International Journal of Mycobacteriology最新文献

{"title":"Risk Factors Analysis of Nontuberculous Mycobacterial Pulmonary Infection in Hospitalized Patients in Yulin, China.","authors":"Danping Qiu, Ye Xue, Chaoshi Zou, Xinru Xie, Meixiang Qin, Chan Liang, Taijie Li","doi":"10.4103/ijmy.ijmy_106_25","DOIUrl":"https://doi.org/10.4103/ijmy.ijmy_106_25","url":null,"abstract":"<p><strong>Background: </strong>Nontuberculous mycobacterial lung disease (NTM-LD) is an increasingly serious chronic lung infection, especially in people with low immune function.</p><p><strong>Methods: </strong>This study collected clinical inpatient data from January 2020 to December 2024 at the First People's Hospital of Yulin, aiming to evaluate the risk factors for nontuberculous mycobacterial (NTM) infection.</p><p><strong>Results: </strong>A study involving 199 patients found that 143 (71.86%) were infected with Mycobacterium tuberculosis (MTB), whereas 56 (28.14%) were infected with NTM. The most common NTM species were Mycobacteroides abscessus, accounting for 53.57% (30/56), followed by Mycobacterium intracellulare at 10.71% (6/56). The NTM separation department mainly focuses on respiratory medicine, accounting for 80.36% (45/56) of cases. The median age of the patients is 60 years. The risk factors associated with NTM infection include age (45-65), autoimmune diseases, chronic obstructive pulmonary disease, bronchiectasis, concomitant pulmonary aspergillosis, and immunosuppressant use. Among these, bronchiectasis is an independent risk factor for infection (odds ratio [OR]: 7.357, 95% confidence interval [CI] 3.080-17.574). In addition, expectoration is a significant risk factor for rapidly growing mycobacteria (RGM) infection in NTM-LD (OR: 4.278, 95% CI 1.314-13.928).</p><p><strong>Conclusions: </strong>Over one-third of patients suspected of having tuberculosis are actually infected with NTM, and those with bronchiectasis have a higher risk of NTM infection. The most common NTM-LD strain is M. abscessus, which is clinically associated with expectoration as a risk factor for RGM infection.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"14 3","pages":"261-267"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spondylodiscitis by Mycobacterium avium in an Immunocompromised Patient: Diagnostic and Therapeutic Challenges.","authors":"Enrique Rodríguez-Guerrero, Azahara Fernández-Carbonell, María Aguilera-Franco, María Del Carmen Ortega-Gavilán, Clara Beatriz Palacios-Morenilla","doi":"10.4103/ijmy.ijmy_230_24","DOIUrl":"10.4103/ijmy.ijmy_230_24","url":null,"abstract":"<p><p>The Mycobacterium avium complex (MAC), consisting mainly of M. avium and Mycobacterium intracellulare, is a group of nontuberculous mycobacteria found in water, soil, and aerosols. While generally low in pathogenicity for immunocompetent individuals, MAC can cause severe infections in immunocompromised patients, such as those with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome, organ transplants, or on immunosuppressive therapy. Although pulmonary infections are most common, extrapulmonary infections like spondylodiscitis are becoming important diagnostic and therapeutic challenges. This report describes a case of M. avium spondylodiscitis in a 79-year-old woman with a history of myelofibrosis, treated with ruxolitinib, and previous M. avium infection. The patient presented with fever and exacerbated bone pain, particularly in the lumbar spine and sacroiliac joints. Diagnostic imaging and microbiological analysis confirmed the diagnosis of spondylodiscitis caused by M. avium. Despite the initiation of appropriate antimicrobial therapy, including azithromycin, rifampicin, ethambutol, and amikacin, the patient developed severe acute respiratory failure and ultimately succumbed to respiratory distress, likely secondary to pulmonary edema from the infection. This case underscores the rarity and diagnostic complexity of M. avium-induced spondylodiscitis, particularly in immunocompromised patients. It highlights the critical need for early clinical suspicion, microbiological confirmation, and a multidisciplinary approach to treatment, including both pharmacological and surgical interventions when necessary.