International Journal of Mycobacteriology最新文献

{"title":"Depression Level and Quality of Life between Shorter and Longer Regimens among Patients with Multidrug-resistant Tuberculosis.","authors":"Oki Nugraha Putra, Nur Indah, Nurul Damayanti","doi":"10.4103/ijmy.ijmy_49_25","DOIUrl":"10.4103/ijmy.ijmy_49_25","url":null,"abstract":"<p><strong>Background: </strong>This study estimated the prevalence of depression among Indonesian multidrug-resistant tuberculosis (MDR-TB) patients and quality of life (QoL) between shorter and longer regimens, as well as factors associated with depression.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Haji Hospital from May to November 2024, using the Indonesian Patient Health Questionnaire-9 (PHQ-9) and the WHOQOL BREF to assess depression and QoL. A cutoff ≥5 of the PHQ-9 score was classified as depression. We used an independent t -test to analyze the differences between the two groups and a bivariate test to analyze depression-related factors.</p><p><strong>Results: </strong>Eighteen and 24 MDR-TB patients received shorter and longer regimens during the study period. The study found that the prevalence of depression was higher (55.1%) in patients receiving longer regimens than in shorter regimens (33.3%), with a P = 0.036. 16/24 of patients (55.2%) had mild-to-moderate depression in longer regimens. MDR-TB patients who had a history of TB treatment were 4.97 times more likely to develop depression. The mean score of each domain and the total score of WHOQOL BREF were similar between the two groups, with a P ≥ 0.05.</p><p><strong>Conclusion: </strong>In conclusion, approximately 50% of MDR-TB patients receiving longer regimens had depression, and a history of TB treatment is a risk factor for developing depression; therefore, TB treatment approaches should address psychological distress among MDR-TB patients.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"75-83"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360427","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":"Comparative Evaluation of Fluorescein Diacetate/Ethidium Bromide Viability Microscopy and Ziehl-Neelsen Staining for Rapid Diagnosis of Pulmonary Tuberculosis.","authors":"Shubhendu Singh, Dakshina Bisht, Ajoy Kumar Verma, Ashutosh Rawat","doi":"10.4103/ijmy.ijmy_243_25","DOIUrl":"10.4103/ijmy.ijmy_243_25","url":null,"abstract":"<p><strong>Background: </strong>Ziehl-Neelsen (ZN) staining is routinely used for tuberculosis (TB) diagnosis, but cannot differentiate viable from nonviable bacilli. This limitation is particularly relevant in smear-positive pulmonary TB patients, where assessment of treatment response is essential. Fluorescein diacetate/ethidium bromide (FDA/EtBr) viability microscopy detects live Mycobacterium tuberculosis based on metabolic activity. This study compared the diagnostic performance of FDA/EtBr microscopy with ZN staining, using culture and drug susceptibility testing (DST) as the reference standard.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 300 smear-positive pulmonary TB patients at Santosh Medical College, Ghaziabad, and National Institute of TB and Respiratory Diseases, New Delhi. After n-acetyl-l-cysteine-sodium hydroxide decontamination, sputum samples were examined using ZN staining, FDA/EtBr viability microscopy, and mycobacteria growth indicator tube 960 culture/DST. Sensitivity, specificity, positive predictive value, negative predictive value (NPV), and diagnostic accuracy were calculated, and paired statistical comparision were performed and statistical significance ( P < 0.05) was assessed for diagnostic outcomes. Inter-test agreement was evaluated using Cohen's κ-statistic.</p><p><strong>Results: </strong>FDA/EtBr microscopy demonstrated significantly higher sensitivity (94.4% vs. 88.9%; absolute increase 5.5%, P = 0.018) and higher diagnostic accuracy (91.0% vs. 86.7%; absolute increase 4.3%, P = 0.04) compared to ZN staining. While ZN staining showed marginally higher specificity (66.7% vs. 60.0%; P = 0.42), FDA/EtBr provided a significantly improved NPV (54.5% vs. 40.0%; absolute increase 14.5%, P = 0.03). Agreement with culture/DST was almost perfect for FDA/EtBr (κ = 0.85) and substantial for ZN staining (κ = 0.72).