patients underwent a clinical evaluation, an overnight polysomnography and answered sleep questionnaires (Pittsburgh Sleep Quality Index - PSQI and Epworth sleepiness scale - ESS)...
December 7, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27923938/computerized-respiratory-sounds-novel-outcomes-for-pulmonary-rehabilitation-in-copd
#15
Cristina Jácome, Alda Marques
BACKGROUND: Computerized respiratory sounds are a simple and noninvasive measure to assess lung function. Nevertheless, their potential to detect changes after pulmonary rehabilitation (PR) is unknown and needs clarification if respiratory acoustics are to be used in clinical practice. Thus, this study investigated the short- and mid-term effects of PR on computerized respiratory sounds in subjects with COPD. METHODS: Forty-one subjects with COPD completed a 12-week PR program and a 3-month follow-up...
December 6, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27922234/long-term-azithromycin-therapy-in-patients-with-cystic-fibrosis
#16
Nagehan Emiralioğlu, Zeynelabidin Öztürk, Ebru Yalçın, Deniz Doğru, Uğur Özçelik, Nural Kiper
Inflammation is a central contributor to the pathogenesis of cystic fibrosis (CF) pulmonary disease; so limiting the excessive production of inflammatory mediators represents a major therapeutic strategy for slowing the decline in lung function and improving survival. The macrolide antibiotic azithromycin (AZM) has anti-inflammatory properties and immunomodulatory effects that may be beneficial in CF. The aim of this study was to document the long term use of AZM effect on pulmonary function, nutritional status and number of pulmonary exacerbations in patients with CF...
2016: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27920515/effect-of-elom-080-on-exacerbations-and-symptoms-in-copd-patients-with-a-chronic-bronchitis-phenotype-a-post-hoc-analysis-of-a-randomized-double-blind-placebo-controlled-clinical-trial
#17
Kai-Michael Beeh, Jutta Beier, Henning Candler, Thomas Wittig
BACKGROUND: Treating symptoms and preventing exacerbations are key components of chronic obstructive pulmonary disease (COPD) long-term management. Recently, a more tailored treatment approach has been proposed, in particular for two well-established clinical phenotypes, frequent exacerbators and chronic bronchitis-dominant COPD. ELOM-080 has demonstrated clinical efficacy in treating symptoms and preventing exacerbations in subjects with chronic bronchitis. However, little is known about the potential effects of ELOM-080 in COPD patients...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27919693/performance-evaluation-of-xpert-mtb-rif-in-a-moderate-tuberculosis-incidence-compared-with-taqman-mtb-and-trcrapid-m-tb
#18
Kazunari Tsuyuguchi, Hideaki Nagai, Kenji Ogawa, Tomoshige Matsumoto, Kozo Morimoto, Akiko Takaki, Satoshi Mitarai
Xpert MTB/RIF is an automated nucleic acid amplification test (NAT) that can detect the presence of Mycobacterium tuberculosis complex (MTC) in clinical specimens as well as rifampicin (RIF) resistance resulting from rpoB mutation. Despite its high sensitivity and specificity for diagnosing tuberculosis (TB) with or without RIF resistance, the clinical performance of the test is variable. In this study, we evaluated the performance of Xpert MTB/RIF in a setting of moderate TB burden and high medical resources...
December 2, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27913761/best-practices-in-the-treatment-of-early-cystic-fibrosis-lung-disease
#19
REVIEW
Marijke Proesmans
For many years, management of cystic fibrosis (CF) lung disease was focused on symptomatic treatment of chronic lung infection, which is characterized by cough and sputum production, leading to progressive lung damage. With increasing survival and better knowledge of the pathogenesis of CF lung disease, it has become clear that treatment has to start very early because lung damage occurs in young patients, often before obvious symptoms appear. The arrival of new cystic fibrosis transmembrane conductance-regulator (CFTR)-correcting therapies will bring more opportunities to prevent the disease, apart from only treating chronic lung infection...
December 2, 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27913043/evaluation-of-the-genexpert-mtb-rif-assay-on-extrapulmonary-and-respiratory-samples-other-than%C3%A2-sputum-a-low-burden-country-experience
#20
Sushil Pandey, Jacob Congdon, Bradley McInnes, Alina Pop, Christopher Coulter
The aim of this study was to assess the performance of the GeneXpert MTB/RIF assay on extrapulmonary (EP) and respiratory (non-sputum) clinical samples of patients suspected of having tuberculosis (TB) from Queensland, Australia. A total of 269 EP and respiratory (non-sputum) clinical samples collected from Qld patients who were suspected of having TB were subjected to the GeneXpert MTB/RIF analysis, Ziehl-Neelsen (ZN) staining, Mycobacterium tuberculosis (MTB) culture and drug susceptibility testing. Phenotypic and genotypic data were compared...
November 29, 2016: Pathology
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