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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

Host Determinants of Infectiousness in Smear-Positive Patients With Pulmonary Tuberculosis

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  • Medientyp: E-Artikel
  • Titel: Host Determinants of Infectiousness in Smear-Positive Patients With Pulmonary Tuberculosis
  • Beteiligte: 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
  • Erschienen: Oxford University Press (OUP), 2019
  • Erschienen in: Open Forum Infectious Diseases
  • Sprache: Englisch
  • DOI: 10.1093/ofid/ofz184
  • ISSN: 2328-8957
  • Schlagwörter: Infectious Diseases ; Oncology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>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 &amp;gt; 0). Logistic regression models were built to identify factors associated with aerosol positivity.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>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.</jats:p> </jats:sec>
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