</p><p><strong>Conclusion: </strong>FDA/EtBr viability microscopy offers statistically significant improvements in sensitivity, NPV, and diagnostic accuracy over ZN staining in smear-positive pulmonary TB patients, supporting its prioritized use for treatment monitoring and programmatic decision-making in resource-limited, high-burden settings.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"95-103"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360656","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":"Pulmonary Tuberculosis following Chemotherapy for Metastatic Testicular Germ Cell Tumor: Possible Reactivation of Latent Tuberculosis Infection.","authors":"Dika Safari Ramadhan, Isnin Anang Marhana","doi":"10.4103/ijmy.ijmy_97_26","DOIUrl":"10.4103/ijmy.ijmy_97_26","url":null,"abstract":"<p><p>Testicular germ cell tumors (TGCTs) are the most common solid malignancies in young adult men. Advanced disease requiring systemic chemotherapy may lead to immunosuppression and increase vulnerability to opportunistic infections, particularly in tuberculosis (TB)-endemic regions. Coexistence of visceral metastases and infectious comorbidities such as pulmonary TB can substantially complicate diagnostic evaluation and therapeutic decision-making. Latent TB infection (LTBI) reactivation following chemotherapy is a recognized but likely underreported complication in patients with solid tumors, posing additional clinical challenges. A 41-year-old male with a history of mixed TGCT who had undergone radical orchiectomy followed by platinum-based chemotherapy, presented with chronic cough, weight loss, and neurological symptoms. Imaging revealed a large pulmonary mass and a cerebral lesion consistent with metastases. Further evaluation confirmed pulmonary and brain metastases of TGCT origin. Pulmonary TB was bacteriologically confirmed by bronchoalveolar lavage GeneXpert. He received anti-TB therapy, supportive neurological treatment, and delayed neurosurgery after stabilization. Temporal association between prior chemotherapy, significant immunosuppression, and active TB development raised the suspicion of LTBI reactivation. He was discharged in the stable condition with plans for oncologic restaging and second-line chemotherapy. This case highlights the diagnostic and therapeutic challenges posed by the coexistence of metastatic TGCT and pulmonary TB. In TB-endemic settings, clinicians should maintain a high index of suspicion for TB in immunocompromised cancer patients presenting with pulmonary lesions. Multidisciplinary management and careful timing of oncologic and anti-TB treatments are essential to optimize the outcomes, and possible reactivation of LTBI should be considered following chemotherapy.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"183-188"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360669","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":"In silico Designing of a Multiepitope Vaccine using the Hallmark Proteins of Mycobacterium tuberculosis Involved in Different Aspects of Virulence.","authors":"Haleema Fayaz, Waseem Ali, Gauri Shrivastava, Shivangi Prandiyal, Nasreen Z Ehtesham, Seyed E Hasnain, Anwar Alam","doi":"10.4103/ijmy.ijmy_86_26","DOIUrl":"10.4103/ijmy.ijmy_86_26","url":null,"abstract":"<p><strong>Background: </strong>Mycobacterium tuberculosis ( M.tb ) remains a leading global cause of mortality. The current Bacillus Calmette-Guérin vaccine lacks efficacy in adults and fails to generate a long-term memory response. With the rise of multidrug-resistant strains, there is an urgent need for novel vaccines that can provide broader protection. This study aimed to design a multiepitope vaccine (MEV) targeting hallmark proteins involved in different aspects of M.tb virulence.</p><p><strong>Methods: </strong>Four unique M.tb proteins, Rv1507A (role in memory response), Rv1509 (role in phagolysosomal escape), Rv1954A (role in macrophage activation/antigen presentation), and Rv2231A (role in persistence) were selected. In silico analyses were performed to identify epitopes with high-binding affinity for Toll-like receptors (TLRs). Two MEVs were optimized for codon and were linked with adjuvants that could bind with TLR4 or TLR2 (TLR4-laterosporulin and TLR2-PorB). Physicochemical properties, allergenicity, toxicity, and structural stability were evaluated, followed by molecular docking with TLR receptors, molecular dynamic (MD) simulation, in silico cloning, and immune simulations.