Consensus Document on the Diagnosis, Treatment and Prevention of Tuberculosis

González-Martín, Julià; García-García, José-María; Anibarro, Luis; Vidal, Rafael; Esteban, Jaime; Blanquer, Rafael; Moreno, Santiago; Ruiz-Manzano, Juan

doi:10.1016/s1579-2129(10)70061-6

Cited by 30 publications

(34 citation statements)

References 50 publications

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“…14 (37) 3 (8) 15 (39) 4 (11) Benzagmout et al 9 (7) -7 (6) 49 (43) 10 (9) 42 (37) 3 (3) Alavi et al [55] 68 (99) 18 (26) -18 (26) 12 (17) 10 ( 3 (50) 0 (0) 3 (50) 0 (0) Fedoul et al [57] 81 (9) 34 ( Although the incidence of TB has increased around the world, it is higher in low income countries [3,19].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis of the spine. A systematic review of case series

Fuentes‐Ferrer

Torres

Ramírez

et al. 2011

International Orthopaedics (SICOT)

147

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Section: Discussionmentioning

confidence: 99%

Tuberculosis of the spine. A systematic review of case series

Fuentes‐Ferrer

Torres

Ramírez

et al. 2011

International Orthopaedics (SICOT)

147

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“…Different national guidelines propose that IGRAs should either replace (Germany [12] and Switzerland [3]), be used interchangeably with (France [15]), or be combined with (United States [25], Spain [17], United Kingdom [26], and Canada [8]) TST.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Gamma Interferon Release Assays and Tuberculin Skin Testing for Tuberculosis Screening in a Cohort of Patients with Rheumatic Diseases Starting Anti-Tumor Necrosis Factor Therapy

Vassilopoulos

Tsikrika

Hatzara

et al. 2011

Clin Vaccine Immunol

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Gamma interferon release assays (IGRAs) are increasingly used for latent Mycobacterium tuberculosis infection (LTBI) screening in patients with rheumatic diseases starting anti-tumor necrosis factor (anti-TNF) therapies. We compared the performances of two IGRAs, an enzyme-linked immunospot release assay (T-SPOT.TB) and an enzyme-linked immunosorbent assay (QuantiFERON-TB Gold In Tube [QFT-GIT]), to that of tuberculin skin testing (TST) for LTBI screening of 157 consecutive rheumatic patients starting anti-TNF therapies. Among 155 patients with valid results, 58 (37%) were positive by TST, 39 (25%) by T-SPOT.TB assay, and 32 (21%) by QFT-GIT assay. IGRAs were associated more strongly with at least one risk factor for tuberculosis (TB) than TST. Risk factors for a positive assay included chest X-ray findings of old TB (TST), advanced age (both IGRAs), origin from a country with a high TB prevalence, and a positive TST (T-SPOT.TB assay). Steroid use was negatively associated with a positive QFT-GIT assay. The agreement rate between IGRAs was 81% (kappa rate ‫؍‬ 0.47), which was much higher than that observed between an IGRA and TST. If positivity by either TST or an IGRA was required for LTBI diagnosis, then the rate of LTBI would have been 46 to 47%, while if an IGRA was performed only for TST-positive patients, the respective rate would have been 11 to 17%. In conclusion, IGRAs appear to correlate better with TB risk than TST and should be included in TB screening of patients starting anti-TNF therapies. In view of the high risk of TB in these patients, a combination of one IGRA and TST is probably more appropriate for LTBI diagnosis.The accurate diagnosis of latent Mycobacterium tuberculosis infection (LTBI) is critical for patients with various autoimmune diseases who are starting anti-tumor necrosis factor (anti-TNF) therapies, since the majority of tuberculosis (TB) cases developing in this population are due to LTBI reactivation (1.5 to 4 times increased risk) (18)(19)(20). Traditional methods for LTBI diagnosis, such as the tuberculin skin test (TST), have well-known limitations regarding their sensitivity and specificity for LTBI diagnosis (18)(19)(20). Over the last decade, different gamma interferon (IFN-␥) release assays (IGRAs) have been approved for LTBI diagnosis (13). These assays detect IFN-␥ secreted by peripheral mononuclear cells after in vitro stimulation with specific M. tuberculosis antigens not present in the M. bovis bacillus Calmette-Guérin (BCG) vaccine, either by enzyme-linked immunosorbent assay (ELISA) (QuantiFERON-TB Gold [QFT-G] and QuantiFERON-TB Gold In Tube [QFT-GIT] assays; Cellestis Limited, Carnegie, Victoria, Australia) or by enzyme-linked immunospot assay (T-SPOT.TB assay; Oxford Immunotec, Oxford, United Kingdom). Newer techniques for the diagnosis of LTBI or active TB based on the secretion of IFN-␥ after specific stimulation with specific M. tuberculosis antigens, such as the heparinbinding hemagglutinin (HBHA), have also shown promising results (28).Although there have b...

