mycobacterium tuberculosis (mtb)

结核分枝杆菌 ( MTB )
  • 文章类型: Journal Article
    结核病后肺病(PTLD)在结核病(TB)高负担的地区提出了重大的临床挑战。这篇综述提供了PTLD的全面概述,包括其发病机理,临床表现,诊断方式,管理策略,长期结果,和公共卫生影响。PTLD产生于结核病治疗后的残余肺损伤,其特征是一系列病理变化,包括纤维化,支气管扩张,和空化。临床表现差异很大,从慢性咳嗽和咯血到反复呼吸道感染,这通常是诊断困境。放射成像,肺功能检查,仔细考虑患者病史在诊断中起着关键作用。管理策略涉及药物干预,以减轻症状和预防疾病进展,受到肺损伤程度的影响,合并症,和获得医疗保健。康复计划和手术选择可用于选择的病例。预后受肺损伤程度的影响,合并症,和获得医疗保健。通过结核病控制计划和早期检测的预防工作对于减轻PTLD的负担至关重要。这篇综述强调了理解和解决PTLD的重要性,以减轻其对全球个人和公共卫生系统的影响。
    Post-tuberculosis lung disease (PTLD) poses a significant clinical challenge in regions with a high burden of tuberculosis (TB). This review provides a comprehensive overview of PTLD, encompassing its pathogenesis, clinical manifestations, diagnostic modalities, management strategies, long-term outcomes, and public health implications. PTLD arises from residual lung damage following TB treatment and is characterized by a spectrum of pathological changes, including fibrosis, bronchiectasis, and cavitation. Clinical presentation varies widely, from chronic cough and hemoptysis to recurrent respiratory infections, which are oftentimes a diagnostic dilemma. Radiological imaging, pulmonary function tests, and careful consideration of patient history play pivotal roles in diagnosis. Management strategies involve pharmacological interventions to alleviate symptoms and prevent disease progression, which are influenced by the extent of lung damage, comorbidities, and access to healthcare. Rehabilitation programs and surgical options are available for select cases. Prognosis is influenced by the extent of lung damage, comorbidities, and access to healthcare. Prevention efforts through a TB control program and early detection are crucial in reducing the burden of PTLD. This review stresses the importance of understanding and addressing PTLD to mitigate its impact on individuals and public health systems worldwide.
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  • 文章类型: Case Reports
    长骨/股骨结核,尤其是在一个有免疫能力的人身上,这是一个具有挑战性的诊断。这是一个罕见的实体,即使在地方性环境中。非特异性临床特征,即使在地方性环境中,对此类演示的怀疑也很低,可能导致延迟诊断和通常不利的治疗结果。在没有肺灶和结核病接触史的情况下,情况变得更具挑战性。这是一个年轻的成年男性的案例,他抱怨左腿疼痛三个月。通过磁共振成像和使用基于盒的核酸扩增测试从骨活检中分离细菌来实现诊断。及时开始抗结核治疗。
    Tuberculosis of the long bones/femur, especially in an immunocompetent person, is a challenging diagnosis. It is a rare entity, even in endemic settings. The non-specific clinical features, backed by a low suspicion about such presentations even in endemic settings, may result in delayed diagnosis and often unfavorable treatment outcomes. The situation becomes even more challenging in the absence of pulmonary foci and a contact history of tuberculosis. Here is a case of a young adult male who presented with complaints of pain over his left leg for three months. A diagnosis was achieved with magnetic resonance imaging and the isolation of the bacteria from a bone biopsy using a cartridge-based nucleic acid amplification test. Antituberculous treatment was promptly initiated.