</p><p><strong>Results: </strong>Both MEVs exhibited favorable biophysical properties and high structural stability. Molecular docking confirmed strong binding affinities with TLR2 and TLR4 receptors, suggesting a robust activation of innate and adaptive immunity. Immunological simulations predicted a potent immune response characterized by high cytokine production and memory cell differentiation. The designed MEV demonstrated approximately 90% global population coverage.</p><p><strong>Conclusions: </strong>The designed MEVs effectively bridge gaps in existing TB immunization by targeting multiple aspects of M.tb pathogenesis. These in silico leads provide a promising framework for preclinical studies, potentially moving toward a more effective clinical solution against TB.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"153-160"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360679","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":"Concurrent Multibacillary Lepromatous Leprosy with Autonomic Dysfunction and Cavitary Pulmonary Tuberculosis Complicated by Spontaneous Pneumothorax and Subcutaneous Emphysema.","authors":"Amisha Harish Soni, Babaji Ghewade, Viraj Vishal Wadhera, Poonam Avinash Patil, Barkha Mathur, Aarnav Mitesh Mehta","doi":"10.4103/ijmy.ijmy_96_26","DOIUrl":"10.4103/ijmy.ijmy_96_26","url":null,"abstract":"<p><p>The concurrent presentation of two distinct mycobacterial diseases - Mycobacterium tuberculosis and Mycobacterium leprae - in a single patient is exceptionally rare. Lepromatous leprosy (LL), the multibacillary form of Hansen's disease, is characterized by profound defects in cell-mediated immunity, which may predispose individuals to other intracellular infections, including tuberculosis. We present a unique case of a patient with undiagnosed lepromatous leprosy presenting with ichthyosiform scaling and autonomic dysfunction who developed a life-threatening pulmonary complication from reactivation pulmonary tuberculosis (PTB). A 54-year-old male farmer presented to the emergency department with acute respiratory distress due to a large right-sided spontaneous pneumothorax complicated by bilateral massive subcutaneous emphysema. He reported a chronic cough, weight loss, and night sweats over several months, with a history of treated PTB 15 years back. Systemic examination revealed diffuse, symmetrical ichthyosiform scaling of the skin, bilateral peripheral neuropathy in a stocking-glove distribution, palpably thickened ulnar nerves, and orthostatic hypotension suggestive of autonomic dysfunction. Skin slit smear demonstrated numerous acid-fast bacilli (Bacteriological Index 5+), and skin biopsy confirmed lepromatous leprosy with a diffuse histiocytic infiltrate. Sputum examination was positive for Mycobacterium tuberculosis . The patient was managed with intercostal chest drain insertion for the pneumothorax and concurrently initiated on anti-tubercular therapy (ATT) and World Health Organization multi-drug therapy (MDT) for multibacillary leprosy. The pneumothorax resolved completely by day 7, and sputum smear converted to negative by day 12. At a 2-month follow-up, the patient remained clinically stable with no leprosy reactions and improving respiratory symptoms. This case highlights the importance of considering underlying immunosuppressive conditions, such as lepromatous leprosy, in patients presenting with complicated tuberculosis. The ichthyosiform presentation of leprosy is often misdiagnosed, and autonomic dysfunction indicates advanced disease. This report highlights the delicate and often difficult battle between mycobacterial diseases and the human body's defences - a battle that has profound consequences for how we diagnose illness, care for patients, and protect the health of entire communities where these diseases are most common.