Objective:Health-care workers(HCWs)are known to be at high risk for occupational biological hazards,and this includes exposure to mycobacterium tuberculosis(TB)which can result in either active or latent TB infection(...Objective:Health-care workers(HCWs)are known to be at high risk for occupational biological hazards,and this includes exposure to mycobacterium tuberculosis(TB)which can result in either active or latent TB infection(LTBI).This study aims to provide an overview of the incidence of LTBI among HCWs in Brunei Darussalam,to examine associated risk factors,and to evaluate LTBI treatment compliance.Materials and Methods:This is a retrospective cross-sectional study which was conducted using data from January 2018 to December 2021,on notified cases of LTBI in HCWs which identified 115 cases.Demographic data,underlying medical conditions,and compliance to treatment were assessed through reviews of their electronic health records.Results:The incidence of LBTI was 14.6/year/1000 HCWs.The incidence rate reached a high of 24.6/1000 in 2020,and majority of cases were in the older age groups.There was good treatment acceptance and compliance(82.6%),and this was observed to be significantly higher in females than males(P=0.02).Conclusion:This study showed an average incidence of LTBI of 14.6/1000 HCWs over 4 years and high LTBI treatment acceptance(82.6%)and compliance.Emphasis on infection prevention and control measures in health-care settings and actions to increase awareness of LTBI are crucial interventions toward reducing the burden of LTBI.展开更多
Student contacts of tuberculosis（TB）cases are susceptible to latent tuberculosis infection（LTBI）,and chemo-prophylaxis can reduce the risk of active TB among them.This study aimed to assess the acceptance of chemo...Student contacts of tuberculosis（TB）cases are susceptible to latent tuberculosis infection（LTBI）,and chemo-prophylaxis can reduce the risk of active TB among them.This study aimed to assess the acceptance of chemo-prophylaxis for LTBI among students, and their concerns regarding TB and its preventive treatment.展开更多
Health care facilities are a high-risk environment for generating and spreading respiratory infectious diseases such as tuberculosis （TB）. The TB prevention and treatment staff in health care facilities are responsi...Health care facilities are a high-risk environment for generating and spreading respiratory infectious diseases such as tuberculosis （TB）. The TB prevention and treatment staff in health care facilities are responsible for the identification, diagnosis, treatment, supervision, and management of TB patients .展开更多
Preventive treatment has an essential effect on latent tuberculosis infection(LTBI)[purified protein derivative(PPD)induration≥15 mm].Between2010 and 2013,there were 6 tuberculosis(TB)outbreaks in the universities in...Preventive treatment has an essential effect on latent tuberculosis infection(LTBI)[purified protein derivative(PPD)induration≥15 mm].Between2010 and 2013,there were 6 tuberculosis(TB)outbreaks in the universities in Dalian,China.So far,in Dalian,the directly observed therapy(DOT)and展开更多
Latent tuberculosis infection(LTBI)has become a major source of active tuberculosis(ATB).Although the tuberculin skin test and interferon-gamma release assay can be used to diagnose LTBI,these methods can only differe...Latent tuberculosis infection(LTBI)has become a major source of active tuberculosis(ATB).Although the tuberculin skin test and interferon-gamma release assay can be used to diagnose LTBI,these methods can only differentiate infected individuals from healthy ones but cannot discriminate between LTBI and ATB.Thus,the diagnosis of LTBI faces many challenges,such as the lack of effective biomarkers from Mycobacterium tuberculosis(MTB)for distinguishing LTBI,the low diagnostic efficacy of biomarkers derived from the human host,and the absence of a gold standard to differentiate between LTBI and ATB.Sputum culture,as the gold standard for diagnosing tuberculosis,is time-consuming and cannot distinguish between ATB and LTBI.In this article,we review the pathogenesis of MTB and the immune mechanisms of the host in LTBI,including the innate and adaptive immune responses,multiple immune evasion mechanisms of MTB,and epigenetic regulation.Based on this knowledge,we summarize the current status and challenges in diagnosing LTBI and present the application of machine learning(ML)in LTBI diagnosis,as well as the advantages and limitations of ML in this context.Finally,we discuss the future development directions of ML applied to LTBI diagnosis.展开更多
<b><span style="font-family:Verdana;">Introduction: </span></b><span><span><span style="font-family:;" "=""><span style="font-family...<b><span style="font-family:Verdana;">Introduction: </span></b><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">The diagnosis of latent tuberculosis infection (LTBI) is based on secular ways: chest radiography and tuberculin skin test (TST). In front of a recent enthusiasm for LTBI, this paper reports a historical perspective of this concept. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">Bibliometric analysis and literature review from medi</span><span style="font-family:Verdana;">cal databases, using the terms “latent tuberculosis infection (“LTBI”), “prim</span><span style="font-family:Verdana;">ary tuberculosis”, “tuberculin skin test”, “tuberculosis”, and from reference books on tuberculosis. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">In the PubMED/MEDLINE search for LTBI, a total of 7787 articles were found between 1901 and 2020, 95% </span><span style="font-family:Verdana;">from 2000 to 2020. In the first part of the 20</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> century, </span><span style="font-family:Verdana;">LTBI term was used for sub-clinical tu</span><span><span style="font-family:Verdana;">berculosis disease, the latency being also called “</span><i><span style="font-family:Verdana;">primary tuberculosis</span></i><span style="font-family:Verdana;">” or <i>“</i></span><i><i><span style="font-family:Verdana;">ab</span></i></i></span><i><i><span style="font-family:Verdana;">ortive tuberculosis infection</span></i><span style="font-family:Verdana;">”</span></i>. <span style="font-family:Verdana;">From 1960, randomized prospective therapeutic studies mentioned </span></span><span><i></i></span><i><span style="font-family:Verdana;">“</span><i><span style="font-family:Verdana;">tuberculosis chemoprophylaxis</span></i><span style="font-family:Verdana;">”</span></i><span style="font-family:Verdana;">. By the end of the 20</span></span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> century,</span><span style="font-family:Verdana;"> the epidemic of AIDS impeded tuberculosis decrease, making LTBI </span><span><span style="font-family:Verdana;">search more efficient. In 2000, the <i></i></span><i><i><span style="font-family:Verdana;">American Thoracic Society</span></i></i></span><i><span style="font-family:Verdana;"></span></i></span><span><span style="font-family:Verdana;"> and the <i></i></span><i><i><span style="font-family:Verdana;">Center</span></i></i></span><i><i><span style="font-family:Verdana;">s </span><span style="font-family:Verdana;">for Disease Controls and Prevention</span></i><span style="font-family:Verdana;"></span></i><i><span> </span></i><span style="font-family:Verdana;">proposed the systematic used of LTBI, rel</span><span style="font-family:Verdana;">ayed through public health policies. A significant higher scientific produc</span><span style="font-family:Verdana;">tion about LT</span><span style="font-family:Verdana;">BI was noted, supported by IGRA tests comm</span><span><span style="font-family:Verdana;">ercialization. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In the recent years, health public policies, combined with epidemiologic and economic factors, strengthened the use of LTBI terminology.</span></span>展开更多