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  • 文章类型: Journal Article
    结核分枝杆菌(Mtb)的PE和PPE家族蛋白仅在致病性分枝杆菌物种中发现,包含大约8-10%的Mtb基因组。已观察到这些新兴的毒力因子通过各种策略在Mtb发病机理和免疫逃避中起关键作用。已知这些免疫原性蛋白通过靶向细胞的动力室来调节宿主免疫应答和细胞死亡途径。支持Mtb存活的线粒体。在这篇文章中,我们专注于PE/PPE家族蛋白如何靶向宿主线粒体以诱导线粒体扰动,调节细胞ROS(活性氧)的水平并控制细胞死亡途径。我们观察到,这些蛋白质在感染不同阶段的表达时间对于阐明它们对细胞死亡途径和最终感染结果的影响至关重要。本文主要通过解开宿主线粒体的三联体来理解PE/PPE蛋白的贡献,促进Mtb持久性的氧化应激和细胞死亡途径。了解这些蛋白质在宿主细胞途径中的作用和复杂的机制为开发新型治疗策略以对抗TB感染铺平了道路。
    The PE and PPE family proteins of Mycobacterium tuberculosis (Mtb) is exclusively found in pathogenic Mycobacterium species, comprising approximately 8-10 % of the Mtb genome. These emerging virulent factors have been observed to play pivotal roles in Mtb pathogenesis and immune evasion through various strategies. These immunogenic proteins are known to modulate the host immune response and cell-death pathways by targeting the powerhouse of the cell, the mitochondria to support Mtb survival. In this article, we are focused on how PE/PPE family proteins target host mitochondria to induce mitochondrial perturbations, modulate the levels of cellular ROS (Reactive oxygen species) and control cell death pathways. We observed that the time of expression of these proteins at different stages of infection is crucial for elucidating their impact on the cell death pathways and eventually on the outcome of infection. This article focuses on understanding the contributions of the PE/PPE proteins by unravelling the triad of host mitochondria, oxidative stress and cell death pathways that facilitate the Mtb persistence. Understanding the role of these proteins in host cellular pathways and the intricate mechanisms paves the way for the development of novel therapeutic strategies to combat TB infections.
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  • 文章类型: Journal Article
    结核病(TB)仍然是一个重要的全球健康问题,特别是随着耐多药结核病(MDR-TB)和广泛耐药结核病(XDR-TB)的出现。传统的结核病耐药诊断方法耗时且往往缺乏准确性,导致延迟适当的治疗开始和加剧耐药菌株的传播。近年来,人工智能(AI)技术在革新结核病诊断方面显示出了希望,提供快速准确的耐药菌株鉴定。这篇全面的综述探讨了用于诊断MDR-TB和XDR-TB的AI应用的最新进展。我们讨论了各种人工智能算法和方法,包括机器学习,深度学习,和合奏技术,以及它们在结核病诊断中的比较表现。此外,我们研究了人工智能与新的诊断方式的整合,如全基因组测序,分子测定,和放射成像,提高结核病诊断的准确性和效率。围绕在结核病诊断中实施人工智能的挑战和局限性,例如数据可用性,算法可解释性,和监管方面的考虑,也解决了。最后,我们强调未来将人工智能整合到常规临床实践中以对抗耐药结核病的方向和机会,最终有助于改善患者预后和加强全球结核病控制工作。
    Tuberculosis (TB) remains a significant global health concern, particularly with the emergence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). Traditional methods for diagnosing drug resistance in TB are time-consuming and often lack accuracy, leading to delays in appropriate treatment initiation and exacerbating the spread of drug-resistant strains. In recent years, artificial intelligence (AI) techniques have shown promise in revolutionizing TB diagnosis, offering rapid and accurate identification of drug-resistant strains. This comprehensive review explores the latest advancements in AI applications for the diagnosis of MDR-TB and XDR-TB. We discuss the various AI algorithms and methodologies employed, including machine learning, deep learning, and ensemble techniques, and their comparative performances in TB diagnosis. Furthermore, we examine the integration of AI with novel diagnostic modalities such as whole-genome sequencing, molecular assays, and radiological imaging, enhancing the accuracy and efficiency of TB diagnosis. Challenges and limitations surrounding the implementation of AI in TB diagnosis, such as data availability, algorithm interpretability, and regulatory considerations, are also addressed. Finally, we highlight future directions and opportunities for the integration of AI into routine clinical practice for combating drug-resistant TB, ultimately contributing to improved patient outcomes and enhanced global TB control efforts.