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"189-195"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360354","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":"Diabetes-associated Phenotypic Masking of Fluoroquinolone Resistance in Multidrug-resistant Tuberculosis: Evidence from Genotypic-Phenotypic Discordance in Surabaya, Indonesia.","authors":"Lyndia Effendy, Ni Made Mertaniasih, Soedarsono Soedarsono, Tutik Kusmiati","doi":"10.4103/ijmy.ijmy_70_26","DOIUrl":"10.4103/ijmy.ijmy_70_26","url":null,"abstract":"<p><strong>Background: </strong>Emerging fluoroquinolone (FQ) resistance threatens multidrug-resistant tuberculosis (MDR-TB) management, complicating access to shorter regimens. This study characterizes FQ-resistant TB (FQ-R-TB) patients in Surabaya, Indonesia, and assesses diagnostic performance and therapeutic outcomes associated with this resistance.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted using national TB data from 1037 MDR-TB patients (2020-2025). Among them, 32 cases with genotypic FQ resistance (Xpert MTB/XDR) were stratified into concordant (genotypic mutation with phenotypic resistance, n = 21) and discordant (genotypic mutation with phenotypic susceptibility, n = 11) groups. Demographics, comorbidities, diagnostics, and treatment outcomes were evaluated.</p><p><strong>Results: </strong>The proportion of FQ resistance among MDR-TB patients rose from 0% in 2020 to 1.37% in 2025. Discordant cases were significantly older (mean: 54 ± 14; P = 0.203), predominantly male (10:1; P = 0.037), had higher body mass index (BMI; 24.44 ± 6.04; P = 0.197), and had a markedly higher prevalence of diabetes mellitus (90.9% versus 9.5%; P = 0.028). Diagnostic discordance occurred in 34.4% of FQ-R-TB cases, causing 1-3 month delays in regimen adjustment and initial ineffective FQ exposure. While subsequent FQ-free BPaL regimens improved outcomes, initial diagnostic uncertainty complicated decisions and increased adverse effects.</p><p><strong>Conclusion: </strong>FQ resistance is an emerging threat in Surabaya. Diagnostic discordance and high comorbidity burden complicate treatment. Advanced age and higher BMI are linked to increased diabetes probability. Diabetes is a powerful predictor of genotypic-phenotypic discordance, likely via host-mediated mechanisms affecting bacterial fitness and resistance expression. A strong clinical consensus is needed to recommend genotypic test results as the primary guide for treating TB patients with diabetes. However, for diabetic TB patients whose initial phenotypic results indicate FQ susceptibility, close monitoring of their clinical and microbiological response during therapy remains crucial to confirm effectiveness until more definitive evidence is available.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"84-94"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360486","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":"Discriminatory Performance of Novel Inflammatory-Nutritional Indices for Identifying Chronic Obstructive Pulmonary Disease Comorbidity in Patients with Nontuberculous Mycobacterial Pulmonary Disease: A Retrospective Cross-sectional Study.","authors":"Zexiao Ye, Fei He","doi":"10.4103/ijmy.ijmy_90_26","DOIUrl":"10.4103/ijmy.ijmy_90_26","url":null,"abstract":"<p><strong>Background: </strong>The coexistence of nontuberculous mycobacterial pulmonary disease (NTM-PD) and chronic obstructive pulmonary disease (COPD) represents a severe clinical phenotype. This study aimed to investigate the factors associated with COPD comorbidity in patients with NTM-PD and evaluate the discriminatory performance of novel composite inflammatory-nutritional indices, specifically the C-reactive protein-to-albumin ratio (CAR) and the neutrophil-to-lymphocyte ratio-to-albumin ratio (NAR).</p><p><strong>Methods: </strong>In this single-center, retrospective, cross-sectional study, we reviewed the clinical records of 153 patients with NTM-PD diagnosed between January 2019 and December 2024. Eligible patients were categorized into the NTM-PD alone group and the NTM-PD with comorbid COPD group based on postbronchodilator pulmonary function testing. A clinically driven multivariable logistic regression model was used to identify factors associated with COPD comorbidity after adjustment for potential confounders, including smoking index, comorbidity score, and NTM species. Discriminatory performance was assessed using receiver operating characteristic analysis, with internal validation by 1000-resample bootstrapping. Model calibration was evaluated using the Brier score and calibration plot, and clinical utility was explored using decision curve analysis.