Objective: The aim of this study is to investigate how individuals with type 2 diabetes mellitus’ pancreatic β-cell function index and insulin resistance index are affected by tuberculosis infection. Methods: The st...Objective: The aim of this study is to investigate how individuals with type 2 diabetes mellitus’ pancreatic β-cell function index and insulin resistance index are affected by tuberculosis infection. Methods: The study group consisted of 89 patients with type 2 diabetes mellitus and tuberculosis infection who were admitted to Jingzhou Chest Hospital between March 2019 and March 2021. Gender and duration of diabetes were matching conditions. The control group was made up of 89 patients with type 2 diabetes who were admitted to Jingzhou Central Hospital’s endocrinology department during the same period. The two patient groups provided general information such as gender, age, length of diabetes, and blood biochemical indexes such as glycosylated hemoglobin (HbA1c), fasting glucose (FPG), and fasting C-peptide (FC-P). The HOMA calculator was used to calculate the HOMA-β and the HOMA-IR, and intergroup comparisons and correlation analyses were carried out. Results: Regarding gender, age, disease duration, FC-P, and HbA1c, the differences between the two groups were not statistically significant (P > 0.05). However, BMI, FPG, HOMA-β, and HOMA-IR showed statistically significant differences (P < 0.05). In comparison to the control group, the study group’s HOMA-β was lower and its HOMA-IR was greater. According to Spearman’s correlation analysis, HOMA-β had a negative association (P th FPG, HbA1c, and the length of the disease, and a positive correlation with BMI and FC-P. A positive correlation was found between HOMA-IR and BMI, FPG, and FC-P (P < 0.01), as well as a correlation with the length of the disease (P > 0.05) and HbA1c. Conclusions: In type 2 diabetes mellitus combined with tuberculosis infection, the patients had higher FPG levels and lower FC-P levels, the secretory function of pancreatic β-cells was more severely impaired, and insulin resistance was more obvious.展开更多
Introduction:We explored risk factors for latent tuberculosis infection(LTBI)and developed a risk prediction model using machine learning algorithms.Methods:Patients with active pulmonary TB in months 3 to 6 of anti-T...Introduction:We explored risk factors for latent tuberculosis infection(LTBI)and developed a risk prediction model using machine learning algorithms.Methods:Patients with active pulmonary TB in months 3 to 6 of anti-TB treatment in Henan Province,China,July–September 2024 were selected as index cases.Close contacts identified through epidemiological investigation underwent tuberculinpurified protein derivative testing to determine LTBI status.Face-to-face questionnaires were conducted to collect epidemiological data.The dataset was divided into training and testing sets(6:4),using a fixed random seed.Five models—logistic regression(LR),decision tree(DT),random forest(RF),support vector machines(SVM),and multilayer perceptron(MLP)—were trained and evaluated using the mean squared error(MSE)and coefficient of determination.The test set was subjected to external validation.Receiver operating characteristic curve analysis,area under the curve(AUC),and F1-scores were used to quantify predictive performance.Results:Among 795 close contacts,LTBI prevalence was 401(50.5%).By MSE,models ranked:SVM(0.121),RF(0.165),DT(0.197),LR(0.229),and MLP(0.233).SVM identified five key predictors:contact type of index case,key population classification,residential area,frequency of participation in group activities,and etiological results.Internal validation showed strong performance(AUC=0.921,F1=0.858),whereas external validation showed moderate performance(AUC=0.752,F1=0.694).Conclusion:The SVM model incorporating contact type of index case,key population classification,residential area,frequency of group activity participation,and etiological results demonstrated robust predictive value for LTBI risk.This model shows promise for the targeted screening and management of high-risk populations.展开更多
Background and Objectives:Tuberculosis(TB)remains a major public health threat worldwide,but most of the presumed infected individuals remain asymptomatic and contain Mycobacterium tuberculosis(MTB)in a latent tubercu...Background and Objectives:Tuberculosis(TB)remains a major public health threat worldwide,but most of the presumed infected individuals remain asymptomatic and contain Mycobacterium tuberculosis(MTB)in a latent tuberculosis infection(LTBI),and some of them will progress to active tuberculosis.Vitamin B-12 is crucial to maintain immune function,and play a role in the metabolism of MTB,while few studies investigated the impact of vitamin B-12 deficiency on tuberculosis.Therefore,we carried out the study to explore the association be tween vitamin B-12 deficiency and LTBI using the National Health and Nutrition Examination Surveys(NHANES).Methods and Study Design:A cross-sectional study was conducted by using data from NHANES 2011-2012.Adults(aged≥18 years)who had available data on serum Vitamin B-12,serum Methylmalonic Acid(MMA)and QuantiFERON-TB Gold In-Tube(QFT-GIT)results were included in the analysis.Multivariable lo gistic regression was used to assess the association between Vitamin B-12 deficiency and LTBI.Results:A total of 4773 subjects were included in the present study,of whom 479 were screened as LTBI.The LTBI group had a higher proportion of participants with low Vitamin B-12 status.After adjusting for the possible confounders,Vit amin B-12 deficiency was independently associated with a 37%increased odds ratio of LTBI in the participants(OR:1.37;95%CI:1.01-1.85).Similar correlations remained in subjects aged≥35 years and female subjects by further stratified analysis.Conclusions:Vitamin B-12 deficiency was significantly associated with higher preva lence of LTBI in US adults.Maintenance of optimal Vitamin B-12 status has potential benefits for LTBI preven tion.Future studies are needed to assess the roles and clinical implications of Vitamin B-12 in MTB infection.展开更多
Background The health-care workers （HCWs） are at high risk of acquiring infection with Mycobacterium tuberculosis. The objectives of this study were to compare the performance of the T-SPOT.TB and tuberculin skin te...Background The health-care workers （HCWs） are at high risk of acquiring infection with Mycobacterium tuberculosis. The objectives of this study were to compare the performance of the T-SPOT.TB and tuberculin skin test （TST） for latent tuberculosis infection （LTBI）, evaluate diagnostic concordance and risk factors for LTBI, and observe the progression to active tuberculosis （TB） disease among HCWs in a general hospital in Beijing. Methods The prospective cohort study enrolled HCWs in a tertiary general hospital in Beijing, China, to evaluate LTBI with T-SPOT.TB and TST. The subjects were evaluated every 12 months during the 60-month follow-up. Results Of 101 participating HCWs, 96 and 101 had valid TST and T-SPOT.TB results, respectively. Twenty-nine （28.7%, 95% confidence interval （C/）, 19.9%-37.5%） were defined as positive by T-SPOT.TB and 53 （55.2%, 95% CI, 45.2%-64.9%） were defined as positive by TST （using a ≥10 mm cutoff）. An agreement between the two tests was poor （57.3%, K=0.18, 95% CI, 0.01%-0.52%）. In multJvariate analysis, direct exposure to sputum smear-positive TB patients was a significant risk factor for a positive T-SPOT.TB （OR 5.76; 95% CI 1.38-24.00）. Pooled frequency of antigen- specific IFN-y secreting T-cells for subjects who reported direct contact with sputum smear-positive TB patients was significantly higher than that for participants without direct contact （P=0.045）. One of 20 participants with positive result of T-SPOT.TB and TST developed active TB at 24-month follow-up.Conclusion T-SPOT.TB is a more accurate, targeted method of diagnosing LTBI than TST.展开更多