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"14 3","pages":"306-308"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Hepatoprotectors on the Risk of Drug-induced Hepatitis in Pulmonary Tuberculosis Patients.","authors":"Eko Indra Noviansyah, Irawaty Djaharuddin, Harry Akza Putrawan, Jamaluddin Madolangan, Bulkis Natsir, Edward Pandu","doi":"10.4103/ijmy.ijmy_67_25","DOIUrl":"10.4103/ijmy.ijmy_67_25","url":null,"abstract":"<p><strong>Background: </strong>Anti-tuberculosis (TB) drugs are a common cause of hepatotoxicity. Hepatoprotective agents are often empirically used to prevent anti-TB drug-induced hepatitis (DIH). This study aimed to evaluate the incidence of DIH in new TB patients receiving hepatoprotective agents and identify associated risk factors.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted on 140 new pulmonary TB patients at two hospitals in Makassar, Indonesia. The diagnosis of TB and DIH severity (based on World Health Organization criteria) was determined by pulmonologists. Data on demographics, comorbidities, time to DIH onset, liver enzyme levels such aspartate aminotransferase (AST), alanine aminotransferase (ALT), and bilirubin were analyzed using Chi-square and paired t-tests.</p><p><strong>Results: </strong>DIH was observed in 38 (27.1%) patients. It was more prevalent in females and individuals over 50 years. The majority of DIH cases were grade two, characterized by elevated AST (71.1%) and ALT (47.7%). Comorbidities, including diabetes mellitus (28.9%), human immunodeficiency virus (10.5%), and chronic kidney disease (2.6%), were significantly associated with a higher incidence of DIH (P < 0.001). The mean onset of DIH was within 14 days in 94.7% of cases. While AST and ALT significantly increased posttreatment (P < 0.001), bilirubin levels did not correlate with these increases. The administration of hepatoprotective agents was associated with a 73% reduction in DIH incidence.</p><p><strong>Conclusion: </strong>Despite the use of hepatoprotective agents, advanced age and the presence of comorbidities significantly increase the risk of DIH in TB patients undergoing anti-TB treatment. These findings highlight the importance of careful monitoring and management of high-risk TB patients, even with hepatoprotective co-administration.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"14 3","pages":"219-225"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concordance and Interferon-gamma Response Variability between TB1 and TB2 in the QuantiFERON-TB Gold Plus Assay: Insights Across Clinical Subgroups.","authors":"Zied Gaifer, Sarah A Alharbi, Lina Alharbi, Hammam Khaled Jafar, Montaha Waleed Demyati, Basmah H Aljehani, Amer Alshengeti","doi":"10.4103/ijmy.ijmy_80_25","DOIUrl":"10.4103/ijmy.ijmy_80_25","url":null,"abstract":"<p><strong>Background: </strong>The QuantiFERON-TB Gold Plus (QFT-Plus) assay, widely used for latent tuberculosis infection (LTBI) screening, includes two antigen tubes: TB1, which stimulates T-helper cells expressing CD4 (CD4⁺ T cells), and TB2, which additionally stimulates cytotoxic T cells expressing CD8 (CD8⁺ T cells). However, the added diagnostic value of CD8⁺ stimulation in TB2 remains uncertain. This study aimed to evaluate the diagnostic agreement between TB1 and TB2 responses in the QFT-Plus assay and assess whether TB2 provides a significant incremental benefit over TB1 in detecting tuberculosis infection across demographic and clinical subgroups.</p><p><strong>Methods: </strong>This was a retrospective study that included individuals aged ≥14 years who underwent QFT-Plus testing. Interferon-gamma (IFN-γ) responses in TB1 and TB2 tubes were compared using the Wilcoxon signed-rank test. Qualitative concordance was assessed using Cohen's kappa coefficient. Subgroup analyses were stratified by age, sex, diabetes, and immunosuppressive therapy.</p><p><strong>Results: </strong>Among 761 participants, median IFN-γ responses were slightly higher in TB2 than TB1 (0.21 vs. 0.19 IU/mL; median delta 0.02 IU/mL; P = 0.0002). This difference was consistent but small across most subgroups. Overall concordance between TB1 and TB2 qualitative results was 94.3% (Cohen's kappa = 0.868). Agreement remained strong across sex, age, and diabetes groups, though it was lower among users of tumor necrosis factor inhibitors (kappa = 0.582). No subgroup demonstrated a clinically significant added benefit of TB2 over TB1.</p><p><strong>Conclusion: </strong>TB2 elicited slightly higher IFN-γ responses than TB1, but the small delta values and high concordance suggest limited additional diagnostic value in most populations.