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Cough-aerosol cultures of Mycobacterium tuberculosis in the prediction of outcomes after exposure. A household contact study in Brazil
Mycobacterium tuberculosis cultures of cough-generated aerosols from patients with pulmonary tuberculosis (TB) are a quantitative method to measure infectiousness and to predict secondary outcomes in exposed contacts. However, their reproducibility has not been established. To evaluate the predictiv...
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| Published in: | PloS one 2018-10, Vol.13 (10), p.e0206384-e0206384 |
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| creator | Acuña-Villaorduña, Carlos Schmidt-Castellani, Luiz Guilherme Marques-Rodrigues, Patricia White, Laura F Hadad, David Jamil Gaeddert, Mary Ellner, Jerrold J Fennelly, Kevin P Palaci, Moises Dietze, Reynaldo Jones-López, Edward C |
| description | Mycobacterium tuberculosis cultures of cough-generated aerosols from patients with pulmonary tuberculosis (TB) are a quantitative method to measure infectiousness and to predict secondary outcomes in exposed contacts. However, their reproducibility has not been established.
To evaluate the predictive value of colony-forming units (CFU) of M. tuberculosis in cough aerosols on secondary infection and disease in household contacts in Brazil.
Adult sputum smear+ and culture+ pulmonary TB cases underwent a standard evaluation and were categorized according to aerosol CFU. We evaluated household contacts for infection at baseline and at 8 weeks with TST and IGRA, and secondary disease.
We enrolled 48 index TB cases; 40% had negative aerosols, 27% low aerosols ( |
| doi_str_mv | 10.1371/journal.pone.0206384 |
| format | article |
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To evaluate the predictive value of colony-forming units (CFU) of M. tuberculosis in cough aerosols on secondary infection and disease in household contacts in Brazil.
Adult sputum smear+ and culture+ pulmonary TB cases underwent a standard evaluation and were categorized according to aerosol CFU. We evaluated household contacts for infection at baseline and at 8 weeks with TST and IGRA, and secondary disease.
We enrolled 48 index TB cases; 40% had negative aerosols, 27% low aerosols (<10 CFU) and 33% high aerosols (≥10 CFU). Of their 230 contacts, the proportion with a TST ≥10 mm at 8 weeks was 59%, 65% and 75%, respectively (p = 0.34). Contacts of high aerosol cases had greater IGRA readouts (median 4.6 IU/mL, IQR 0.02-10) when compared to those with low (0.8, 0.2-10) or no aerosol (0.1, 0-3.7; p = 0.08). IGRA readouts in TST converters of high aerosol cases (median 20 IU/mL, IQR 10-24) were larger than those from aerosol-negative (0.13, 0.04-3; p = o.o2). 8/9 (89%) culture+ secondary TB cases occurred in contacts of aerosol+ cases.
Aerosol CFU predicts quantitatively IGRA readouts among household contacts of smear positive TB cases. Our results strengthen the argument of using cough aerosols to guide targeted preventive treatment strategies, a necessary component of current TB elimination projections.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0206384</identifier><identifier>PMID: 30372480</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aerosols ; Biology and Life Sciences ; Brazil ; Cough - microbiology ; Culture Techniques ; Disease transmission ; Female ; Housing ; Humans ; Male ; Medicine and Health Sciences ; Middle Aged ; Mycobacterium tuberculosis ; Mycobacterium tuberculosis - growth & development ; Mycobacterium tuberculosis - physiology ; People and places ; Physical Sciences ; Predictive Value of Tests ; Tuberculosis, Pulmonary - microbiology ; Tuberculosis, Pulmonary - transmission</subject><ispartof>PloS one, 2018-10, Vol.13 (10), p.e0206384-e0206384</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Acuña-Villaorduña et al 2018 Acuña-Villaorduña et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c640t-c0f697087d3dd572228140b0df87144bff0c47b6298e42d7e0ba07b927e45d3c3</citedby><cites>FETCH-LOGICAL-c640t-c0f697087d3dd572228140b0df87144bff0c47b6298e42d7e0ba07b927e45d3c3</cites><orcidid>0000-0001-6966-5682</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205616/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205616/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,37013,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30372480$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Rawkins, Ann</contributor><creatorcontrib>Acuña-Villaorduña, Carlos</creatorcontrib><creatorcontrib>Schmidt-Castellani, Luiz Guilherme</creatorcontrib><creatorcontrib>Marques-Rodrigues, Patricia</creatorcontrib><creatorcontrib>White, Laura F</creatorcontrib><creatorcontrib>Hadad, David Jamil</creatorcontrib><creatorcontrib>Gaeddert, Mary</creatorcontrib><creatorcontrib>Ellner, Jerrold J</creatorcontrib><creatorcontrib>Fennelly, Kevin P</creatorcontrib><creatorcontrib>Palaci, Moises</creatorcontrib><creatorcontrib>Dietze, Reynaldo</creatorcontrib><creatorcontrib>Jones-López, Edward C</creatorcontrib><title>Cough-aerosol cultures of Mycobacterium tuberculosis in the prediction of outcomes after exposure. A household contact study in Brazil</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Mycobacterium tuberculosis cultures of cough-generated aerosols from patients with pulmonary tuberculosis (TB) are a quantitative method to measure infectiousness and to predict secondary outcomes in exposed contacts. However, their reproducibility has not been established.