Background: Differential diagnosis of active tuberculosis (ATB) and latent tuberculosis infection (LTBI) has been a challenge for clinicians in high TB burden countries. The purpose of this study was to improve the ac...Background: Differential diagnosis of active tuberculosis (ATB) and latent tuberculosis infection (LTBI) has been a challenge for clinicians in high TB burden countries. The purpose of this study was to improve the accuracy of differential diagnosis of ATB and LTBI by using fluorescent immunospot (FluoroSpot) assay to detect specific Th1 cell immune responses. The novelmycobacterium tuberculosis (MTB) latency-associated antigens Rv1733c and synthetic long peptides derived from Rv1733c (Rv1733c SLP) were used based on virulence factors early secreting antigen target-6 (ESAT-6) and culture filtrate protein-10 (CFP-10).Methods: Fifty-seven ATB cases, including 20 pathogen-confirmed ATB and 37 clinically diagnosed ATB, and 36 LTBI cases, were enrolled between January and December 2017. FluoroSpot assay was used to detect the interferon γ (IFN-γ) and interleukin 2 (IL-2) secreted by the specific T cells after being stimulated with MTB virulence factors ESAT-6 and CFP-10, MTB latency-associated antigens Rv1733c and Rv1733c SLP. The receiver operating characteristic (ROC) curve was used to define the best cutoff value of latency-associated antigens in the use of differentiating ATB and LTBI. The sensitivity, specificity, predictive value, and likelihood ratio of ESAT-6 and CFP-10-FluoroSpot combined with latency-associated antigen in the differential diagnosis of ATB and LTBI were also calculated.Results: Following the stimulation with Rv1733c and Rv1733c SLP, the frequency of single IL-2-secreting T cells stimulated by Rv1733c SLP had the largest area under the ROC curve, which was 0.766. With a cutoff value of 1 (spot-forming cells [SFCs]/2.5 × 105 peripheral blood mononuclear cells) for frequency, the sensitivity and specificity of distinguishing ATB from LTBI were 72.2% and 73.7%, respectively. ESAT-6 and CFP-10-FluoroSpot detected the frequency and proportion of single IFN-γ-secreting T cells;the sensitivity and specificity of distinguishing ATB from LTBI were 82.5% and 66.7%, respectively. Combined with the frequency of single IL-2-secreting T cells stimulated by Rv1733c SLP on the basis of ESAT-6 and CFP-10-FluoroSpot, the sensitivity and specificity increased to 84.2% and 83.3%, respectively.Conclusion: Rv1733c SLP, combined with ESAT-6 and CFP-10, might be used as a candidate antigen for T cell-based tuberculosis diagnostic tests to differentiate ATB from LTBI.展开更多
Objective Current commercially available immunological tests cannot be used for discriminating active tuberculosis(TB)from latent TB infection.To evaluate the value of biomarker candidates in the diagnosis of active T...Objective Current commercially available immunological tests cannot be used for discriminating active tuberculosis(TB)from latent TB infection.To evaluate the value of biomarker candidates in the diagnosis of active TB,this study aimed to identify differentially expressed genes in peripheral blood mononuclear cells(PBMCs)between patients with active TB and individuals with latent TB infection by transcriptome sequencing.Methods The differentially expressed genes in unstimulated PBMCs and in Mycobacterium tuberculosis(Mtb)antigen-stimulated PBMCs from patients with active TB and individuals with latent TB infection were identified by transcriptome sequencing.Selected candidate genes were evaluated in cohorts consisting of 110 patients with TB,30 individuals with latent TB infections,and 50 healthy controls by quantitative real-time RT-PCR.Receiver operating characteristic(ROC)curve analysis was performed to calculate the diagnostic value of the biomarker candidates.Results Among the differentially expressed genes in PBMCs without Mtb antigen stimulation,interferon-induced protein with tetratricopeptide repeats 3(IFIT3)had the highest area under curve(AUC)value(0.918,95%CI:0.852-0.984,P<0.0001)in discriminating patients with active TB from individuals with latent TB infection,with a sensitivity of 91.86%and a specificity of 84.00%.In Mtb antigen-stimulated PBMCs,orosomucoid 1(ORM1)had a high AUC value(0.833,95%CI:0.752-0.915,P<0.0001),with a sensitivity of 81.94%and a specificity of 70.00%.Conclusion IFIT3 and ORM1 might be potential biomarkers for discriminating active TB from latent TB infection.展开更多
Background:Diagnosing latent tuberculosis(TB)infection(LTBI)and active TB(ATB)is crucial for preventing disease progression and transmission.However,current diagnostic tests have limitations in terms of accuracy and s...Background:Diagnosing latent tuberculosis(TB)infection(LTBI)and active TB(ATB)is crucial for preventing disease progression and transmission.However,current diagnostic tests have limitations in terms of accuracy and sensitivity,making it challenging to diagnose these different infection states.Therefore,this study intends to develop a promising biomarker for LTBI and ATB diagnosis to overcome the limitations of the current diagnostic tests.Methods:We developed a novelmultiepitope-based diagnostic biomarker(MEBDB)fromLTBI region of differentiation antigens using bioinformatics and immunoinformatics.Immune responses induced byMEBDM were detected using enzyme-linked immunosorbent spot and cytometric bead assays.This study was conducted from April 2022 to December 2022 in the SeniorDepartment of Tuberculosis at the 8thMedical Center of PLA General Hospital,China.Blood samples were collected from participants with ATB,individuals with LTBI,and healthy controls(HCs).The diagnostic efficacy of MEBDB was evaluated using receiver operating characteristic curves.Results:A novel MEBDB,designated as CP19128P,was generated.CP19128P comprises 19 helper T lymphocyte epitopes,12 cytotoxic T lymphocyte epitopes,and 8 B-cell epitopes.In silico simulations demonstrated that CP19128P possesses strong affinity for Toll-like receptors and elicits robust innate and adaptive immune responses.CP19128P generated significantly higher levels of tumor necrosis factor(TNF-α),interleukin 4(IL-4),and IL-10 in ATB patients(n=7)and LTBI(n=8)individuals compared with HCs(n=62)(P<0.001).Moreover,CP19128P-induced specific cytokines could be used to discriminate LTBI and ATB from healthy subjects with high sensitivity and specificity.Combining IL-2 with IL-4 or TNF-α could differentiate LTBI from HCs(the area under the receiver operating characteristic curve[AUC],0.976[95% confidence interval[CI],0.934-1.000]or 0.986[0.956-1.000]),whereas combining IL-4 with IL-17A or TNF-α could differentiate ATB from HCs(AUC,0.887[0.782-0.993]or 0.984[0.958-1.000]).Conclusions:Our study revealed that CP19128P is a potential MEBDBfor the diagnosis of LTBI andATB.Our findings suggest a promising strategy for developing novel,accurate,and sensitive diagnostic biomarkers and identifying new targets for TB diagnosis and management.展开更多
Background:Latent tuberculosis infection(LTBI)is a significant source of active tuberculosis(ATB),yet distinguishing between them is challenging because specific biomarkers are lacking.Methods:We analyzed four microar...Background:Latent tuberculosis infection(LTBI)is a significant source of active tuberculosis(ATB),yet distinguishing between them is challenging because specific biomarkers are lacking.Methods:We analyzed four microarray datasets(GSE19491,GSE37250,GSE54992,GSE28623)from the gene expression omnibus to identify differ-entially expressed genes(DEGs).Using protein-protein interaction(PPI)networks and LASSO-SVM algorithms,we selected three candidate bio-markers and evaluated their diagnostic efficacy.The expression levels of core genes were validated by RNA sequencing of healthy,ATB,and LTBI groups in a real-world cohort.We conducted Gene Ontology and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses,predicted shared upstream miRNAs,constructed miRNA-hub and transcription factor(TF)-hub gene networks,and performed immune infiltration analysis.Results:Three hub genes(SERPING1,C1QC,C1QB)were identified from 45 DEGs by PPI networks and machine learning screening.The diagnostic model based on the three hub genes had an area under the curve(AUC)value of 0.843 in the training set GSE19491 and 0.865 in the validation set GSE28623.Real-world transcriptome sequencing confirmed the expression trends of the hub genes across healthy,LTBI,and ATB groups.GO analysis showed that the 45 hub genes were primarily associated with immune inflammatory responses and pattern recognition receptors,whereas KEGG analysis indicated enrich-ment in complement and coagulation cascades.The miRNA-hub and TF-hub gene network analysis identified nine miRNAs and the zinc finger TF GATA2 as potential co-regulators of SERPING1,C1QC,and C1QB.Immune cell infiltration analysis identified significant differences in the immune micro-environment between LTBI and ATB,with macrophages and natural killer cells showing significant correlations with tuberculosis infection.Conclusion:The diagnostic model with SERPING1,C1QC,and C1QB shows promise in distinguishing LTBI from ATB,indicating its potential as a diag-nostic tool.展开更多