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“…In infections of the central nervous system, such as TBM, the bacterial load is extremely low, thus making diagnoses based on the culture or staining of CSF difficult, as the results are usually negative. Furthermore, the clinical manifestations of TBM are often non-specific, similar to those of other forms of meningitis, such as neurocysticercosis, neuroborreliosis, or viral infections; thus, its diagnosis is currently based on clinical characteristics, radiological tests, responses to treatment and in the characteristics of CFS (9)(10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Identification of Mycobacterium tuberculosis in the cerebrospinal fluid of patients with meningitis using nested PCR

Rios-Sarabia

Hernández-González

González-y-Merchand

et al. 2016

International Journal of Molecular Medicine

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Abstract. Tuberculous meningitis (TBM) is the most severe form of tuberculosis. It is caused by Mycobacterium tubercu losis (M. tuberculosis; MT) and it is very difficult to diagnose. The symptoms are similar to other infectious neurological diseases, such as neurocysticercosis, neuroborreliosis, or herpes viral infection. The aim of this study was to identify tuberculosis (TB) in cases of meningitis with clinical and laboratory evidence suggestive of TBM, and to confirm our findings with molecular tests for TB infection. We recruited patients with neurological symptoms who were examined at the neurology services of Hospitals of Instituto Mexicano del Seguro Social (IMSS) in Mexico City. A total of 144 consecutive patients with suggestive infectious meningitis were initially included; 94 cases of meningitis with clinical and laboratory evidence suggestive of TBM were included, but only 50 of these cases fulfilled the criteria for probable TBM. As the controls, we included 50 cases of meningitis with clinical and laboratory evidence suggestive of non-TBM. Cerebrospinal fluid (CSF) was collected from all 100 patients (cases and controls) and tested for TB by multiplex and nested PCR analyses. Nested PCR detected 0.1 fg of M. tuberculosis DNA. TB infection was confirmed with molecular tests in 49 patients from the 50 cases suggestive of TBM and in 1 of the 50 non-TBM cases. The analysis exhibited a sensitivity of 98.0%, a specificity of 92.0%, a positive predictive value of 88.0% and a negative predictive value of 98.0%. The use CSF for the analyses proved to be effective for the rapid diagnosis of TBM using a developed system of multiplex and nested PCR analyses in patients presenting neurological symptoms.

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Consensus Document on the Diagnosis, Treatment and Prevention of Tuberculosis

Cited by 30 publications

References 50 publications

Tuberculosis of the spine. A systematic review of case series

Tuberculosis of the spine. A systematic review of case series

Comparison of Two Gamma Interferon Release Assays and Tuberculin Skin Testing for Tuberculosis Screening in a Cohort of Patients with Rheumatic Diseases Starting Anti-Tumor Necrosis Factor Therapy

Identification of Mycobacterium tuberculosis in the cerebrospinal fluid of patients with meningitis using nested PCR

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