To evaluate the predictive value of colony-forming units (CFU) of M. tuberculosis in cough aerosols on secondary infection and disease in household contacts in Brazil.
Adult sputum smear+ and culture+ pulmonary TB cases underwent a standard evaluation and were categorized according to aerosol CFU. We evaluated household contacts for infection at baseline and at 8 weeks with TST and IGRA, and secondary disease.
We enrolled 48 index TB cases; 40% had negative aerosols, 27% low aerosols (<10 CFU) and 33% high aerosols (≥10 CFU). Of their 230 contacts, the proportion with a TST ≥10 mm at 8 weeks was 59%, 65% and 75%, respectively (p = 0.34). Contacts of high aerosol cases had greater IGRA readouts (median 4.6 IU/mL, IQR 0.02-10) when compared to those with low (0.8, 0.2-10) or no aerosol (0.1, 0-3.7; p = 0.08). IGRA readouts in TST converters of high aerosol cases (median 20 IU/mL, IQR 10-24) were larger than those from aerosol-negative (0.13, 0.04-3; p = o.o2). 8/9 (89%) culture+ secondary TB cases occurred in contacts of aerosol+ cases.
Aerosol CFU predicts quantitatively IGRA readouts among household contacts of smear positive TB cases. Our results strengthen the argument of using cough aerosols to guide targeted preventive treatment strategies, a necessary component of current TB elimination projections.</description><subject>Adult</subject><subject>Aerosols</subject><subject>Biology and Life Sciences</subject><subject>Brazil</subject><subject>Cough - microbiology</subject><subject>Culture Techniques</subject><subject>Disease transmission</subject><subject>Female</subject><subject>Housing</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mycobacterium tuberculosis</subject><subject>Mycobacterium tuberculosis - growth & development</subject><subject>Mycobacterium tuberculosis - physiology</subject><subject>People and places</subject><subject>Physical Sciences</subject><subject>Predictive Value of Tests</subject><subject>Tuberculosis, Pulmonary - microbiology</subject><subject>Tuberculosis, Pulmonary - transmission</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNqNkluL1DAYhoso7rr6D0QKgujFjGmSJu2NMA4eBlYWPN2GNPk6zdA2sznIrj_A323qjMsUvJBCW5LnfQhf3ix7WqBlQXjxemejG2W_3NsRlggjRip6LzsvaoIXDCNy_-T_LHvk_Q6hklSMPczOCCIc0wqdZ7_WNm67hQRnve1zFfsQHfjctvmnW2UbqQI4E4c8xAZc2rbe-NyMeegg3zvQRgVjx4m3MSg7pKxsUyaHm731ybXMV3lno4fO9jpXdgzJmfsQ9e3keevkT9M_zh60svfw5Pi9yL69f_d1_XFxefVhs15dLhSjKCwUalnNUcU10brkGOOqoKhBuq14QWnTtkhR3jBcV0Cx5oAaiXhTYw601ESRi2xz8Gord2LvzCDdrbDSiD8L1m2FdMGoHgQjoEpeSqLrhtKqrOu6lUoqihumC46T683BtY_NAFrBGJzsZ9L5zmg6sbU_RLqRkhUsCV4eBc5eR_BBDMYr6Hs5QhqYwAXmRV2lV0KfH9CtTEczY2uTUU24WJUMEVYSMp1o-Q8qPRoGkyYPrUnrs8CrWWC6HbgJWxm9F5svn_-fvfo-Z1-csB3IPnSpXnGqip-D9ACq1D_voL0bX4HEVHNxrLmYai6ONU-xZ6ejvwv97TX5DTlK-7A</recordid><startdate>20181029</startdate><enddate>20181029</enddate><creator>Acuña-Villaorduña, Carlos</creator><creator>Schmidt-Castellani, Luiz Guilherme</creator><creator>Marques-Rodrigues, Patricia</creator><creator>White, Laura F</creator><creator>Hadad, David Jamil</creator><creator>Gaeddert, Mary</creator><creator>Ellner, Jerrold J</creator><creator>Fennelly, Kevin P</creator><creator>Palaci, Moises</creator><creator>Dietze, Reynaldo</creator><creator>Jones-López, Edward C</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6966-5682</orcidid></search><sort><creationdate>20181029</creationdate><title>Cough-aerosol cultures of Mycobacterium tuberculosis in the prediction of outcomes after exposure. A household contact study in Brazil</title><author>Acuña-Villaorduña, Carlos ; Schmidt-Castellani, Luiz Guilherme ; Marques-Rodrigues, Patricia ; White, Laura F ; Hadad, David Jamil ; Gaeddert, Mary ; Ellner, Jerrold J ; Fennelly, Kevin P ; Palaci, Moises ; Dietze, Reynaldo ; Jones-López, Edward C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c640t-c0f697087d3dd572228140b0df87144bff0c47b6298e42d7e0ba07b927e45d3c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aerosols</topic><topic>Biology and Life Sciences</topic><topic>Brazil</topic><topic>Cough - microbiology</topic><topic>Culture Techniques</topic><topic>Disease transmission</topic><topic>Female</topic><topic>Housing</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Mycobacterium tuberculosis</topic><topic>Mycobacterium tuberculosis - growth & development</topic><topic>Mycobacterium