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  • 文章类型: Case Reports
    结核病可以出现在各种肺外部位。然而,即使在流行国家,很少报道同一患者的不同部位同时受累.Further,结核性心包炎占所有结核感染的一小部分,是肺外结核的一种罕见形式。在不发达国家,它是大量心包积液的最常见原因。此外,它是成人缩窄性心包炎的最常见原因,死亡率高,预后差。此外,结核分枝杆菌并发胸腔积液的报道很少见.在这里,据报道,一名印度女性并发心包和左侧胸腔积液。她带着呼吸困难的抱怨来了,胸痛,盗汗,和食欲不振。诊断性胸膜胸腔穿刺术和心包穿刺术有助于建立诊断,她开始抗结核治疗168天。
    Tuberculosis can present at various extrapulmonary sites. However, even in endemic countries, concomitant involvement of different sites in the same patient is rarely reported. Further, tuberculous pericarditis represents a fraction of all tuberculosis infections and is an uncommon form of extrapulmonary tuberculosis. In underdeveloped nations, it is the most frequent cause of massive pericardial effusion. Additionally, it is the most common cause of constrictive pericarditis in adults, which has a high death rate and a poor prognosis. Furthermore, concomitant pleural effusion due to Mycobacterium tuberculosis is infrequently reported. Herein, a case of concomitant pericardial and left-sided pleural effusion in an Indian female is reported. She came with complaints of breathlessness, chest pain, night sweats, and loss of appetite. A diagnostic pleural thoracentesis and pericardiocentesis helped establish the diagnosis, and she was commenced on antituberculous treatment for 168 days.
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  • 文章类型: Case Reports
    结核病可以以各种非典型形式存在。临床表现可能涉及骨骼等部位。肩胛骨结核,肱骨,后外侧胸壁极为罕见,由于与肿瘤等疾病的相似性,诊断具有挑战性。一个小男孩出现右肩关节肿胀三个月。由于在最初的放射检查中与尤因肉瘤相似,因此诊断具有挑战性。活检的临床评估和诊断检查,基于盒的核酸扩增测试,和先进的辐射测量调查导致最终诊断。他开始服用抗结核药物12个月。
    Tuberculosis can present in various atypical forms. The clinical manifestations could involve sites like bones. Tuberculosis of the scapula, humerus, and posterolateral thoracic wall is extremely rare, and diagnosis is challenging due to similarities with conditions like tumors. A young boy presented with swelling of the right shoulder joint for three months. The diagnosis was challenging due to similarities with Ewing\'s sarcoma on the initial radiometric workup. A clinical assessment and diagnostic workup with biopsy, a cartridge-based nucleic acid amplification test, and an advanced radiometric investigation resulted in a final diagnosis. He was started on antituberculous drugs for 12 months.
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  • 文章类型: Case Reports
    结核病通常见于肺部。然而,各种肺外部位的参与是由于细菌通过血液传播,淋巴管,或直接接种。本案是一名印度女性罕见的结核病表现,她的右肘关节肿胀,头痛,咳嗽咳痰.诊断评估结果从痰液样本和肘关节中分离出结核分枝杆菌,脑脊液检查的渗出性图片进一步支持了这一点。这些发现得到了先进的辐射测量技术的支持。根据她的体重,她开始接受抗结核治疗。播散性结核病是一个具有挑战性的诊断,因为临床表现往往会延迟。临床医生缺乏对多部位结核感染可能性的认识,以及培养结果可用性的时滞。
    Tuberculosis is usually seen in the lungs. However, the involvement of various extrapulmonary sites is due to the spread of the bacteria via blood, lymphatic, or direct inoculation. The present case is a rare presentation of tuberculosis in an Indian female who came with complaints of swelling in her right elbow joint, headache, and cough with expectoration. A diagnostic evaluation resulted in the isolation of Mycobacterium tuberculosis from the sputum samples and elbow joints, which was further supported by an exudative picture on the cerebrospinal fluid examination. The findings were supported by advanced radiometric techniques. She was commenced on an antituberculous treatment per her weight. Disseminated tuberculosis is a challenging diagnosis as there is often a delay in clinical presentation, a lack of awareness about the possibility of multiple sites with tuberculous infection in clinicians, and a time lag in the availability of the culture results.