Objective:This paper aims to explore the effect of individualized nursing intervention on patients with active tuberculosis(ATB)and latent tuberculosis infection(LTBI).Methods:The nursing study started in January 2020...Objective:This paper aims to explore the effect of individualized nursing intervention on patients with active tuberculosis(ATB)and latent tuberculosis infection(LTBI).Methods:The nursing study started in January 2020 and ended in January 2023.A total of 60 patients with ATB and LTBI were included,and they were divided into two groups according to the intervention schemes selected for control testing,each with 30 cases.The intervention program selected for group A was routine care,and for group B was individualized nursing.The proportion of adverse reactions,changes in the level of lung items,self-management outcomes and satisfaction were evaluated and compared.Results:After evaluating the proportion of adverse reactions,the total proportion of ATB and LTBI in group B was lower than that in group A(P<0.05).Based on the evaluation and testing of the expiratory flow(EF),expiratory volume(EV),and vital capacity(VC)after the intervention,these levels in group B showed higher outcomes than those in group A(P<0.05).The scores in terms of living habits,sleep,diet,and compliance in group B were higher than those in group A(P<0.05).The total proportion of the satisfaction of ATB and LTBI patients in group B was higher than that in group A(P<0.05).Conclusion:After the intervention of individualized nursing measures in patients with ATB and LTBI,it was found that it can not only play a positive role in the prevention and control of adverse reactions,but also improve their lung function,and promote their self-management,with good satisfaction level,thus it has high research and clinical application values.展开更多
Nosocomial infections（NIs） are a critical issue affecting the quality of healthcare. In this study, we performed a retrospective study to explore the incidence rates, mortality rates, and microbial spectrum of NIs i...Nosocomial infections（NIs） are a critical issue affecting the quality of healthcare. In this study, we performed a retrospective study to explore the incidence rates, mortality rates, and microbial spectrum of NIs in Beijing Chest Hospital, a tuberculosis（TB） specialized hospital in China. Our data demonstrate that the overall incidence rate of inpatients with NIs slightly decreased from 2012 to 2016, which may be associated with the implementation of hand hygiene measures, while the mortality rates associated with NI did not significantly change. In addition, the species distribution of NIs was quite different from that presented in previous reports, and Klebsiella pneumoniae was the most frequently isolated microorganism.展开更多
Objective We aimed to understand the willingness and barriers to the acceptance of tuberculosis(TB)preventive treatment(TPT)among people with latent TB infection(LTBI)in China.Methods A multicenter cross-sectional stu...Objective We aimed to understand the willingness and barriers to the acceptance of tuberculosis(TB)preventive treatment(TPT)among people with latent TB infection(LTBI)in China.Methods A multicenter cross-sectional study was conducted from May 18,2023 to December 31,2023 across 10 counties in China.According to a national technical guide,we included healthcare workers,students,teachers,and others occupations aged 15-65 years as our research participants.Results Overall,17.0%(183/1,077)of participants accepted TPT.There were statistically significant differences in the acceptance rate of TPT among different sexes,ages,educational levels,and occupations(P<0.05).The main barriers to TPT acceptance were misconceptions that it had uncertain effects on prevention(57.8%,517/894),and concerns about side effects(32.7%,292/894).Conclusion An enhanced and comprehensive understanding of LTBI and TPT among people with LTBI is vital to further expand TPT in China.Moreover,targeted policies need to be developed to address barriers faced by different groups of people.展开更多
Objective:To investigate the clinical diagnostic significance of peripheral blood T-cell test(T-spot test)for tuberculosis(TB)infection combined with erythrocyte sedimentation rate(ESR)in pulmonary TB.Methods:41 patie...Objective:To investigate the clinical diagnostic significance of peripheral blood T-cell test(T-spot test)for tuberculosis(TB)infection combined with erythrocyte sedimentation rate(ESR)in pulmonary TB.Methods:41 patients with a clinical diagnosis of TB during hospitalization from January 2020 to April 2023 in our hospital were selected as the experimental group,and 45 patients without TB(bronchopneumonia patients)were selected as the control group.The diagnostic specificity,sensitivity,and accuracy of the T-spot TB test,ESR test,and the combined test of the two were calculated respectively.Results:The sensitivity,specificity,and accuracy of the T-spot TB test combined with ESR for the diagnosis of TB in the experimental group were significantly higher than the individual results of the T-spot TB test and ESR test alone(P<0.05).Conclusion:The T-spot TB test combined with the ESR test for TB diagnosis has greater clinical value than carrying out the tests individually.展开更多
Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants ...Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants who were between 3 months and 14 years old and had close contact with smear-positive pulmonary tuberculosis were included. Both QFT-GIT test and TST were done and the results were analyzed by SPSS software and Kappa test. Results: The distribution of gender and age according to QFT-GIT and TST results were matched (P>0.05). Overall agreement between QFT-GIT and TST for diagnosis of latent tuberculosis infection in children was 75%. In addition, the contingency coefficient was 0.257, and the Kappa measure of agreement was 0.246 (P=0.034). Conclusions: Compared to TST, QFT-GIT shows no apparent advantage for diagnosis of latent tuberculosis infection in children.展开更多
Introduction: Tuberculosis (TB) remains a significant public health challenge, particularly in high-endemicity settings where latent TB infections (LTBI) contribute to ongoing transmission. Early identification and ma...Introduction: Tuberculosis (TB) remains a significant public health challenge, particularly in high-endemicity settings where latent TB infections (LTBI) contribute to ongoing transmission. Early identification and management of LTBI are crucial in limiting the spread of the disease. This study demonstrates the role of Interferon Gamma Release Assay (IGRA) as a screening tool for latent tuberculosis in high-burden region. Materials and Methods: This retrospective observational study assessed the detection of LTBI using the QuantiFERON-TB Gold Plus (QFT-Plus) test among 145 patients at the Department of Microbiology & Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from August 2023 to August 2024. The study included patients suspected of TB, those screened before immunosuppressive therapy, organ transplantation, or kidney dialysis. Participants were tested IGRA using QFT-Plus, which detects interferon-gamma (IFN-γ) released in response to Mycobacterium tuberculosis antigens. Results and Discussion: Among 145 patients tested for the QFT-Gold Plus test, 55.17% (n = 80) were positive for LTBI, with a substantial agreement between TB1 and TB2 responses (p Conclusion: The results highlight that QFT-Plus may be utilized as a useful diagnostic screening tool for latent TB in regions with a high disease burden, though challenges related to cost and infrastructure persist. With growing global efforts to eliminate tuberculosis, focused screening and treatment of LTBI in high-risk groups could play a vital role in reducing the progression of TB. The study underscores the importance of targeted screening for LTBI to reduce the progression to active TB, particularly in resource-limited settings.展开更多