tuberculosis - physiology</topic><topic>People and places</topic><topic>Physical Sciences</topic><topic>Predictive Value of Tests</topic><topic>Tuberculosis, Pulmonary - microbiology</topic><topic>Tuberculosis, Pulmonary - transmission</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Acuña-Villaorduña, Carlos</creatorcontrib><creatorcontrib>Schmidt-Castellani, Luiz Guilherme</creatorcontrib><creatorcontrib>Marques-Rodrigues, Patricia</creatorcontrib><creatorcontrib>White, Laura F</creatorcontrib><creatorcontrib>Hadad, David Jamil</creatorcontrib><creatorcontrib>Gaeddert, Mary</creatorcontrib><creatorcontrib>Ellner, Jerrold J</creatorcontrib><creatorcontrib>Fennelly, Kevin P</creatorcontrib><creatorcontrib>Palaci, Moises</creatorcontrib><creatorcontrib>Dietze, Reynaldo</creatorcontrib><creatorcontrib>Jones-López, Edward C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Opposing Viewpoints Resource Center</collection><collection>Gale In Context: Science</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Acuña-Villaorduña, Carlos</au><au>Schmidt-Castellani, Luiz Guilherme</au><au>Marques-Rodrigues, Patricia</au><au>White, Laura F</au><au>Hadad, David Jamil</au><au>Gaeddert, Mary</au><au>Ellner, Jerrold J</au><au>Fennelly, Kevin P</au><au>Palaci, Moises</au><au>Dietze, Reynaldo</au><au>Jones-López, Edward C</au><au>Rawkins, Ann</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cough-aerosol cultures of Mycobacterium tuberculosis in the prediction of outcomes after exposure. A household contact study in Brazil</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-10-29</date><risdate>2018</risdate><volume>13</volume><issue>10</issue><spage>e0206384</spage><epage>e0206384</epage><pages>e0206384-e0206384</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Mycobacterium tuberculosis cultures of cough-generated aerosols from patients with pulmonary tuberculosis (TB) are a quantitative method to measure infectiousness and to predict secondary outcomes in exposed contacts. However, their reproducibility has not been established.
To evaluate the predictive value of colony-forming units (CFU) of M. tuberculosis in cough aerosols on secondary infection and disease in household contacts in Brazil.
Adult sputum smear+ and culture+ pulmonary TB cases underwent a standard evaluation and were categorized according to aerosol CFU. We evaluated household contacts for infection at baseline and at 8 weeks with TST and IGRA, and secondary disease.
We enrolled 48 index TB cases; 40% had negative aerosols, 27% low aerosols (<10 CFU) and 33% high aerosols (≥10 CFU). Of their 230 contacts, the proportion with a TST ≥10 mm at 8 weeks was 59%, 65% and 75%, respectively (p = 0.34). Contacts of high aerosol cases had greater IGRA readouts (median 4.6 IU/mL, IQR 0.02-10) when compared to those with low (0.8, 0.2-10) or no aerosol (0.1, 0-3.7; p = 0.08). IGRA readouts in TST converters of high aerosol cases (median 20 IU/mL, IQR 10-24) were larger than those from aerosol-negative (0.13, 0.04-3; p = o.o2). 8/9 (89%) culture+ secondary TB cases occurred in contacts of aerosol+ cases.
Aerosol CFU predicts quantitatively IGRA readouts among household contacts of smear positive TB cases. Our results strengthen the argument of using cough aerosols to guide targeted preventive treatment strategies, a necessary component of current TB elimination projections.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30372480</pmid><doi>10.1371/journal.pone.0206384</doi><tpages>e0206384</tpages><orcidid>https://orcid.org/0000-0001-6966-5682</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Publicly Available Content Database; PubMed Central |
| subjects | Adult Aerosols Biology and Life Sciences Brazil Cough - microbiology Culture Techniques Disease transmission Female Housing Humans Male Medicine and Health Sciences Middle Aged Mycobacterium tuberculosis Mycobacterium tuberculosis - growth & development Mycobacterium tuberculosis - physiology People and places Physical Sciences Predictive Value of Tests Tuberculosis, Pulmonary - microbiology Tuberculosis, Pulmonary - transmission |
| title | Cough-aerosol cultures of Mycobacterium tuberculosis in the prediction of outcomes after exposure. A household contact study in Brazil |
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