Aerosolization of viable Mycobacterium tuberculosis bacilli by tuberculosis clinic attendees independent of sputum-Xpert Ultra status
Potential Mycobacterium tuberculosis (Mtb) transmission during different pulmonary tuberculosis (TB) disease states is poorly understood. We quantified viable aerosolized Mtb from TB clinic attendees following diagnosis and through six months' follow-up thereafter. Presumptive TB patients (n=102) were classified by laboratory, radiological, and clinical features into Group A: Sputum-Xpert Ultra-positive TB (n=52), Group B: Sputum-Xpert Ultra-negative TB (n=20), or Group C: TB undiagnosed (n=30). All groups were assessed for Mtb bioaerosol release at baseline, and subsequently at 2 wk, 2 mo, and 6 mo. Groups A and B were notified to the national TB program and received standard anti-TB chemotherapy; Mtb was isolated from 92% and 90% at presentation, 87% and 74% at 2 wk, 54% and 44% at 2 mo and 32% and 20% at 6 mo, respectively. Surprisingly, similar numbers were detected in Group C not initiating TB treatment: 93%, 70%, 48% and 22% at the same timepoints. A temporal association was observed between Mtb bioaerosol release and TB symptoms in all three groups. Persistence of Mtb bioaerosol positivity was observed in ~30% of participants irrespective of TB chemotherapy. Captured Mtb bacilli were predominantly acid-fast stain-negative and poorly culturable; however, three bioaerosol samples yielded sufficient biomass following culture for whole-genome sequencing, revealing two different Mtb lineages. Detection of viable aerosolized Mtb in clinic attendees, independent of TB diagnosis, suggests that unidentified Mtb transmitters might contribute a significant attributable proportion of community exposure. Additional longitudinal studies with sputum culture-positive and -negative control participants are required to investigate this possibility.
| Errataetall: |
CommentIn: Proc Natl Acad Sci U S A. 2024 Apr 2;121(14):e2403321121. - PMID 38527210 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:121 |
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| Enthalten in: |
Proceedings of the National Academy of Sciences of the United States of America - 121(2024), 12 vom: 19. März, Seite e2314813121 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Patterson, Benjamin [VerfasserIn] |
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| Anmerkungen: |
Date Completed 14.03.2024 Date Revised 27.03.2024 published: Print-Electronic CommentIn: Proc Natl Acad Sci U S A. 2024 Apr 2;121(14):e2403321121. - PMID 38527210 Citation Status MEDLINE |
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| doi: |
10.1073/pnas.2314813121 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM369606523 |
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| 245 | 1 | 0 | |a Aerosolization of viable Mycobacterium tuberculosis bacilli by tuberculosis clinic attendees independent of sputum-Xpert Ultra status |
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| 520 | |a Potential Mycobacterium tuberculosis (Mtb) transmission during different pulmonary tuberculosis (TB) disease states is poorly understood. We quantified viable aerosolized Mtb from TB clinic attendees following diagnosis and through six months' follow-up thereafter. Presumptive TB patients (n=102) were classified by laboratory, radiological, and clinical features into Group A: Sputum-Xpert Ultra-positive TB (n=52), Group B: Sputum-Xpert Ultra-negative TB (n=20), or Group C: TB undiagnosed (n=30). All groups were assessed for Mtb bioaerosol release at baseline, and subsequently at 2 wk, 2 mo, and 6 mo. Groups A and B were notified to the national TB program and received standard anti-TB chemotherapy; Mtb was isolated from 92% and 90% at presentation, 87% and 74% at 2 wk, 54% and 44% at 2 mo and 32% and 20% at 6 mo, respectively. Surprisingly, similar numbers were detected in Group C not initiating TB treatment: 93%, 70%, 48% and 22% at the same timepoints. A temporal association was observed between Mtb bioaerosol release and TB symptoms in all three groups. Persistence of Mtb bioaerosol positivity was observed in ~30% of participants irrespective of TB chemotherapy. Captured Mtb bacilli were predominantly acid-fast stain-negative and poorly culturable; however, three bioaerosol samples yielded sufficient biomass following culture for whole-genome sequencing, revealing two different Mtb lineages. Detection of viable aerosolized Mtb in clinic attendees, independent of TB diagnosis, suggests that unidentified Mtb transmitters might contribute a significant attributable proportion of community exposure. Additional longitudinal studies with sputum culture-positive and -negative control participants are required to investigate this possibility | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Dinkele, Ryan |e verfasserin |4 aut | |
| 700 | 1 | |a Gessner, Sophia |e verfasserin |4 aut | |
| 700 | 1 | |a Koch, Anastasia |e verfasserin |4 aut | |
| 700 | 1 | |a Hoosen, Zeenat |e verfasserin |4 aut | |
| 700 | 1 | |a January, Vanessa |e verfasserin |4 aut | |
| 700 | 1 | |a Leonard, Bryan |e verfasserin |4 aut | |
| 700 | 1 | |a McKerry, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Seldon, Ronnett |e verfasserin |4 aut | |
| 700 | 1 | |a Vazi, Andiswa |e verfasserin |4 aut | |
| 700 | 1 | |a Hermans, Sabine |e verfasserin |4 aut | |
| 700 | 1 | |a Cobelens, Frank |e verfasserin |4 aut | |
| 700 | 1 | |a Warner, Digby F |e verfasserin |4 aut | |
| 700 | 1 | |a Wood, Robin |e verfasserin |4 aut | |
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