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1.
Tuberculosis (Edinb) ; 116: 17-21, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31153513

RESUMO

SETTING: Mycobacterial sputum culture is a key diagnostic and research tool. OBJECTIVE: To compare mycobacterial culture outcomes of three sputum collection methods. DESIGN: We compared culture results within sets of three sputum samples collected from 18 HIV-infected adult tuberculosis patients at regular intervals up to 84 days after treatment initiation. The first sputum was collected at home and brought to the clinic, where a second and third sputum were consecutively collected under supervision following mouthwash with bottled water and chlorhexidine solution respectively. All sputa were processed for liquid culture in duplicate. RESULTS: Out of 556 cultures 430 (77.3%), 91 (16.4%) and 35 (6.3%) were positive, negative or contaminated, respectively. The odds of contamination were higher with home collection and with water rinse than with chlorhexidine rinse (OR: 12.5, p < 0.001 and OR: 6.7, p = 0.015). Chlorhexidine rinse increased the odds of a negative culture compared to water rinse (OR: 3.5, p = 0.002). The odds of a positive culture were greater with water rinse than with home collection (OR: 2.5, p = 0.005). Water rinse significantly reduced time to culture positivity. CONCLUSION: Compared to sputum collected at home, chlorhexidine rinse reduces culture contamination and water rinse increases the rate and viable mycobacterial load of positive cultures.

2.
BMC Infect Dis ; 17(1): 570, 2017 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-28810840

RESUMO

BACKGROUND: The existence of a bi-directional relationship between tuberculosis (TB) and insulin resistance (IR)/diabetes has been alluded to in literature. Although diabetes has been linked to increased tuberculosis risk, the relationship between tuberculosis as a causative factor for IR remains unclear. The study aimed to determine if an association existed between tuberculosis and IR development in adults with newly diagnosed pulmonary tuberculosis at baseline. It was additionally aimed to document changes in IR status during TB follow-up periods. METHODS: This cross-sectional study evaluated ambulatory participants at baseline for IR prevalence via anthropometry, biochemistry and diagnostic IR tests [homeostasis model assessment-IR (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI)]. A prospective cohort sub-section study was additionally performed on approximately half of the baseline study population, who were followed-up at two and five months whilst on tuberculosis treatment. Summary statistics, correlation co-efficients and appropriate analysis of variance were used to describe and analyse data. Participants were excluded if they presented with other forms of tuberculosis, were HIV-positive, obese or had any pre-disposing IR conditions such as diabetes or metabolic syndrome. RESULTS: Fifty-nine participants were included from August 2013 until December 2014 (33.95 ± 12.02 years old; 81.4% male). IR prevalence was 25.4% at baseline, determined by a calculated HOMA-IR cut-off point of 2.477. Patients with IR were younger (p = 0.04). Although the difference between IR levels in participants between baseline and follow-up was not significant, a decrease was observed over time. The majority of participants (61.0%) presented with a normal BMI at baseline. Mean baseline values of fasting glucose were within normal ranges (4.82 ± 0.80 mmol/L), whereas increased mean CRP levels (60.18 ± 50.92 mg/L) and decreased mean HDL-cholesterol levels (males: 0.94 ± 0.88 mmol/L; females: 1.14 ± 0.88 mmol/L) were found. CONCLUSIONS: The study found an association between tuberculosis and IR development in newly diagnosed pulmonary tuberculosis patients. Although not significant, IR levels decreased over time, which could be indicative of a clinical improvement. A high prevalence of IR amongst young tuberculosis patients therefore highlights the need for early identification in order to facilitate a reversal of IR and prevent possible IR-related complications.


Assuntos
Resistência à Insulina , Tuberculose Pulmonar/fisiopatologia , Adulto , Glicemia/metabolismo , HDL-Colesterol/sangue , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , África do Sul/epidemiologia , Tuberculose Pulmonar/epidemiologia
3.
J Infect Dis ; 190(4): 727-38, 2004 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-15272401

RESUMO

We describe the genome sequence of a macrolide-resistant strain (MGAS10394) of serotype M6 group A Streptococcus (GAS). The genome is 1,900,156 bp in length, and 8 prophage-like elements or remnants compose 12.4% of the chromosome. A 8.3-kb prophage remnant encodes the SpeA4 variant of streptococcal pyrogenic exotoxin A. The genome of strain MGAS10394 contains a chimeric genetic element composed of prophage genes and a transposon encoding the mefA gene conferring macrolide resistance. This chimeric element also has a gene encoding a novel surface-exposed protein (designated "R6 protein"), with an LPKTG cell-anchor motif located at the carboxyterminus. Surface expression of this protein was confirmed by flow cytometry. Humans with GAS pharyngitis caused by serotype M6 strains had antibody against the R6 protein present in convalescent, but not acute, serum samples. Our studies add to the theme that GAS prophage-encoded extracellular proteins contribute to host-pathogen interactions in a strain-specific fashion.


Assuntos
Genoma Bacteriano , Macrolídeos/farmacologia , Fatores R/genética , Streptococcus pyogenes/genética , Alelos , Motivos de Aminoácidos/genética , Anticorpos Antibacterianos/sangue , Proteínas da Membrana Bacteriana Externa/genética , Proteínas de Bactérias/genética , Proteínas de Bactérias/imunologia , Western Blotting , Criança , Farmacorresistência Bacteriana/genética , Exotoxinas/genética , Citometria de Fluxo , Humanos , Proteínas de Membrana/genética , Proteínas de Membrana/imunologia , Faringite/sangue , Faringite/microbiologia , Infecções Estreptocócicas/sangue , Infecções Estreptocócicas/microbiologia , Fagos de Streptococcus/genética , Streptococcus pyogenes/efeitos dos fármacos , Streptococcus pyogenes/isolamento & purificação
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