Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Refractory splenic tuberculosis in acute myeloid Leukemia: The role of advanced diagnostics and surgical intervention","authors":"Hongju Yan,&nbsp;Qin Wen,&nbsp;Xi Zhang","doi":"10.1016/j.jctube.2025.100525","DOIUrl":"10.1016/j.jctube.2025.100525","url":null,"abstract":"<div><div>AML patients are at a high risk of opportunistic infections, with tuberculosis (TB) being a common and challenging one. The immunosuppression caused by both AML and its treatment heightens this risk. Diagnosing TB in AML patients is difficult due to the overlapping symptoms of AML and TB. This case report presents a 22-year-old man diagnosed with AML who developed disseminated TB, manifesting as a refractory tuberculous splenic abscess. Despite achieving complete remission from initial induction chemotherapy, the patient experienced persistent fever. Next-generation sequencing revealed Mycobacterium tuberculosis infection, and anti-TB treatment was initiated. Despite regular anti-tuberculosis therapy, the patient continued to have recurrent fevers, with progressive splenic enlargement and an increase in splenic lesions. Eventually, splenectomy confirmed the presence of abscess-type splenic tuberculosis and resolved the symptoms. Despite the recurrence of leukemia in the bone marrow and the development of central nervous system leukemia during the patient’s treatment, complete remission was achieved again after re - induction chemotherapy and intrathecal chemotherapy. Then the patient underwent successful HSCT. This case highlights the diagnostic and therapeutic challenges in managing disseminated TB in AML patients. It underscores the importance of early and accurate diagnosis using advanced molecular techniques, close monitoring, and aggressive treatment. Surgical interventions should also be considered when standard treatments fail. Additionally, it emphasizes the need for proactive TB screening and prevention strategies in high-risk populations, such as AML patients undergoing chemotherapy.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100525"},"PeriodicalIF":1.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918379","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":"Bridging gaps in tuberculosis control: addressing cross-border challenges between India and Pakistan","authors":"Harendra Kumar ,&nbsp;Fnu Teena ,&nbsp;Aneeta Bai ,&nbsp;Love Kumar ,&nbsp;Sebastian Gallego","doi":"10.1016/j.jctube.2025.100526","DOIUrl":"10.1016/j.jctube.2025.100526","url":null,"abstract":"<div><div>Tuberculosis (TB) continues to pose a substantial public health concern in South Asia, especially in India and Pakistan, which together represent a considerable portion of the worldwide TB burden. Notwithstanding national initiatives, international cooperation in tuberculosis control is insufficient, presenting a considerable obstacle to disease eradication. This viewpoint underscores the pressing need for improved collaboration between the two nations to tackle common difficulties, such as multidrug-resistant tuberculosis (MDR-TB), inadequate data exchange, and inconsistencies in treatment procedures. We suggest a framework to enhance bilateral tuberculosis control efforts via enhanced data-sharing methods, standardization of treatment regimens, collaborative research projects, and cross-border healthcare access. The formation of a regional tuberculosis task force and health corridors, equipped with diagnostic and treatment facilities, may improve disease monitoring and patient care, particularly in border areas. Moreover, combined training programs for healthcare professionals and legislative measures might enhance a more synchronized response. The World Health Organization (WHO) advocates for a worldwide plan to eradicate tuberculosis, presenting India and Pakistan with the potential to use international collaborations, like the Worldwide Fund and the Stop TB Partnership, to deploy novel diagnostic methods and therapies. A cohesive approach to tuberculosis enhances regional health security and establishes a benchmark for wider infectious disease management efforts. This viewpoint emphasizes the need for a collaborative strategy for tuberculosis control, promoting policy-oriented initiatives that surpass political divisions to attain a shared objective—diminishing tuberculosis incidence and enhancing public health outcomes in both countries.