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  • 文章类型: Journal Article
    背景:结核病(TB)仍然是由于单个转染子而导致死亡的主要原因,结核分枝杆菌(MTB)。潜伏性结核感染(LTBI)是以结核病(TB)的存在为特征的病症,其在临床上并不明显,但仍然显示出对MTB的持续应答。目前,结核菌素皮肤试验(TST)和干扰素γ(IFN-γ)释放试验(IGRAs)主要用于通过T细胞介导的免疫来检测LTBI。对于终末期肾病(ESRD)患者,由于T细胞功能障碍,感染MTB的患者诊断困难。为了获得更准确的LTBI诊断结果,它必须弥补IGRA测试的不足。
    方法:本研究纳入了67例血液透析(HD)患者和96例非HD患者,并连续纳入研究人群。通过QuantiFERON-TB金管内(QFT-GIT)测试测量IFN-γ水平。肾功能指标,血尿素氮(BUN),血清肌酐(Cr),和估计的肾小球滤过率(eGFR)用于补偿IGRA测试中IFN-γ水平的下降。
    结果:在以前未被发现的个体中,用血清Cr补偿的结果增加了10.81%,允许大约28%的检测,eGFR的补偿增加了5.41%,考虑到其中约14%的可检测潜力,并采用这两种方法可以增强IGRA测试的先前缺点。当两者都被使用时,最大补偿结果显示灵敏度提高8.81%,大约23%以前无法检测到的患者可能被发现。
    结论:因此,作为HD患者常规检查以弥补IGRA检测不足的肾功能标志物,可提高LTBI诊断的准确性.
    BACKGROUND: Tuberculosis (TB) is still the main cause of mortality due to a single transfectant, Mycobacterium tuberculosis (MTB). Latent tuberculosis infection (LTBI) is a condition characterized by the presence of tuberculosis (TB) that is not clinically apparent but nonetheless shows a sustained response to MTB. Presently, tuberculin skin test (TST) and interferon gamma (IFN-γ) release assays (IGRAs) are mainly used to detect LTBI via cell-mediated immunity of T-cells. For people with end-stage renal disease (ESRD), the diagnosis of patients infected with MTB is difficult because of T-cell dysfunction. To get more accurate diagnosis results of LTBI, it must compensate for the deficiency of IGRA tests.
    METHODS: Sixty-seven hemodialysis (HD) patients and 96 non-HD patients were enrolled in this study and the study population is continuously included. IFN-γ levels were measured by the QuantiFERON-TB Gold In-Tube (QFT-GIT) test. Kidney function indicators, blood urea nitrogen (BUN), serum creatinine (Cr), and estimated glomerular filtration rate (eGFR) were used to compensate for the declined IFN-γ levels in the IGRA test.
    RESULTS: In individuals who were previously undetected, the results of compensation with serum Cr increased by 10.81%, allowing for about 28% more detection, and compensation with eGFR increased by 5.41%, allowing for approximately 14% more detectable potential among them and employing both of them could enhance the prior shortcomings of IGRA tests. when both are used, the maximum compensation results show a sensitivity increase rate of 8.81%, and approximately 23% of patients who were previously undetectable may be found.
    CONCLUSIONS: Therefore, the renal function markers which are routine tests for HD patients to compensate for the deficiency of IGRA tests could increase the accuracy of LTBI diagnosis.