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"14 3","pages":"253-260"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Small Mothers against Decapentaplegic 3 and Transforming Growth Factor Beta Levels in Relation to Lung Fibrosis and Function in Treated Pulmonary Tuberculosis Patients.","authors":"Harry Akza Putrawan, Irfan Idris, Arif Santoso, Harun Iskandar, Zainul Muttaqin, Jamal Zaini, Rosdiana Natzir, Uleng Bahrun, Suryani Tawali","doi":"10.4103/ijmy.ijmy_60_25","DOIUrl":"10.4103/ijmy.ijmy_60_25","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB) is a significant global health issue, with posttreatment fibrosis negatively affecting pulmonary function and patient quality of life. This research investigated the processes driving post-TB pulmonary fibrosis and its impact on patients.</p><p><strong>Methods: </strong>This research involved a cohort of 38 pulmonary TB patients undergoing intensive treatment for 2 months. Transforming Growth Factor Beta (TGFβ) and Small Mothers Against Decapentaplegic 3 (SMAD3) levels were quantified pre- and posttreatment using the Enzyme Linked Immuno Sorbent Assay method. Fibrosis was evaluated via thoracic imaging, and lung function was assessed through spirometry.</p><p><strong>Results: </strong>TGFβ and SMAD3 levels were decreased post-treatment (P = 0.03 and P = 0.01). A significant association existed between postintervention SMAD3 levels and the occurrence of fibrosis (P = 0.03) and diminished lung function (P = 0.01). Receiver operating characteristic analysis indicated that post-intervention SMAD3 exhibited an area under the curve of 0.8, with a sensitivity of 87% and specificity of 71%, suggesting its potential as a biomarker for fibrosis.</p><p><strong>Conclusion: </strong>Levels of TGFβ and SMAD3 following pulmonary TB treatment are linked to fibrosis and reduced lung function. SMAD3 post-intervention may be a fibrosis biomarker in pulmonary TB patients.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"14 3","pages":"239-245"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Presentation, Microbiological Profile, Treatment Outcome, and Predictors of Outcome in Patients with Nontuberculous Mycobacteria Bloodstream Infection.","authors":"Adarsh Joseph Philip, Joy Sarojini Michael, Amith Balachandran, Tina George, Nalini Newbigging, Anuka Alena Abraham, Thomas Isiah Sudarsan, Uday Kulkarni, Ramya Iyadurai","doi":"10.4103/ijmy.ijmy_107_25","DOIUrl":"10.4103/ijmy.ijmy_107_25","url":null,"abstract":"<p><strong>Background: </strong>Nontuberculous mycobacteria (NTM) are ubiquitous organisms with varied clinical syndromes. We conducted this study to identify the clinical spectrum, microbiological diagnosis, outcomes, and predictors of outcome in patients with NTM bloodstream infections (NTM BSIs).</p><p><strong>Methods: </strong>This is a retrospective study of patients diagnosed with NTM BSI from January 2005 to December 2024. Poor outcomes were defined as patients who either expired or were lost to follow-up after being discharged against medical advice, subsequent to a poor prognosis.</p><p><strong>Results: </strong>A total of 40 patients with NTM BSI were included. The median age was 43 years with male predominance (n = 25, 62.5%). Associated risk factors included human immunodeficiency virus (HIV) infection (n = 18, 45%) with a median CD4 count of 18 cells/mm3, diabetes mellitus (n = 7, 31.8%), and immunosuppressive medication use (n = 6, 27.3%). The spectrum of infections among HIV-negative patients (n = 22) were disseminated infection (n = 6), coronary stent infection (n = 5), infective endocarditis (n = 4), catheter-related BSI (n = 4), pacemaker lead infection (n = 1), aortic stent infection (n = 1), thecoperitoneal shunt infection (n = 1), and infected bedsore (n = 1). All HIV-positive patients presented with disseminated NTM infection. Poor outcome for NTM BSI was seen in 64.9% of patients. Among the rapid growers, Mycobacterium abscessus complex had the worst prognosis with a poor outcome in 71.4% of patients.</p><p><strong>Conclusion: </strong>The spectrum of diseases associated with NTM BSI was either disseminated disease in an immunosuppressed host or infection secondary to nosocomial contamination of a catheter, implant, or stent. NTM BSI is associated with poor prognosis. This underscores the need for early diagnosis, appropriate antibiotic therapy, and adequate source control to improve clinical outcomes.