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100526"},"PeriodicalIF":1.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823324","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":"Atypical presentations of mucocutaneous TB in HIV: A case series from South Africa","authors":"Mahlatse Cordelia Kgokolo ,&nbsp;Mohlominyane Jeffrey Mokheseng ,&nbsp;Jabulile Johanna Makhubele ,&nbsp;Shalate Charlotte Siwele ,&nbsp;Tinashe Irvin Maphosa ,&nbsp;Tsholofelo Kungoane","doi":"10.1016/j.jctube.2025.100524","DOIUrl":"10.1016/j.jctube.2025.100524","url":null,"abstract":"<div><h3>Introduction</h3><div>Tuberculosis (TB) remains a major burden of disease worldwide, especially in Human immunodeficiency virus (HIV)-infected patients. Cutaneous forms of TB account for approximately 10 % of all extrapulmonary tuberculosis cases, with oral manifestations accounting for less than 1 % of these cases. A high index of suspicion is essential when diagnosing rare clinical presentations. The response to treatment is excellent in most patients, particularly those receiving concomitant, effective antiretroviral (ARV) treatment.</div></div><div><h3>Patient presentation</h3><div>We report two cases of lupus vulgaris in AIDS patients (CD4 count of 113 cells/mm³ and 172 cells/mm³, respectively) and one case of mucosal TB in a patient with CD4 count of 365 cells/mm³. All the patients were adults referred to the dermatology clinic. The atypical clinical presentations included papules, plaques, and ulcers affecting unusual sites, such as the upper and lower limbs in the case of lupus vulgaris and a tongue ulcer in the patient with oral TB, emphasizing the importance of strong suspicion in HIV-infected patients. All available diagnostic measures were used to confirm the diagnosis.</div></div><div><h3>Management</h3><div>We demonstrate the importance of multidisciplinary care for patients and an excellent response to anti-TB treatment once diagnosed. We also emphasize the importance of concomitant ARV treatment and patient follow-up.</div></div><div><h3>Conclusion</h3><div>The outcomes of two of the three patients were good, highlighting the importance of timely clinical diagnosis and treatment, including monitoring and follow-up, while ensuring continued ARV treatment.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100524"},"PeriodicalIF":1.9,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891649","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":"Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda","authors":"Joseph Baruch Baluku ,&nbsp;Diana Karungi ,&nbsp;Brenda Namanda ,&nbsp;Sharon Namiiro ,&nbsp;Shamim Katusabe ,&nbsp;Angut Mary Madalen ,&nbsp;Martin Nabwana ,&nbsp;Ronald Olum ,&nbsp;Felix Bongomin ,&nbsp;Edwin Nuwagira ,&nbsp;Grace Kansiime ,&nbsp;Christian Kraef ,&nbsp;Megan Shaughnessy ,&nbsp;Joshua Rhein ,&nbsp;David Meya","doi":"10.1016/j.jctube.2025.100523","DOIUrl":"10.1016/j.jctube.2025.100523","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) is the leading cause of mortality among people with HIV (PWH), but the influence of co-infections like tuberculosis (TB) on CVD risk remains underexplored. We aimed to compare cardiometabolic profiles of PWH with and without prior TB to determine if prior TB is associated with distinct cardiometabolic profiles.</div></div><div><h3>Methods</h3><div>We conducted a comparative, cross-sectional study at a tertiary hospital in Kampala, Uganda. Participants were randomly sampled PWH aged ≥ 18 years on antiretroviral therapy. Specifically, we enrolled PWH with and without prior active TB (ratio of 1:1). Anthropometric measurements, blood pressure, fasting blood glucose (FBG), lipid profile, and glycated hemoglobin were assessed.