文摘Objective:Health-care workers(HCWs)are known to be at high risk for occupational biological hazards,and this includes exposure to mycobacterium tuberculosis(TB)which can result in either active or latent TB infection(LTBI).This study aims to provide an overview of the incidence of LTBI among HCWs in Brunei Darussalam,to examine associated risk factors,and to evaluate LTBI treatment compliance.Materials and Methods:This is a retrospective cross-sectional study which was conducted using data from January 2018 to December 2021,on notified cases of LTBI in HCWs which identified 115 cases.Demographic data,underlying medical conditions,and compliance to treatment were assessed through reviews of their electronic health records.Results:The incidence of LBTI was 14.6/year/1000 HCWs.The incidence rate reached a high of 24.6/1000 in 2020,and majority of cases were in the older age groups.There was good treatment acceptance and compliance(82.6%),and this was observed to be significantly higher in females than males(P=0.02).Conclusion:This study showed an average incidence of LTBI of 14.6/1000 HCWs over 4 years and high LTBI treatment acceptance(82.6%)and compliance.Emphasis on infection prevention and control measures in health-care settings and actions to increase awareness of LTBI are crucial interventions toward reducing the burden of LTBI.
基金supported by the National Key Science&Technology project against major infectious diseases[No.2017ZX10105012]the Fourth Round of Three-Year Public Health Action Plan of Shanghai,China[No.15GWZK0101]
文摘Student contacts of tuberculosis（TB）cases are susceptible to latent tuberculosis infection（LTBI）,and chemo-prophylaxis can reduce the risk of active TB among them.This study aimed to assess the acceptance of chemo-prophylaxis for LTBI among students, and their concerns regarding TB and its preventive treatment.
基金funded by the China-Gates Foundation TB Control Project(Phase Ⅱ)(51914)
文摘Health care facilities are a high-risk environment for generating and spreading respiratory infectious diseases such as tuberculosis （TB）. The TB prevention and treatment staff in health care facilities are responsible for the identification, diagnosis, treatment, supervision, and management of TB patients .
文摘Preventive treatment has an essential effect on latent tuberculosis infection(LTBI)[purified protein derivative(PPD)induration≥15 mm].Between2010 and 2013,there were 6 tuberculosis(TB)outbreaks in the universities in Dalian,China.So far,in Dalian,the directly observed therapy(DOT)and
文摘Latent tuberculosis infection(LTBI)has become a major source of active tuberculosis(ATB).Although the tuberculin skin test and interferon-gamma release assay can be used to diagnose LTBI,these methods can only differentiate infected individuals from healthy ones but cannot discriminate between LTBI and ATB.Thus,the diagnosis of LTBI faces many challenges,such as the lack of effective biomarkers from Mycobacterium tuberculosis(MTB)for distinguishing LTBI,the low diagnostic efficacy of biomarkers derived from the human host,and the absence of a gold standard to differentiate between LTBI and ATB.Sputum culture,as the gold standard for diagnosing tuberculosis,is time-consuming and cannot distinguish between ATB and LTBI.In this article,we review the pathogenesis of MTB and the immune mechanisms of the host in LTBI,including the innate and adaptive immune responses,multiple immune evasion mechanisms of MTB,and epigenetic regulation.Based on this knowledge,we summarize the current status and challenges in diagnosing LTBI and present the application of machine learning(ML)in LTBI diagnosis,as well as the advantages and limitations of ML in this context.Finally,we discuss the future development directions of ML applied to LTBI diagnosis.
文摘<b><span style="font-family:Verdana;">Introduction: </span></b><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">The diagnosis of latent tuberculosis infection (LTBI) is based on secular ways: chest radiography and tuberculin skin test (TST). In front of a recent enthusiasm for LTBI, this paper reports a historical perspective of this concept. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">Bibliometric analysis and literature review from medi</span><span style="font-family:Verdana;">cal databases, using the terms “latent tuberculosis infection (“LTBI”), “prim</span><span style="font-family:Verdana;">ary tuberculosis”, “tuberculin skin test”, “tuberculosis”, and from reference books on tuberculosis. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">In the PubMED/MEDLINE search for LTBI, a total of 7787 articles were found between 1901 and 2020, 95% </span><span style="font-family:Verdana;">from 2000 to 2020. In the first part of the 20</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> century, </span><span style="font-family:Verdana;">LTBI term was used for sub-clinical tu</span><span><span style="font-family:Verdana;">berculosis disease, the latency being also called “</span><i><span style="font-family:Verdana;">primary tuberculosis</span></i><span style="font-family:Verdana;">” or <i>“</i></span><i><i><span style="font-family:Verdana;">ab</span></i></i></span><i><i><span style="font-family:Verdana;">ortive tuberculosis infection</span></i><span style="font-family:Verdana;">”</span></i>. <span style="font-family:Verdana;">From 1960, randomized prospective therapeutic studies mentioned </span></span><span><i></i></span><i><span style="font-family:Verdana;">“</span><i><span style="font-family:Verdana;">tuberculosis chemoprophylaxis</span></i><span style="font-family:Verdana;">”</span></i><span style="font-family:Verdana;">. By the end of the 20</span></span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> century,</span><span style="font-family:Verdana;"> the epidemic of AIDS impeded tuberculosis decrease, making LTBI </span><span><span style="font-family:Verdana;">search more efficient. In 2000, the <i></i></span><i><i><span style="font-family:Verdana;">American Thoracic Society</span></i></i></span><i><span style="font-family:Verdana;"></span></i></span><span><span style="font-family:Verdana;"> and the <i></i></span><i><i><span style="font-family:Verdana;">Center</span></i></i></span><i><i><span style="font-family:Verdana;">s </span><span style="font-family:Verdana;">for Disease Controls and Prevention</span></i><span style="font-family:Verdana;"></span></i><i><span> </span></i><span style="font-family:Verdana;">proposed the systematic used of LTBI, rel</span><span style="font-family:Verdana;">ayed through public health policies. A significant higher scientific produc</span><span style="font-family:Verdana;">tion about LT</span><span style="font-family:Verdana;">BI was noted, supported by IGRA tests comm</span><span><span style="font-family:Verdana;">ercialization. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In the recent years, health public policies, combined with epidemiologic and economic factors, strengthened the use of LTBI terminology.</span></span>
文摘Objective: The aim of this study is to investigate how individuals with type 2 diabetes mellitus’ pancreatic β-cell function index and insulin resistance index are affected by tuberculosis infection. Methods: The study group consisted of 89 patients with type 2 diabetes mellitus and tuberculosis infection who were admitted to Jingzhou Chest Hospital between March 2019 and March 2021. Gender and duration of diabetes were matching conditions. The control group was made up of 89 patients with type 2 diabetes who were admitted to Jingzhou Central Hospital’s endocrinology department during the same period. The two patient groups provided general information such as gender, age, length of diabetes, and blood biochemical indexes such as glycosylated hemoglobin (HbA1c), fasting glucose (FPG), and fasting C-peptide (FC-P). The HOMA calculator was used to calculate the HOMA-β and the HOMA-IR, and intergroup comparisons and correlation analyses were carried out. Results: Regarding gender, age, disease duration, FC-P, and HbA1c, the differences between the two groups were not statistically significant (P > 0.05). However, BMI, FPG, HOMA-β, and HOMA-IR showed statistically significant differences (P < 0.05). In comparison to the control group, the study group’s HOMA-β was lower and its HOMA-IR was greater. According to Spearman’s correlation analysis, HOMA-β had a negative association (P th FPG, HbA1c, and the length of the disease, and a positive correlation with BMI and FC-P. A positive correlation was found between HOMA-IR and BMI, FPG, and FC-P (P < 0.01), as well as a correlation with the length of the disease (P > 0.05) and HbA1c. Conclusions: In type 2 diabetes mellitus combined with tuberculosis infection, the patients had higher FPG levels and lower FC-P levels, the secretory function of pancreatic β-cells was more severely impaired, and insulin resistance was more obvious.