</p><p><strong>Results: </strong>Of the 153 included patients, 75 (49.0%) had NTM-PD alone, and 78 (51.0%) had comorbid COPD. In the multivariable model, male sex (odds ratio [OR] = 4.93, 95% confidence interval [CI]: 2.01-12.09, P < 0.001), the presence of computed tomography (CT) cavities (OR = 3.82, 95% CI: 1.57-9.30, P = 0.003), and a higher NAR level (per 0.1-unit increase, OR = 1.85, 95% CI: 1.16-2.93, P = 0.009) were independently associated with COPD comorbidity. CAR and NAR showed similar discriminatory performance, with area under the curves (AUCs) of 0.768 and 0.767, respectively. The multivariable model showed good discrimination after internal validation by 1000-resample bootstrapping (bootstrapped AUC = 0.858, 95% CI: 0.796-0.910) and acceptable calibration (Brier score = 0.164).</p><p><strong>Conclusions: </strong>Male sex, the presence of CT cavities, and elevated NAR were independently associated with COPD comorbidity in patients with NTM-PD. In addition, CAR and NAR showed acceptable discriminatory performance as potential adjunctive screening markers for identifying patients who may warrant further evaluation for concurrent COPD. However, external validation is still required before broader clinical application.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"140-146"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360492","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":"Gene-specific Functional Roles of MSMEG_5046 , MSMEG_0241 , and MSMEG_0232 in Pyrazinoic Acid Efflux Identified through Clustered Regularly Interspaced Short Palindromic Repeat Interference.","authors":"Kevin R Obando Ballardo, Kiara Aricoche-Del Campo, B Carlos Alonso Flores, Robert H Gilman, Mirko Zimic, Patricia Sheen","doi":"10.4103/ijmy.ijmy_8_26","DOIUrl":"10.4103/ijmy.ijmy_8_26","url":null,"abstract":"<p><strong>Background: </strong>Efflux-mediated export of pyrazinoic acid (POA) has been associated with pyrazinamide (PZA) resistance, yet the specific transport components remain incompletely defined. Mycobacterium smegmatis , which exhibits intrinsically high POA efflux, provides a quantitative model to study PZA/POA transport mechanisms.</p><p><strong>Methods: </strong>Using clustered regularly interspaced short palindromic repeats interference, we silenced three efflux pump orthologs of Mycobacterium tuberculosis in M. smegmatis : MSMEG_5046 ( Rv1250c ), MSMEG_0241 ( Rv0202c /MmpL11), and MSMEG_0232 ( Rv0191c ). Gene knockdown was validated by quantitative reverse transcription polymerase chain reaction, achieving 45.1-, 14.6-, and 4.18-fold repression, respectively. POA export kinetics were assessed after PZA loading (final concentration 6.5 mM; 800 µg/mL) using a colorimetric assay over 0-60 min. Efflux rates were calculated from slope values, normalized to intracellular protein content, and compared across biological replicates using analysis of covariance.</p><p><strong>Results: </strong>All silenced strains showed significant differences in efflux slope compared with controls: MSMEG_5046 ( P = 0.0184), MSMEG_0241 ( P = 0.0497), and MSMEG_0232 ( P < 0.0001). At 60 min, normalized POA export changed by +32% (0.0048 mM POA/protein) for MSMEG_5046 , -89.33% (0.0134 mM POA/protein) for MSMEG_0241 , and -39.33% (0.0059 mM POA/protein) for MSMEG_0232 relative to wild type. MSMEG_0241 and MSMEG_0232 knockdowns reduced both efflux slope and total export, supporting a direct role in POA transport, whereas MSMEG_5046 repression increased efflux, suggesting compensatory activity.</p><p><strong>Conclusion: </strong>This protein-normalized, slope-based POA export assay resolves gene-specific contributions within a networked efflux system and prioritizes targeted validation in M. tuberculosis.