</div></div><div><h3>Results</h3><div>A total of 396 participants were enrolled (196 TB survivors and 200 controls). TB survivors had higher median FBG (5.5 vs. 5.1 mmol/l, p &lt; 0.001) and a higher prevalence of DM (17.9 % vs. 9.5 %, p = 0.015). However, they had lower body mass index (23.0 vs. 25.1 kg/m², p &lt; 0.001) and waist circumference (81.0 vs. 84.0 cm, p = 0.026). TB survivors had higher HDL-c levels (1.0 vs. 0.8 mmol/l, p &lt; 0.001), lower LDL-c levels (2.7 vs. 3.1 mmol/l, p &lt; 0.001) and lower prevalence of dyslipidemia (81.7 % vs. 96.5 %, p &lt; 0.001). Prior TB was independently associated with higher prevalence of elevated FBG (adjusted prevalence ratio (aPR) 1.79, 95 % CI 1.10–2.92) and DM (aPR 2.34, 95 % CI 1.11–4.94), but decreased risk of obesity (aPR 0.42, 95 % CI 0.20–0.88).</div></div><div><h3>Conclusion</h3><div>TB survivors with HIV exhibit a higher risk of DM but lower risk of obesity compared to those without a history of TB, indicating a need for blood glucose monitoring among TB survivors.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100523"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matters of the heart: A scoping review toward better management of nontuberculous mycobacterial infections of cardiac devices","authors":"Rattanaporn Mahatanan ,&nbsp;Maria Alkozah ,&nbsp;Devin Lee ,&nbsp;Anais A. Ovalle ,&nbsp;Natalie B.V. Riblet ,&nbsp;Elizabeth A. Talbot","doi":"10.1016/j.jctube.2025.100521","DOIUrl":"10.1016/j.jctube.2025.100521","url":null,"abstract":"<div><h3>Background</h3><div>Implantable cardiac device-related (ICDR) nontuberculous mycobacteria (NTM) infections are increasingly reported in the literature, but guidelines for optimal management are lacking.</div></div><div><h3>Methods</h3><div>We searched Medline, Embase, and Scopus from inception to 1/20/2022 for cases of ICDR NTM infection. Cardiac devices include but are not limited to prosthetic valves, cardiovascular implantable device (CIED), and left ventricular-assist devices (LVAD). We categorized outcomes as death, failure, relapse, cure, and treatment complete.</div></div><div><h3>Main results</h3><div>A total of 81 articles met our inclusion criteria, representing 122 patients. Eleven different NTM species were reported, with rapidly growing mycobacteria (RGM) including <em>M. fortuitum, M. chelonae,</em> and <em>M. abscessus</em> comprising approximately 60 % of the identified organisms. Prosthetic heart valves (N = 61; 50 %) and CIED (N = 46; 38 %) were the most frequently associated cardiac devices. Favorable outcomes, defined as treatment complete and cure, were significantly associated with device removal after adjusting for age, gender, and device type (aOR 3.45, 95 %CI 1.30–9.14).</div></div><div><h3>Conclusion</h3><div>We found that patients who underwent device removal had better outcomes than those with retained devices. Device removal should be strongly considered when possible.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100521"},"PeriodicalIF":1.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the global Response to Tuberculosis: Insights from the 2024 WHO global TB report","authors":"Fatemeh Estaji ,&nbsp;Ali Kamali ,&nbsp;Masoud Keikha","doi":"10.1016/j.jctube.2025.100522","DOIUrl":"10.1016/j.jctube.2025.100522","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100522"},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of extensive drug resistance by the Xpert MTB/XDR assay in multidrug resistant tuberculosis cases at a tertiary care centre in northern India, and therapeutic decision making for the six-month BPaLM regimen","authors":"Richa Misra ,&nbsp;Parijat Das ,&nbsp;Alok Nath ,&nbsp;Zafar Neyaz","doi":"10.1016/j.jctube.2025.100520","DOIUrl":"10.1016/j.jctube.2025.100520","url":null,"abstract":"<div><div>The Xpert MTB/XDR assay has been approved by World Health Organization (WHO) as a reflex test on sputum samples after testing for rifampicin resistance. Recently, the Union Health Ministry of India in September 2024 approved the introduction of the six-month BPaLM regimen under its National TB Elimination Program (NTEP). In this study, the Xpert MTB/XDR assay was used to detect extensive drug resistance in pulmonary and extra-pulmonary tuberculosis patients with positive result for MTBC, and RIF resistance by the Xpert MTB/RIF ULTRA assay. We also aimed to assess the eligibility of patients for the BPaLM regimen based on the drug susceptibility profile of this test in a high burden Indian setting.