基金Supported by grants from Henan Provincial Science and Technology Development Program(Grant No.242102311109).
文摘Introduction:We explored risk factors for latent tuberculosis infection(LTBI)and developed a risk prediction model using machine learning algorithms.Methods:Patients with active pulmonary TB in months 3 to 6 of anti-TB treatment in Henan Province,China,July–September 2024 were selected as index cases.Close contacts identified through epidemiological investigation underwent tuberculinpurified protein derivative testing to determine LTBI status.Face-to-face questionnaires were conducted to collect epidemiological data.The dataset was divided into training and testing sets(6:4),using a fixed random seed.Five models—logistic regression(LR),decision tree(DT),random forest(RF),support vector machines(SVM),and multilayer perceptron(MLP)—were trained and evaluated using the mean squared error(MSE)and coefficient of determination.The test set was subjected to external validation.Receiver operating characteristic curve analysis,area under the curve(AUC),and F1-scores were used to quantify predictive performance.Results:Among 795 close contacts,LTBI prevalence was 401(50.5%).By MSE,models ranked:SVM(0.121),RF(0.165),DT(0.197),LR(0.229),and MLP(0.233).SVM identified five key predictors:contact type of index case,key population classification,residential area,frequency of participation in group activities,and etiological results.Internal validation showed strong performance(AUC=0.921,F1=0.858),whereas external validation showed moderate performance(AUC=0.752,F1=0.694).Conclusion:The SVM model incorporating contact type of index case,key population classification,residential area,frequency of group activity participation,and etiological results demonstrated robust predictive value for LTBI risk.This model shows promise for the targeted screening and management of high-risk populations.
基金supported by the Natural Science Foundation of Shandong Province(No.ZR2022MH233).
文摘Background and Objectives:Tuberculosis(TB)remains a major public health threat worldwide,but most of the presumed infected individuals remain asymptomatic and contain Mycobacterium tuberculosis(MTB)in a latent tuberculosis infection(LTBI),and some of them will progress to active tuberculosis.Vitamin B-12 is crucial to maintain immune function,and play a role in the metabolism of MTB,while few studies investigated the impact of vitamin B-12 deficiency on tuberculosis.Therefore,we carried out the study to explore the association be tween vitamin B-12 deficiency and LTBI using the National Health and Nutrition Examination Surveys(NHANES).Methods and Study Design:A cross-sectional study was conducted by using data from NHANES 2011-2012.Adults(aged≥18 years)who had available data on serum Vitamin B-12,serum Methylmalonic Acid(MMA)and QuantiFERON-TB Gold In-Tube(QFT-GIT)results were included in the analysis.Multivariable lo gistic regression was used to assess the association between Vitamin B-12 deficiency and LTBI.Results:A total of 4773 subjects were included in the present study,of whom 479 were screened as LTBI.The LTBI group had a higher proportion of participants with low Vitamin B-12 status.After adjusting for the possible confounders,Vit amin B-12 deficiency was independently associated with a 37%increased odds ratio of LTBI in the participants(OR:1.37;95%CI:1.01-1.85).Similar correlations remained in subjects aged≥35 years and female subjects by further stratified analysis.Conclusions:Vitamin B-12 deficiency was significantly associated with higher preva lence of LTBI in US adults.Maintenance of optimal Vitamin B-12 status has potential benefits for LTBI preven tion.Future studies are needed to assess the roles and clinical implications of Vitamin B-12 in MTB infection.
文摘Background The health-care workers （HCWs） are at high risk of acquiring infection with Mycobacterium tuberculosis. The objectives of this study were to compare the performance of the T-SPOT.TB and tuberculin skin test （TST） for latent tuberculosis infection （LTBI）, evaluate diagnostic concordance and risk factors for LTBI, and observe the progression to active tuberculosis （TB） disease among HCWs in a general hospital in Beijing. Methods The prospective cohort study enrolled HCWs in a tertiary general hospital in Beijing, China, to evaluate LTBI with T-SPOT.TB and TST. The subjects were evaluated every 12 months during the 60-month follow-up. Results Of 101 participating HCWs, 96 and 101 had valid TST and T-SPOT.TB results, respectively. Twenty-nine （28.7%, 95% confidence interval （C/）, 19.9%-37.5%） were defined as positive by T-SPOT.TB and 53 （55.2%, 95% CI, 45.2%-64.9%） were defined as positive by TST （using a ≥10 mm cutoff）. An agreement between the two tests was poor （57.3%, K=0.18, 95% CI, 0.01%-0.52%）. In multJvariate analysis, direct exposure to sputum smear-positive TB patients was a significant risk factor for a positive T-SPOT.TB （OR 5.76; 95% CI 1.38-24.00）. Pooled frequency of antigen- specific IFN-y secreting T-cells for subjects who reported direct contact with sputum smear-positive TB patients was significantly higher than that for participants without direct contact （P=0.045）. One of 20 participants with positive result of T-SPOT.TB and TST developed active TB at 24-month follow-up.Conclusion T-SPOT.TB is a more accurate, targeted method of diagnosing LTBI than TST.
