南非开普敦大学Keertan Dheda课题组的最新工作,发现了耐药性和药敏性肺结核患者咳嗽气溶胶培养物阳性的细菌和宿主决定因素。相关论文于2020年6月29日在线发表在《自然—医学》上。
Title: Bacterial and host determinants of cough aerosol culture positivity in patients with drug-resistant versus drug-susceptible tuberculosis
Author: Grant Theron, Jason Limberis, Rouxjeane Venter, Liezel Smith, Elize Pietersen, Aliasgar Esmail, Greg Calligaro, Julian te Riele, Marianna de Kock, Paul van Helden, Tawanda Gumbo, Taane G. Clark, Kevin Fennelly, Robin Warren, Keertan Dheda
Issue&Volume: 2020-06-29
Abstract: A burgeoning epidemic of drug-resistant tuberculosis (TB) threatens to derail global control efforts. Although the mechanisms remain poorly clarified, drug-resistant strains are widely believed to be less infectious than drug-susceptible strains. Consequently, we hypothesized that lower proportions of patients with drug-resistant TB would have culturable Mycobacterium tuberculosis from respirable, cough-generated aerosols compared to patients with drug-susceptible TB, and that multiple factors, including mycobacterial genomic variation, would predict culturable cough aerosol production. We enumerated the colony forming units in aerosols (≤10μm) from 452 patients with TB (227 with drug resistance), compared clinical characteristics, and performed mycobacterial whole-genome sequencing, dormancy phenotyping and drug-susceptibility analyses on M. tuberculosis from sputum. After considering treatment duration, we found that almost half of the patients with drug-resistant TB were cough aerosol culture-positive. Surprisingly, neither mycobacterial genomic variants, lineage, nor dormancy status predicted cough aerosol culture positivity. However, mycobacterial sputum bacillary load and clinical characteristics, including a lower symptom score and stronger cough, were strongly predictive, thereby supporting targeted transmission-limiting interventions. Effective treatment largely abrogated cough aerosol culture positivity; however, this was not always rapid. These data question current paradigms, inform public health strategies and suggest the need to redirect TB transmission-associated research efforts toward host–pathogen interactions.
DOI: 10.1038/s41591-020-0940-2
Source: https://www.nature.com/articles/s41591-020-0940-2
Nature Medicine:《自然—医学》,创刊于1995年。隶属于施普林格·自然出版集团,最新IF:87.241
官方网址:https://www.nature.com/nm/
投稿链接:https://mts-nmed.nature.com/cgi-bin/main.plex
本期文章:《自然—医学》:Online/在线发表