Beyond pulmonary nontuberculous mycobacteria disease: do extra-pulmonary forms represent an emerging clinical and public health threat?

Pulmonary and extra-pulmonary diseases caused by nontuberculous mycobacteria: new clinical and public health threats http://ow.ly/87Dm30eMFd9.

Effect of teriflunomide on QuantiFERON-TB Gold results.

Multiple sclerosis is a chronic inflammatory disease of the central nervous system characterized by damage to myelin and axons, over time leading to progressive neuronal degeneration and microglial activation. There is still no curative treatment, but during the last 20 years eight different therapies have become available including interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate, natalizumab, fingolimod, alemtuzumab, mitoxantrone and teriflunomide. Teriflunomide is an immunomodulatory drug that exerts an inhibitory effect on T cell activation in central nervous system of the patients with multiple sclerosis. We determined whether teriflunomide affect the production of interferon-gamma, interleukin-2 and tumor-necrosis-factor-α in the QuantiFERON-TB in-Tube-assay. Blood from 24 adults with latent tuberculosis infection was added to one standard set of QuantiFERON tubes and one further set containing teriflunomide. Teriflunomide resulted in a change in QuantiFERON results from positive to negative in four patients with a marked reduction in interferon-γ. Our data indicated that results from QuantiFERON in patients on teriflunomide therapy should be interpreted with caution.

Tuberculosis in Sardinia: An investigation into the relationship between natives and immigrants.

OBJECTIVE/BACKGROUND: Tuberculosis (TB) has had a recrudescence in the last few decades in Italy as a result of many factors, among which migration from countries where TB is endemic is one of them. In Sardinia, a major island of Italy, there was no knowledge of the mechanisms of transmission of TB in the immigrant subpopulation and the impact it may have on the native subpopulation and on the community as a whole. Therefore, a molecular epidemiological study was carried out to get a clearer picture of the number and genetic features of Mycobacterium tuberculosis strains isolated from immigrants and from natives in Sardinia. METHODS: Two groups of clinical isolates of M. tuberculosis, one collected from immigrants and the other one from Sardinians, were analyzed in this study. The genotyping was executed through the variable number tandem repeat-mycobacterial interspersed repetitive units technique and a first-line antimycobacterial drug-susceptibility test was also carried out. RESULTS: Thirty-six clinical isolates from immigrants and 25 from Sardinians were analyzed. Variable number tandem repeat-mycobacterial interspersed repetitive units technique showed that all of them belonged to different strains and there was a quite high allelic diversity among them. Moreover, data collected allowed the finding of, with a good approximation, the phylogenetic relations among the strains isolated and the best-known phylogenetic groups. CONCLUSION: The study pointed out that since every strain is different, there was no TB transmission in any of the subpopulations and between immigrants and natives. This showed that the presence of immigrants was not a risk factor for contracting TB in the community.

Bacterial agents as a cause of infertility in humans.

Infertility is a problem affecting almost 15% of couples. There are many causes for this condition, among which urogenital bacterial infections seem to play an important role. Many studies have explained the mechanisms by which bacteria cause infertility both in men and women. Therefore we undertook this study to evaluate the presence of genito-urinary infections in infertile couples who sought counselling to investigate their condition. Microbiological analysis was performed on semen and vaginal/cervical samples of both partners of each couple. The percentage of individuals affected by a urogenital bacterial infection was between 14 and 20%. More significantly, most of the species isolated both in men and women have been described in the literature as potential causes of infertility.

Could inducible protein-10 and heparin-binding hemagglutinin improve the detection of Mycobacterium tuberculosis-infected subjects in a country with low incidence of tuberculosis?

BACKGROUND: This study aimed to evaluate inducible protein-10 (IP-10) as a biomarker besides interferon-gamma (IFN-γ) to improve the identification of active tuberculosis (TB) and latent tubercular infection (LTBI) in a country with a low incidence of TB. METHODS: Whole blood from Mycobacterium tuberculosis-infected subjects was stimulated with region-of-difference-1 (RD1)-specific peptides and with heparin-binding hemagglutinin (HBHA) to determine the release of IP-10 and IFN-γ. RESULTS: No statistically significant difference was observed between positive rates of IP-10 and IFN-γ after RD1-specific peptide stimulation in the TB and LTBI groups; a different response was detected in QuantiFERON TB-gold test-negative (QFT-) subjects. A significantly different proportion of positive responses was observed between IP-10 and IFN-γ following HBHA stimulation in the TB group and in the QFT- group but not in the LTBI group. CONCLUSIONS: The IP-10 test seemed to identify false-negative QFT results in some subjects with a positive IFN-γ/IP-10/HBHA pattern.

Identification of non-tuberculous mycobacteria from clinical samples.

Non-tuberculous mycobacterial infections cause morbidity worldwide. NTM are considered opportunistic pathogens, and several species have been associated with human disease which has typically pulmonary, skin and soft tissue, lymphatic or disseminated presentation. This study evaluated the distribution of non-tuberculous mycobacteria in Sardinia. Mycobacterium avium, Mycobacterium gordonae and Mycobacterium xenopi were frequently found. Our results agreed with literature data both for the frequent isolation of M. avium, M. xenopi and M. gordonae, and the symptoms and radiological evidence of the patients analysed.

Tuberculin skin test and QuantiFERON in children.

Until some time ago, the tuberculin skin test was the only available screening test for the diagnosis of tubercular infection. Now the new interferon-? release assay QuantiFERON-TB Gold shows promise of greater accuracy in the detection of Mycobacterium tuberculosis-infected subjects. The aim of our study was to evaluate the use of QuantiFERONTB Gold in children and to verify its agreement with the tuberculin skin test. A total of 27 children had a positive tuberculin skin test, 76 subjects were negative and the remaining 2 had a dubious Mantoux test. A positive QuantiFERONTB Gold result was obtained in 21 children while in 84 it was negative. No statistically significant difference was detected between the two assays, which showed a concordance of 90.57%. Our results demonstrated a good concordance between the tuberculin skin test and the interferon-? release assay, though the QuantiFERON-TB may have several advantages over the Mantoux test.

Epidemic of tuberculosis in a high school in Northern Sardinia.

The aim of this study was to investigate the Mycobacterium tuberculosis transmission among high school student and teacher populations in a high school in Northern Sardinia. Tuberculin skin-test screening, chest-X-rays, QuantiFERON-TB Gold, microbiological examination, spoligotyping and variable numbers of tandem repeats (VNTR) analysis of M. tuberculosis isolates were performed. This study indicates the effectiveness of the epidemiological investigation.

Preliminary data of different methods for the indirect diagnosis of Mycobacterium bovis infection.

We compared the response induced by QuantiFERON-TB Gold antigens to that obtained with the Intradermal Comparative Tuberculin Test and BOVIGAM assay. Our results showed that the QuantiFERON-TB Gold technique used in humans could also be applied for the diagnosis of TB infection in cattle.

Usefulness of the QuantiFERON-TB-Gold in tube in a population at risk of bovine tubercular infection.

The effectiveness of the QuantiFERON-TB-Gold in tube was compared with PPD to detect tuberculosis infection in the staff of cattle-farms, as a consequence of an outbreak of bovine tuberculosis in livestock. The data revealed the advantage of the immunological test for the specific detection of subjects infected by Mycobacterium tuberculosis complex.