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"14 3","pages":"275-281"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Activity of Solanum torvum Crude Extracts against Important Mycobacterial Strains.","authors":"Joseph Mwanzia Nguta","doi":"10.4103/ijmy.ijmy_69_25","DOIUrl":"https://doi.org/10.4103/ijmy.ijmy_69_25","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) caused by Mycobacterium tuberculosis (M. tb) complex remains a leading cause of morbidity and mortality worldwide. The zoonotic infectious condition represents a never-ending challenge for which drug discovery efforts are needed. The current study was designed to evaluate the in vitro antimycobacterial activity and phytochemical composition of hydroethanolic extracts from roots, stem bark, leaves, and unripe fruits derived from Solanum torvum, a shrub traditionally used against respiratory tract illnesses, including TB.</p><p><strong>Methods: </strong>The phenotypic colorimetric microplate alamar blue assay was used to study the antimycobacterial activity of the hydroethanolic extracts against six mycobacterial strains. Each experiment was run in triplicate. Data generated were analyzed using descriptive statistics to obtain mean minimum inhibitory concentration (MIC) values.</p><p><strong>Results: </strong>The roots, stem bark, leaves, and unripe fruits exhibited MIC values of 0.0195 mg/mL, 0.0781 mg/mL, 1.250 mg/mL, and 0.625 mg/mL against the pathogenic mycobacterial strain, M. tb H37Rv (ATCC 27294), respectively.</p><p><strong>Conclusions: </strong>S. torvum stem bark has demonstrated significant activity against the pathogenic M. tb strain. This observation validates the ethno-pharmacological use of the plant species against TB. Further studies are required to isolate, elucidate the structure, and characterize the antimycobacterial compounds responsible for the observed activity. These will potentially contribute toward bioprospecting for a new class of ligands with activity against sensitive and drug-resistant strains of M. tb.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"14 3","pages":"246-252"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimycobacterial Activity of Allium Cepa and Allium sativum Hydroethanolic Crude Extracts against Pathogenic and Nonpathogenic Mycobacterial Strains.","authors":"Joseph Mwanzia Nguta","doi":"10.4103/ijmy.ijmy_81_25","DOIUrl":"https://doi.org/10.4103/ijmy.ijmy_81_25","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) caused by Mycobacterium tuberculosis complex remains a leading cause of morbidity and mortality worldwide. The zoonotic infectious condition represents a never-ending challenge toward which drug discovery efforts are needed. The current study was designed to evaluate the in vitro antimycobacterial activity of hydroethanolic extracts from Allium sativum and Allium cepa bulbs and leaves, traditionally used against respiratory tract illnesses, including TB.</p><p><strong>Methods: </strong>The phenotypic colorimetric microplate Alamar blue assay was used to study the antimycobacterial activity of the ethanolic extracts against six mycobacterial strains. Each experiment was run in triplicate. Data generated were analyzed using descriptive statistics to obtain mean minimum inhibitory concentration (MIC) values.</p><p><strong>Results: </strong>The A. sativum bulbs, A. sativum leaves, A. cepa bulbs, and A. cepa leaves exhibited MIC values of 19.5 µg/mL, 78.1 µg/mL, 78.1 µg/mL, and 19.5 µg/mL against the pathogenic mycobacterial strain, M. tuberculosis H37Rv (ATCC 27294), respectively.</p><p><strong>Conclusion: </strong>In conclusion, the tested A. sativum and A. cepa bulbs and leaves have demonstrated significant activity against the pathogenic M. tuberculosis strain. This observation validates the ethnopharmacological use of the Allium species against TB. Further studies are required to isolate, elucidate the structure, and characterize the antimycobacterial compounds responsible for the observed activity. These will potentially contribute toward bioprospecting for a new class of ligands with activity against sensitive and drug-resistant strains of M. tuberculosis.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"14 3","pages":"226-231"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Delay and its Predictors among Tuberculosis Patients in Kandahar, Afghanistan: A Cross-sectional Analytical Study.","authors":"Hazratullah Bariz, Muhammad Haroon Stanikzai, Ghulam Mohayuddin Mudaser, Khalid Ahmad Stanikzai, Omid Dadras","doi":"10.4103/ijmy.ijmy_91_25","DOIUrl":"10.4103/ijmy.ijmy_91_25","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic delay among tuberculosis (TB) patients leads to late anti-TB treatment initiation, which is associated with poor prognosis and increased TB transmission. Despite its recognized negative consequences, diagnostic delay among TB patients is common in developing countries, including Afghanistan, where evidence on its predictors is limited. We aimed to evaluate diagnostic delay and its predictors among newly diagnosed TB patients attending healthcare facilities in Kandahar, Afghanistan.