Characterization of
            <i>Mycobacterium tuberculosis</i>
            Complex Isolates from the Cerebrospinal Fluid of Meningitis Patients at Six Fever Hospitals in Egypt

Cooksey, Robert C.; Abbadi, Said; Woodley, Charles L.; Sikes, David; Wasfy, Momtaz; Crawford, Jack T.; Mahoney, Frank

doi:10.1128/jcm.40.5.1651-1655.2002

Cited by 23 publications

(20 citation statements)

References 16 publications

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“…TB remains a great public health concern in Egypt; however, little information on the prevailing genotypes of the tubercle bacilli and their spread is available (1,6). In a country where TB is endemic, it is critical to identify the genotypes of the predominant strains in order to study the transmission patterns and the epidemiological features of the disease.…”

Section: Resultsmentioning

confidence: 99%

Unexpectedly High Proportion of Ancestral Manu Genotype Mycobacterium tuberculosis Strains Cultured from Tuberculosis Patients in Egypt

et al. 2009

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Tuberculosis is one of the important public health problems in Egypt. However, limited information on the Mycobacterium tuberculosis genotypes circulating in Egypt is available. A total of 151 M. tuberculosis strains were characterized by spoligotyping. The results revealed that 74.8% of M. tuberculosis isolates grouped into 13 different clusters, while 25.2% had unique spoligotype patterns. Comparison with an international spoligotyping database (the SITVIT2 database) showed that types SIT53 (T1 variant) and SIT54 (Manu2 variant) were the most common types between cluster groups. In addition, new shared types SIT2977, SIT2978, and SIT2979 were observed. The results identified for the first time an unusually high proportion of ancestral Manu strains of M. tuberculosis from patients in Egypt. The percentage of the Manu clade in this study (27.15%) was significantly higher than its overall representation of 0.4% in the SITVIT2 database. We show that in Egypt tuberculosis is caused by a predominant M. tuberculosis genotype belonging to the ancestral Manu lineage which could be a missing link in the split between ancestral and modern tubercle bacilli during the evolution of M. tuberculosis.Despite the availability of antituberculosis (anti-TB) drugs, the disease burden of human TB remains a very serious and widespread public health problem. Many of the 22 countries most affected by human TB identified by the World Health Organization (WHO) are developing countries (11). Although Egypt is not on the WHO list of 22 high-TB-burden countries, it is considered one of the high-burden countries in WHO's Eastern Mediterranean region, where TB constitutes the second most important public health problem after schistosomiasis (21). Every year, the National Tuberculosis Control Program of the Ministry of Health and Population (MOHP) registers over 12,000 new TB patients; more than 50% of the cases are sputum smear-positive pulmonary TB. On the basis of an annual risk of infection of 0.32%, it is estimated that about 8,000 people receive a diagnosis of TB at facilities other than those of MOHP (25).In the context described above, it is important to have a precise picture of the predominant and emerging Mycobacterium tuberculosis clones in Egypt, in order to have a first snapshot of the epidemiology of TB. The advent of molecular typing methods has given a new boost to epidemiological studies of TB in recent years (3); the most commonly used methods are IS6110-based restriction fragment length polymorphism (RFLP) (IS6110-RFLP) and spoligotyping (12,22). As opposed to IS6110-RFLP, which was considered the "gold standard" for the genotyping of M. tuberculosis in the early 1990s (22) and which is time-consuming and labor-intensive and requires large amounts of highly purified DNA, PCR-based spoligotyping avoids the problems associated with the slow growth of these bacteria, thereby offering the possibility of the rapid recognition of outbreaks (2,4,12). The clinical usefulness of spoligotyping is determined by its rapidity both in d...

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Section: Resultsmentioning

confidence: 99%

Unexpectedly High Proportion of Ancestral Manu Genotype Mycobacterium tuberculosis Strains Cultured from Tuberculosis Patients in Egypt

et al. 2009

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“…The problems associated with the sensitivity of TBM diagnosis by smear microscopy and the prolonged time taken by culture have been overcome by molecular techniques (4,7,9,20,22,42). However, most of these techniques have been limited to detection of pathogenic mycobacteria as belonging to the MTC.…”

Section: Discussionmentioning

confidence: 99%

“…In India, there are no surveys to date to assess the public health problems posed by zoonotic TB. Human infection with M. bovis in immunocompetent, as well as in immunocompromised, individuals has been reported (3,9,16,21,25,33). The epidemic of human immunodeficiency virus in developing countries, particularly where M. bovis infection prevails in animals and conditions favor zoonotic transmission, constitutes a serious public health threat (2).…”