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"147-152"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360615","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":"Reuse of Residual DNA Eluates from TrueNat™ Testing for Mycobacterium tuberculosis Complex Subspecies Differentiation: A Proof-of-concept Implementation Feasibility Study.","authors":"Hindol Maity, Keshao Hiwale, Supriya Meshram, Mohan Papanna, Vijayshri Deotale, Pratibha Narang","doi":"10.4103/ijmy.ijmy_44_26","DOIUrl":"10.4103/ijmy.ijmy_44_26","url":null,"abstract":"<p><strong>Background: </strong>The Mycobacterium tuberculosis complex (MTBC) includes human-and animal-adapted species. Routine TrueNat™ testing detects MTBC but does not differentiate subspecies. This study evaluated the reuse of residual TrueNat™ DNA eluates for MTBC subspecies identification.</p><p><strong>Methods: </strong>A cross-sectional laboratory feasibility study was performed using residual DNA (~78 µL) from 1,115 high-bacillary-load TrueNat™ MTBC-positive clinical specimens collected between 2022 and 2025. A two-step real-time polymerase chain reaction (PCR) assay targeting IS1081, MTCHum, MTCAni, and species-specific loci for Mycobacterium bovis (Mbov), Mycobacterium caprae (Mcap), and Mycobacterium orygis (Morg) was performed. All Mbov detections underwent confirmatory PCR and culture.</p><p><strong>Results: </strong>All eluates produced valid amplification. Of 1,115 samples, 1,114 (99.91%) were identified as M. tuberculosis sensu stricto and one (0.09%) as Mbov. The Mbov isolate, obtained from a 2-year-old child with lymphadenitis, was confirmed to be a Bacillus Calmette-Guérin (BCG) vaccine strain rather than wild-type Mbov. No Mcap or Morg were detected. Negative controls remained negative, and repeat testing showed 100% concordance.</p><p><strong>Conclusions: </strong>Residual DNA from routine TrueNat™ testing can be effectively reused for MTBC subspecies differentiation. This implementation feasibility study demonstrates that residual DNA from routine TrueNat™ testing can be reused for MTBC subspecies differentiation within existing workflows without additional specimen collection or DNA extraction. Dedicated validation and epidemiologic studies are required to evaluate its utility in surveillance applications.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"115-122"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360667","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":"Disseminated Mycobacterium immunogenum -associated Hemophagocytic Lymphohistiocytosis after Stem Cell Transplantation.","authors":"Robert Sean Tyler, Drew W Charles, Alexandra G Mills, Yosra Alkabab","doi":"10.4103/ijmy.ijmy_84_26","DOIUrl":"10.4103/ijmy.ijmy_84_26","url":null,"abstract":"<p><p>Secondary hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome most commonly triggered by infection, malignancy, or transplant-related immune dysregulation. Rapidly growing mycobacteria are uncommon causes of disseminated infection and have only rarely been reported as infectious triggers of HLH. A 56-year-old immunocompromised woman with a history of allogeneic hematopoietic stem cell transplant presented with recurrent fever, progressive transaminitis, and laboratory features consistent with secondary HLH. Liver biopsy showed granulomatous hepatitis with iron overload. Initial treatment with dexamethasone and anakinra resulted in transient clinical improvement. Less than 2 weeks later, she was readmitted with worsening hepatic dysfunction and found to have acid-fast bacilli in blood and bone marrow cultures, later identified as Mycobacterium immunogenum. Despite targeted antimicrobial therapy, the patient developed progressive hepatic and renal failure and died. To our knowledge, this case represents the first reported case of disseminated M. immunogenum infection precipitating secondary HLH, expanding the recognized clinical spectrum of this rapidly growing nontuberculous mycobacterium and highlights the diagnostic challenges of atypical mycobacterial infection in immunocompromised hosts.</p>","PeriodicalId":14133,"journal":{"name":"International Journal of Mycobacteriology","volume":"15 2","pages":"179-182"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360440","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}