基金This study was supported by grants from the National Science and Technology Major Project of China(No.2017ZX10201302)the Chinese Academy of Medical Sciences Initiative for Innovative Medicine(Nos.2016-I2M-1-013,2019-I2M-2-005)。
文摘Background: Differential diagnosis of active tuberculosis (ATB) and latent tuberculosis infection (LTBI) has been a challenge for clinicians in high TB burden countries. The purpose of this study was to improve the accuracy of differential diagnosis of ATB and LTBI by using fluorescent immunospot (FluoroSpot) assay to detect specific Th1 cell immune responses. The novelmycobacterium tuberculosis (MTB) latency-associated antigens Rv1733c and synthetic long peptides derived from Rv1733c (Rv1733c SLP) were used based on virulence factors early secreting antigen target-6 (ESAT-6) and culture filtrate protein-10 (CFP-10).Methods: Fifty-seven ATB cases, including 20 pathogen-confirmed ATB and 37 clinically diagnosed ATB, and 36 LTBI cases, were enrolled between January and December 2017. FluoroSpot assay was used to detect the interferon γ (IFN-γ) and interleukin 2 (IL-2) secreted by the specific T cells after being stimulated with MTB virulence factors ESAT-6 and CFP-10, MTB latency-associated antigens Rv1733c and Rv1733c SLP. The receiver operating characteristic (ROC) curve was used to define the best cutoff value of latency-associated antigens in the use of differentiating ATB and LTBI. The sensitivity, specificity, predictive value, and likelihood ratio of ESAT-6 and CFP-10-FluoroSpot combined with latency-associated antigen in the differential diagnosis of ATB and LTBI were also calculated.Results: Following the stimulation with Rv1733c and Rv1733c SLP, the frequency of single IL-2-secreting T cells stimulated by Rv1733c SLP had the largest area under the ROC curve, which was 0.766. With a cutoff value of 1 (spot-forming cells [SFCs]/2.5 × 105 peripheral blood mononuclear cells) for frequency, the sensitivity and specificity of distinguishing ATB from LTBI were 72.2% and 73.7%, respectively. ESAT-6 and CFP-10-FluoroSpot detected the frequency and proportion of single IFN-γ-secreting T cells;the sensitivity and specificity of distinguishing ATB from LTBI were 82.5% and 66.7%, respectively. Combined with the frequency of single IL-2-secreting T cells stimulated by Rv1733c SLP on the basis of ESAT-6 and CFP-10-FluoroSpot, the sensitivity and specificity increased to 84.2% and 83.3%, respectively.Conclusion: Rv1733c SLP, combined with ESAT-6 and CFP-10, might be used as a candidate antigen for T cell-based tuberculosis diagnostic tests to differentiate ATB from LTBI.
基金supported by grants from the Thirteen-Fifth Mega-Scientific Project on“Prevention and Treatment of AIDS,Viral Hepatitis and Other Infectious Diseases”(No.2017ZX10201301-007-002)the National Natural Science Foundation of China(No.82072233).
文摘Objective Current commercially available immunological tests cannot be used for discriminating active tuberculosis(TB)from latent TB infection.To evaluate the value of biomarker candidates in the diagnosis of active TB,this study aimed to identify differentially expressed genes in peripheral blood mononuclear cells(PBMCs)between patients with active TB and individuals with latent TB infection by transcriptome sequencing.Methods The differentially expressed genes in unstimulated PBMCs and in Mycobacterium tuberculosis(Mtb)antigen-stimulated PBMCs from patients with active TB and individuals with latent TB infection were identified by transcriptome sequencing.Selected candidate genes were evaluated in cohorts consisting of 110 patients with TB,30 individuals with latent TB infections,and 50 healthy controls by quantitative real-time RT-PCR.Receiver operating characteristic(ROC)curve analysis was performed to calculate the diagnostic value of the biomarker candidates.Results Among the differentially expressed genes in PBMCs without Mtb antigen stimulation,interferon-induced protein with tetratricopeptide repeats 3(IFIT3)had the highest area under curve(AUC)value(0.918,95%CI:0.852-0.984,P<0.0001)in discriminating patients with active TB from individuals with latent TB infection,with a sensitivity of 91.86%and a specificity of 84.00%.In Mtb antigen-stimulated PBMCs,orosomucoid 1(ORM1)had a high AUC value(0.833,95%CI:0.752-0.915,P<0.0001),with a sensitivity of 81.94%and a specificity of 70.00%.Conclusion IFIT3 and ORM1 might be potential biomarkers for discriminating active TB from latent TB infection.
基金supported by the BeijingMunicipal Science&Technology Commission(7212103)the Eighth Medical Center of PLA General Hospital(MS202211002).
文摘Background:Diagnosing latent tuberculosis(TB)infection(LTBI)and active TB(ATB)is crucial for preventing disease progression and transmission.However,current diagnostic tests have limitations in terms of accuracy and sensitivity,making it challenging to diagnose these different infection states.Therefore,this study intends to develop a promising biomarker for LTBI and ATB diagnosis to overcome the limitations of the current diagnostic tests.Methods:We developed a novelmultiepitope-based diagnostic biomarker(MEBDB)fromLTBI region of differentiation antigens using bioinformatics and immunoinformatics.Immune responses induced byMEBDM were detected using enzyme-linked immunosorbent spot and cytometric bead assays.This study was conducted from April 2022 to December 2022 in the SeniorDepartment of Tuberculosis at the 8thMedical Center of PLA General Hospital,China.Blood samples were collected from participants with ATB,individuals with LTBI,and healthy controls(HCs).The diagnostic efficacy of MEBDB was evaluated using receiver operating characteristic curves.Results:A novel MEBDB,designated as CP19128P,was generated.CP19128P comprises 19 helper T lymphocyte epitopes,12 cytotoxic T lymphocyte epitopes,and 8 B-cell epitopes.In silico simulations demonstrated that CP19128P possesses strong affinity for Toll-like receptors and elicits robust innate and adaptive immune responses.CP19128P generated significantly higher levels of tumor necrosis factor(TNF-α),interleukin 4(IL-4),and IL-10 in ATB patients(n=7)and LTBI(n=8)individuals compared with HCs(n=62)(P<0.001).Moreover,CP19128P-induced specific cytokines could be used to discriminate LTBI and ATB from healthy subjects with high sensitivity and specificity.Combining IL-2 with IL-4 or TNF-α could differentiate LTBI from HCs(the area under the receiver operating characteristic curve[AUC],0.976[95% confidence interval[CI],0.934-1.000]or 0.986[0.956-1.000]),whereas combining IL-4 with IL-17A or TNF-α could differentiate ATB from HCs(AUC,0.887[0.782-0.993]or 0.984[0.958-1.000]).Conclusions:Our study revealed that CP19128P is a potential MEBDBfor the diagnosis of LTBI andATB.Our findings suggest a promising strategy for developing novel,accurate,and sensitive diagnostic biomarkers and identifying new targets for TB diagnosis and management.
基金approved by The Ethics Committee of the Eighth Medical Center of PLA General Hospital(Approval Number:30920230825701232).