</p><p><strong>Methods: </strong>A multicenter, cross-sectional study was conducted in Kandahar between February and May 2025. Newly diagnosed TB patients aged 18 years or older were randomly recruited from the TB care centers of six healthcare facilities. Delays in TB diagnosis encompassed both patient and healthcare system delays. The predictors of diagnostic delay were identified using a multivariable logistic regression model.</p><p><strong>Results: </strong>Patient and health system delays were noted in 44% and 59.4% of cases, respectively. Patients' low education level, extrapulmonary TB, longer distance to healthcare facility, and positive history of self-medication were significant predictors of diagnostic delays.</p><p><strong>Conclusion: </strong>Despite the well-established benefits of early TB diagnosis, this study revealed that delay in TB diagnosis is still a public health challenge in Kandahar province. Late presentation for TB care was a result of factors that relate to the patient's education, TB type, distance to healthcare facility, and history of self-medication. Therefore, focusing extra attention on these factors could potentially reduce diagnostic delays among TB patients in Afghanistan.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"14 3","pages":"232-238"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying High-Risk Tuberculosis Cases: Implementation of a Programmatic Screening Tool in Bengaluru.","authors":"P K Sreenath Menon, B N Sharath, M D Sangeetha, R S Reshma, T M Sibi, L Ashwini","doi":"10.4103/ijmy.ijmy_53_25","DOIUrl":"10.4103/ijmy.ijmy_53_25","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a significant global health challenge, causing 1.3 million deaths in 2020. The COVID-19 pandemic has further exacerbated the TB burden, leading to an 11% rise in TB mortality in India from 2019 to 2020. The World Health Organization aims to reduce TB deaths by 90% by 2030 and 95% by 2035. Early identification and management of severely ill TB patients are crucial for achieving these targets. This study aimed to identify adult TB patients at high risk of severe illness (HRSI) using a programmatic screening tool, assess referral linkages, and evaluate care outcomes within the first 7 days post-diagnosis in Bengaluru, India.</p><p><strong>Methods: </strong>A cross-sectional study was conducted over 18 months (August 2022 to July 2023) across five Tuberculosis Units in the Bruhat Bengaluru Mahanagara Palike district. Data were collected from National Tuberculosis Elimination Program records and patient interviews, including 263 adult drug-sensitive TB patients diagnosed at public health facilities. Patients were screened for HRSI within 7 days of diagnosis using a tool assessing body mass index (BMI), respiratory rate, and oxygen saturation. Descriptive statistics summarized patient characteristics and outcomes, and associations were analyzed using Chi-square and Fisher's exact tests.</p><p><strong>Results: </strong>Of the 263 TB patients screened, 20.9% were identified as being at HRSI. Among these high-risk patients, 73.3% accessed inpatient care, with 51% seeking treatment at district hospitals and 20% at private hospitals. Inpatient mortality among high-risk patients was 19.4%, while no deaths were reported among those managed as outpatients. Key severity indicators included BMI ≤14 kg/m2 (12%), respiratory rate >24 breaths/min (3%), oxygen saturation <94% (7%), and inability to stand without support (8%). High-risk status was more prevalent among patients over 65 years of age, males, those with microbiologically confirmed or smear-positive pulmonary TB, HIV-reactive status, and diabetes mellitus.</p><p><strong>Conclusion: </strong>Early identification and referral of TB patients at HRSI are essential to reduce mortality. The study highlights the effectiveness of a simple screening tool in routine programmatic settings and underscores the need for targeted interventions and improved healthcare access for high-risk TB patients in India.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"14 3","pages":"268-274"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}