</div><div>We conducted a single centre prospective cohort study between January 2023 to August 2024 on 42 old, and 68 new patients presenting with MDR/RR tuberculosis. A total of 110 samples (82 pulmonary and 28 extra pulmonary samples) were included in the study. The Xpert MTB/XDR assay was used to determine the susceptibilities to isoniazid, fluoroquinolones, amikacin, kanamycin, capreomycin, and ethionamide.</div><div>Out of 110 samples processed, 13 samples were ‘not detected’ by the assay while three gave invalid results. Resistance to isoniazid, fluoroquinolones, amikacin, kanamycin, capreomycin and ethionamide was detected in 85/94 cases (90·42%), 74/94 cases (78·72%), 08/94 cases (8·5%), 13/94 cases (13·83%), 08/94 cases (8·5%), and 14/94 cases (14·89%) respectively.</div><div>With the updated definitions of drug-resistant TB and high burden of fluoroquinolone resistance the Xpert MTB/XDR assay has a limited application in India.</div><div>Detection of extensive drug resistance by the Xpert MTB/XDR assay in multidrug resistant tuberculosis cases at a tertiary care centre in northern India, and therapeutic decision making for the six-month BPaLM regimen.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100520"},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost effectiveness analysis of expanding tuberculosis preventive therapy to household contacts aged 5–14 years in the Philippines","authors":"Ghassan Ilaiwy ,&nbsp;Jessica Keim-Malpass ,&nbsp;Romella Tuppal ,&nbsp;Alexander F. Ritua ,&nbsp;Flordeliza R. Bassiag ,&nbsp;Tania A. Thomas","doi":"10.1016/j.jctube.2025.100519","DOIUrl":"10.1016/j.jctube.2025.100519","url":null,"abstract":"<div><h3>Background</h3><div>Children aged 5–14 years who are household contacts (HHCs) of index people with active TB disease (PWTB) have limited coverage for TB preventive therapy (TPT) due to variable uptake of the national guideline recommendations in the Philippines. We conducted a cost-effectiveness analysis evaluating the expansion of TB infection (TBI) testing and treatment among pediatric (5–14 years) HHCs of index PWTB in the Philippines to assist the National TB program in choosing the most cost-effective testing and treatment strategy for TBI among HHCs of index PWTB.</div></div><div><h3>Methods</h3><div>Using a Markov state transition model, eligible HHCs age 5–14 years are screened for TBI with either the tuberculin skin test (TST) or interferon gamma release assay (IGRA). Those who test positive are then simulated to receive one of the following TPT strategies: 6 months of daily isoniazid (6H), 3 months of weekly isoniazid and rifapentine (3HP), 3 months of daily isoniazid plus rifampicin (3HR) and the current practice of no testing or treatment for TBI (NTT). The analysis assesses the projected cost and quality-adjusted life years (QALY) gained for every strategy from the perspective of the Philippines public healthcare system over a time horizon of 20 years. The total cost and gain in QALYs are presented as an incremental cost-effectiveness ratio (ICER) comparing cost per QALY gained for each strategy over NTT.</div></div><div><h3>Results</h3><div>Our model estimates that expanding TPT coverage to HHCs aged 5–14 years would be cost-effective with incremental cost-effectiveness ratios (ICERs) ranging from 1,024 $/QALY gained when using TST and 6H (Uncertainty range: 497–––2,334) to 2,293 $/QALY gained when IGRA and 3HR are used (Uncertainty range: 1,140 – 5,203). These findings were robust to sensitivity analyses over a wide range of parameter values.</div></div><div><h3>Conclusion</h3><div>Expanding TPT coverage to HHCs aged 5–14 years is cost-effective when using TST and 6H closely followed by a strategy combining TST and 3HP.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100519"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy study of STANDARD TB-Feron FIA and STANDARD TB-Feron ELISA tests for tuberculosis infection diagnosis in Eastern European setting","authors":"Valeriu Crudu ,&nbsp;Dumitru Chesov ,&nbsp;Alexandru Codreanu ,&nbsp;Nadejda Turcanu ,&nbsp;Nelly Ciobanu ,&nbsp;Liuba Nepoliuc ,&nbsp;Doina Rusu","doi":"10.1016/j.jctube.2025.100518","DOIUrl":"10.1016/j.jctube.2025.100518","url":null,"abstract":"<div><h3>Introduction</h3><div>Tuberculosis infection (TBI) is diagnosed based on a positive immune response to <em>M. tuberculosis</em> antigens. This study aimed to evaluate both the qualitative and quantitative performance of two novel IGRA-based tests, the STANDARD E TB-Feron ELISA (TB-Feron-ELISA) and the STANDARD F TB-Feron FIA (IFN-γ) (TB-Feron-FIA), and compare their results to those of QuantiFERON-TB Gold Plus (QuantiFERON).