文摘Background:Latent tuberculosis infection(LTBI)is a significant source of active tuberculosis(ATB),yet distinguishing between them is challenging because specific biomarkers are lacking.Methods:We analyzed four microarray datasets(GSE19491,GSE37250,GSE54992,GSE28623)from the gene expression omnibus to identify differ-entially expressed genes(DEGs).Using protein-protein interaction(PPI)networks and LASSO-SVM algorithms,we selected three candidate bio-markers and evaluated their diagnostic efficacy.The expression levels of core genes were validated by RNA sequencing of healthy,ATB,and LTBI groups in a real-world cohort.We conducted Gene Ontology and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses,predicted shared upstream miRNAs,constructed miRNA-hub and transcription factor(TF)-hub gene networks,and performed immune infiltration analysis.Results:Three hub genes(SERPING1,C1QC,C1QB)were identified from 45 DEGs by PPI networks and machine learning screening.The diagnostic model based on the three hub genes had an area under the curve(AUC)value of 0.843 in the training set GSE19491 and 0.865 in the validation set GSE28623.Real-world transcriptome sequencing confirmed the expression trends of the hub genes across healthy,LTBI,and ATB groups.GO analysis showed that the 45 hub genes were primarily associated with immune inflammatory responses and pattern recognition receptors,whereas KEGG analysis indicated enrich-ment in complement and coagulation cascades.The miRNA-hub and TF-hub gene network analysis identified nine miRNAs and the zinc finger TF GATA2 as potential co-regulators of SERPING1,C1QC,and C1QB.Immune cell infiltration analysis identified significant differences in the immune micro-environment between LTBI and ATB,with macrophages and natural killer cells showing significant correlations with tuberculosis infection.Conclusion:The diagnostic model with SERPING1,C1QC,and C1QB shows promise in distinguishing LTBI from ATB,indicating its potential as a diag-nostic tool.
文摘Objective:This paper aims to explore the effect of individualized nursing intervention on patients with active tuberculosis(ATB)and latent tuberculosis infection(LTBI).Methods:The nursing study started in January 2020 and ended in January 2023.A total of 60 patients with ATB and LTBI were included,and they were divided into two groups according to the intervention schemes selected for control testing,each with 30 cases.The intervention program selected for group A was routine care,and for group B was individualized nursing.The proportion of adverse reactions,changes in the level of lung items,self-management outcomes and satisfaction were evaluated and compared.Results:After evaluating the proportion of adverse reactions,the total proportion of ATB and LTBI in group B was lower than that in group A(P<0.05).Based on the evaluation and testing of the expiratory flow(EF),expiratory volume(EV),and vital capacity(VC)after the intervention,these levels in group B showed higher outcomes than those in group A(P<0.05).The scores in terms of living habits,sleep,diet,and compliance in group B were higher than those in group A(P<0.05).The total proportion of the satisfaction of ATB and LTBI patients in group B was higher than that in group A(P<0.05).Conclusion:After the intervention of individualized nursing measures in patients with ATB and LTBI,it was found that it can not only play a positive role in the prevention and control of adverse reactions,but also improve their lung function,and promote their self-management,with good satisfaction level,thus it has high research and clinical application values.
文摘Nosocomial infections（NIs） are a critical issue affecting the quality of healthcare. In this study, we performed a retrospective study to explore the incidence rates, mortality rates, and microbial spectrum of NIs in Beijing Chest Hospital, a tuberculosis（TB） specialized hospital in China. Our data demonstrate that the overall incidence rate of inpatients with NIs slightly decreased from 2012 to 2016, which may be associated with the implementation of hand hygiene measures, while the mortality rates associated with NI did not significantly change. In addition, the species distribution of NIs was quite different from that presented in previous reports, and Klebsiella pneumoniae was the most frequently isolated microorganism.
基金Public-Benefit Project on Tuberculosis Patient Care Action[09107].
文摘Objective We aimed to understand the willingness and barriers to the acceptance of tuberculosis(TB)preventive treatment(TPT)among people with latent TB infection(LTBI)in China.Methods A multicenter cross-sectional study was conducted from May 18,2023 to December 31,2023 across 10 counties in China.According to a national technical guide,we included healthcare workers,students,teachers,and others occupations aged 15-65 years as our research participants.Results Overall,17.0%(183/1,077)of participants accepted TPT.There were statistically significant differences in the acceptance rate of TPT among different sexes,ages,educational levels,and occupations(P<0.05).The main barriers to TPT acceptance were misconceptions that it had uncertain effects on prevention(57.8%,517/894),and concerns about side effects(32.7%,292/894).Conclusion An enhanced and comprehensive understanding of LTBI and TPT among people with LTBI is vital to further expand TPT in China.Moreover,targeted policies need to be developed to address barriers faced by different groups of people.
文摘Objective:To investigate the clinical diagnostic significance of peripheral blood T-cell test(T-spot test)for tuberculosis(TB)infection combined with erythrocyte sedimentation rate(ESR)in pulmonary TB.Methods:41 patients with a clinical diagnosis of TB during hospitalization from January 2020 to April 2023 in our hospital were selected as the experimental group,and 45 patients without TB(bronchopneumonia patients)were selected as the control group.The diagnostic specificity,sensitivity,and accuracy of the T-spot TB test,ESR test,and the combined test of the two were calculated respectively.Results:The sensitivity,specificity,and accuracy of the T-spot TB test combined with ESR for the diagnosis of TB in the experimental group were significantly higher than the individual results of the T-spot TB test and ESR test alone(P<0.05).Conclusion:The T-spot TB test combined with the ESR test for TB diagnosis has greater clinical value than carrying out the tests individually.
文摘Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants who were between 3 months and 14 years old and had close contact with smear-positive pulmonary tuberculosis were included. Both QFT-GIT test and TST were done and the results were analyzed by SPSS software and Kappa test. Results: The distribution of gender and age according to QFT-GIT and TST results were matched (P>0.05). Overall agreement between QFT-GIT and TST for diagnosis of latent tuberculosis infection in children was 75%. In addition, the contingency coefficient was 0.257, and the Kappa measure of agreement was 0.246 (P=0.034). Conclusions: Compared to TST, QFT-GIT shows no apparent advantage for diagnosis of latent tuberculosis infection in children.
文摘Introduction: Tuberculosis (TB) remains a significant public health challenge, particularly in high-endemicity settings where latent TB infections (LTBI) contribute to ongoing transmission. Early identification and management of LTBI are crucial in limiting the spread of the disease. This study demonstrates the role of Interferon Gamma Release Assay (IGRA) as a screening tool for latent tuberculosis in high-burden region. Materials and Methods: This retrospective observational study assessed the detection of LTBI using the QuantiFERON-TB Gold Plus (QFT-Plus) test among 145 patients at the Department of Microbiology & Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from August 2023 to August 2024. The study included patients suspected of TB, those screened before immunosuppressive therapy, organ transplantation, or kidney dialysis. Participants were tested IGRA using QFT-Plus, which detects interferon-gamma (IFN-γ) released in response to Mycobacterium tuberculosis antigens. Results and Discussion: Among 145 patients tested for the QFT-Gold Plus test, 55.17% (n = 80) were positive for LTBI, with a substantial agreement between TB1 and TB2 responses (p Conclusion: The results highlight that QFT-Plus may be utilized as a useful diagnostic screening tool for latent TB in regions with a high disease burden, though challenges related to cost and infrastructure persist. With growing global efforts to eliminate tuberculosis, focused screening and treatment of LTBI in high-risk groups could play a vital role in reducing the progression of TB. The study underscores the importance of targeted screening for LTBI to reduce the progression to active TB, particularly in resource-limited settings.