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  • 文章类型: Journal Article
    耐药结核分枝杆菌(Mtb)菌株的出现强调了对新治疗方法的迫切需要。碳基纳米材料,如氧化石墨烯(GO),已经显示出潜在的抗TB活性,但遭受显著的毒性问题。
    这项研究探索了不同功能化的石墨烯量子点(GQDs)的抗结核病潜力-非功能化,L-GQD,胺化(NH2-GQDs),和羧化(COOH-GQDs)-单独和与标准结核病药物联合使用(异烟肼,阿米卡星,和利奈唑胺)。在无菌培养和体外感染模型中评估了它们的作用。
    单独的GQD没有表现出直接的分枝杆菌杀菌作用或捕获活性。然而,在体外模型中,NH2-GQDs与阿米卡星的组合显着降低了CFU。NH2-GQDs和COOH-GQDs也增强了阿米卡星在感染的巨噬细胞中的抗菌活性,虽然L-GQDs和COOH-GQDs单独没有显示出显著的活性。
    结果表明,特定类型的GQDs,特别是NH2-GQDs,可以增强现有抗结核药物的疗效。这些纳米颗粒可能通过提高药物性能和减少宿主细胞中的细菌计数,作为抗结核治疗的有效佐剂。强调它们作为结核病治疗中先进药物输送系统的一部分的潜力。需要进一步的研究以更好地了解其机制并优化其在临床环境中的使用。
    UNASSIGNED: The emergence of drug-resistant Mycobacterium tuberculosis (Mtb) strains has underscored the urgent need for novel therapeutic approaches. Carbon-based nanomaterials, such as graphene oxide (GO), have shown potential in anti-TB activities but suffer from significant toxicity issues.
    UNASSIGNED: This study explores the anti-TB potential of differently functionalized graphene quantum dots (GQDs) - non-functionalized, L-GQDs, aminated (NH2-GQDs), and carboxylated (COOH-GQDs) - alone and in combination with standard TB drugs (isoniazid, amikacin, and linezolid). Their effects were assessed in both axenic cultures and in vitro infection models.
    UNASSIGNED: GQDs alone did not demonstrate direct mycobactericidal effects nor trapping activity. However, the combination of NH2-GQDs with amikacin significantly reduced CFUs in in vitro models. NH2-GQDs and COOH-GQDs also enhanced the antimicrobial activity of amikacin in infected macrophages, although L-GQDs and COOH-GQDs alone showed no significant activity.
    UNASSIGNED: The results suggest that specific types of GQDs, particularly NH2-GQDs, can enhance the efficacy of existing anti-TB drugs. These nanoparticles might serve as effective adjuvants in anti-TB therapy by boosting drug performance and reducing bacterial counts in host cells, highlighting their potential as part of advanced drug delivery systems in tuberculosis treatment. Further investigations are needed to better understand their mechanisms and optimize their use in clinical settings.
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  • 文章类型: Case Reports
    很少报道引起小骨头的结核病,即使在流行国家。在没有肺部受累的成年印度男性中,左二掌骨孤立受累的病例很少见,以前从未在医学文献中记录过。由于非特异性临床特征,这是一个诊断挑战,没有结核病的体质体征,早期阶段的X光片含糊不清,并经常导致诊断延迟。此外,这是一种少杆菌病,因此,诊断可能是一项艰巨的任务。在这里,一名20岁的印度男性出现了疼痛和肿胀的抱怨,他的左手背侧有一个鼻窦排出。通过基于药筒的核酸扩增测试对结核分枝杆菌的分离进行详细评估,有助于根据其体重诊断和启动适当的抗结核化疗。
    Tuberculosis inflicting small bones is infrequently reported, even in endemic countries. A case of isolated involvement of the left second metacarpal in an adult Indian male with no pulmonary involvement is rare and has never been documented before in the medical literature. It\'s a diagnostic challenge due to non-specific clinical features, absence of constitutional signs of tuberculosis, ambiguity on radiograph films at early stages, and often results in delayed diagnosis. Moreover, it\'s a paucibacillary disease, and hence, diagnosis can be an arduous task. Herein, a case of a 20-year-old Indian male is presented who came with complaints of pain and swelling with a discharging sinus from the dorsum of his left hand. A detailed evaluation with the isolation of Mycobacterium tuberculosis on a cartridge-based nucleic acid amplification test helped in the diagnosis and initiation of appropriate antituberculous chemotherapy per his weight.
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