</div></div><div><h3>Methods</h3><div>At Chiril Draganiuc Phthisiopneumology Institute in the Republic of Moldova, we prospectively enrolled three cohorts of adults: healthy individuals with no known close contact with TB, patients with active tuberculosis (TB), and individuals with a history of TB. The active TB and past TB cohorts were used to assess the tests’ sensitivity, while the healthy group was used to evaluate specificity. Both qualitative and quantitative results from the TB-Feron ELISA and TB-Feron FIA were compared with those of QuantiFERON.</div></div><div><h3>Results</h3><div>The TB-Feron-FIA demonstrated a sensitivity of 80.58 % (95 %CI: 71.90–87.06) in the active TB cohort and 82.93 % (95 %CI: 68.74–91.47) in the past TB cohort, with a specificity of 85.19 % (95 % CI: 73.40–92.30). The TB-Feron-ELISA showed a sensitivity of 80.58 % (95 %CI: 71.90–87.06) in the active TB cohort and 78.57 % (95 %CI: 64.06–88.29) in the past TB cohort, with a specificity of 85.19 % (95 %CI: 73.40–92.30). The agreement coefficient (κ) with QuantiFERON was 0.766 (95 %CI: 0.689–0.843) for TB-Feron-FIA and 0.809 (95 %CI: 0.739–0.880) for TB-Feron-ELISA.</div></div><div><h3>Conclusions</h3><div>Both the TB-Feron-ELISA and TB-Feron-FIA demonstrated good diagnostic accuracy for identifying individuals with TBI, comparable to the performance of QuantiFERON.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100518"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematochemical hallmarks as markers of pulmonary TB severity: A multicenter cross-sectional study","authors":"Francesco Di Gennaro ,&nbsp;Giacomo Guido ,&nbsp;Sergio Cotugno ,&nbsp;Francesco Cavallin ,&nbsp;Mariantonietta Pisaturo ,&nbsp;Lorenzo Onorato ,&nbsp;Federica Zimmerhofer ,&nbsp;Luca Pipitò ,&nbsp;Giuseppina De Iaco ,&nbsp;Giuseppe Bruno ,&nbsp;Massimo Fasano ,&nbsp;Agostina Pontarelli ,&nbsp;Annarita Botta ,&nbsp;Tiziana Iacovazzi ,&nbsp;Rossana Lattanzio ,&nbsp;Virginia Di Bari ,&nbsp;Gianfranco Panico ,&nbsp;Raffaella Libertone ,&nbsp;Caterina Monari ,&nbsp;Alessia Musto ,&nbsp;Annalisa Saracino","doi":"10.1016/j.jctube.2025.100517","DOIUrl":"10.1016/j.jctube.2025.100517","url":null,"abstract":"<div><h3>Background</h3><div>Identifying accessible and reliable biomarkers for tuberculosis (TB) severity is crucial for improving patient management. This study evaluates hematological findings as potential indicators of TB severity in a large multicenter Italian cohort.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter, cross-sectional study analyzed hematological parameters (hemoglobin, white blood cells, inflammatory indices, hepatorenal function, albuminuria) in 577 TB patients from 10 Italian centers (2018–2023). Severe TB was defined by at least two criteria: TIMIKA score &gt; 60, sputum conversion time &gt; 21 days, or need for oxygen supplementation. Statistical analyses included receiver operating characteristic curve (AUC) evaluation, calibration curves, and clinical utility.</div></div><div><h3>Results</h3><div>Of the patients, 30.3 % were classified as severe, 60.2 % as non-severe, and 9.5 % as uncertain. AUC values for predicting severe TB ranged from 0.51 to 0.56 across hematological variables. Anemia and elevated CRP demonstrated sensitivities of 0.71 and 0.74, respectively. Models using continuous or categorical hematological variables achieved AUCs of 0.61 and 0.65, showing poor calibration and limited clinical utility in the 30–60 % threshold range.</div></div><div><h3>Conclusions</h3><div>Hematological markers, while rapid and cost-effective, demonstrated limited discriminative ability for TB severity. Further studies are required to develop reliable predictive models, integrating additional clinical and molecular data.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100517"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}