Section: Discussionmentioning

confidence: 99%

“…M. bovis infection of the central nervous system may lead to EPTB, similar to M. tuberculosis infection, with identical symptomatologies (10,16). M. bovis infection has been reported in immunocompetent, as well as in immunosuppressed, individuals (9,21,25,33). Hence, the present study was undertaken to detect M. tuberculosis and M. bovis in human CSF by using an in-house nested PCR (N-PCR) assay (26).…”

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confidence: 99%

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Occurrence of Overlooked Zoonotic Tuberculosis: Detection of Mycobacterium bovis in Human Cerebrospinal Fluid

Shah¹,

Singhal²,

Jain³

et al. 2006

J Clin Microbiol

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showed that the sensitivity of N-PCR (61.5%) was greater than that of smear microscopy (38.4%). Determination to the species level is important from the viewpoint of determining the prevalence of these mycobacteria in a community and would influence strategies currently adopted for the prevention of tuberculosis.Tuberculosis (TB) is a chronic, systemic infectious disease caused by Mycobacterium tuberculosis. The most common clinical manifestation is pulmonary TB. The inhaled bacilli can localize in alternate sites, leading to extrapulmonary TB (EPTB). Among the different manifestations of EPTB, tuberculous meningitis (TBM) has been considered to be a fatal form (41). Fatality rates in developing countries have been reported to range from 44 to 69% (15,18,30). In fact, delayed or erroneous diagnosis often results in serious long-term debilitating complications. Central nervous system involvement has frequently been found secondary to TB elsewhere in the body, particularly the lungs. The presence of TB elsewhere in the body favors the diagnosis, although its absence does not exclude it. The great majority of patients with neuro-TB are diagnosed on the basis of clinical criteria, imaging, and laboratory investigation of the cerebrospinal fluid (CSF). The clinical response to antituberculosis therapy in all forms of neuro-TB is excellent, provided the diagnosis is made early, before an irreversible neurological defect occurs.Hence, precise and rapid clinical diagnosis of TBM is a critical component of the management of TBM patients (12,24,25). Culture and Ziehl-Neelsen staining of the CSF are specific but insensitive due to the paucity of bacilli. Nucleic acid amplification techniques have shown promising results in overcoming this drawback (20,22,30,42).M. tuberculosis is a member of the M. tuberculosis complex (MTC), which includes M. bovis, "M. MATERIALS AND METHODSPatients. CSF samples from 212 patients were investigated. The patient distribution was as follows. For the first part of the study, 112 patients admitted to the neurology ward of the All India Institute of Medical Sciences (AIIMS), New Delhi, were investigated. Subsequently, for the second part of the study, CSF samples from 100 children (Յ12 years old) admitted to the pediatric ward of Safdarjung Hospital, New Delhi, India, were investigated. The institutional ethical committee approved the study. At the time of data analysis, the AIIMS hospital records of the 69 patients were obtained. These 69 cases were separated into TBM and NTBM (nontubercular meningitis) groups on the basis of the criteria described by Ahuja et al. (1) (Table 1). CSF was collected under aseptic conditions by lumbar puncture. Five hundred microliters to 2.0 ml of CSF was available for the study. Samples were stored at Ϫ20°C, prior to processing for target DNA for N-PCR and smear microscopy for acid-fast bacilli (AFB; auramine O stain).Mycobacterial strains. M. tuberculosis H37Rv DNA was obtained from TB research material, National Institute of Allergy and Infectious Diseases, N...

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“…There are a few reports of TBM caused by M. bovis (Cooksey et al, 2002;Tardieu et al, 1988). Meningitis can also be caused by nontuberculous mycobacteria (NTM) (Huempener et al, 1966).…”

Section: Mtb Lineages Tbm and Evolutionmentioning

confidence: 99%

Molecular Epidemiology and Drug Resistance of Tuberculous Meningitis

Faksri¹,

Prammananan²,

Leechawengwongs³

et al. 2012

Meningitis

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Characterization of Mycobacterium tuberculosis Complex Isolates from the Cerebrospinal Fluid of Meningitis Patients at Six Fever Hospitals in Egypt

Cited by 23 publications

References 16 publications

Unexpectedly High Proportion of Ancestral Manu Genotype Mycobacterium tuberculosis Strains Cultured from Tuberculosis Patients in Egypt

Unexpectedly High Proportion of Ancestral Manu Genotype Mycobacterium tuberculosis Strains Cultured from Tuberculosis Patients in Egypt

Occurrence of Overlooked Zoonotic Tuberculosis: Detection of Mycobacterium bovis in Human Cerebrospinal Fluid

Molecular Epidemiology and Drug Resistance of Tuberculous Meningitis

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