Screening for tuberculosis infections (TBI) using the tuberculin skin test or interferon-gamma release assays (IGRA) is crucial in controlling the global TB burden. This study evaluates the performance of a new IGRA for the detection of T-cell responses against Mycobacterium tuberculosis. Blood samples from 34 adults with tuberculosis disease (TB) and from 30 children with TB, TBI or without TB were analyzed using the prototype Quan-T-Cell TB (EUROIMMUN). The pediatric samples were additionally measured using the established QuantiFERON-TB Gold Plus assay (Qiagen). Clinical performance and inter-assay concordance were analyzed. The prototype Quan-T-Cell TB yielded positivity rates of 88.2% and 100% in adults with TB and children with TBI, respectively, at a specificity of 93.8%. Comparison between the two IGRAs showed positive, negative and overall agreement rates of 100%, 93.8% and 96.3%, respectively, with a kappa score of 0.924 indicating almost perfect agreement. Our study shows promising results of the new prototype Quan-T-Cell TB, as reflected by high concordance with the final diagnosis in adults and children and performance comparable to that of the QuantiFERON IGRA. In individual cases, the data suggest that the prototype Quan-T-Cell TB may be even more consistent with TBI-related clinical findings. Unlike the QuantiFERON assay, the Quan-T-Cell TB has a predefined borderline range, which is advantageous as it may help to differentiate non-specific variation near the cut-off, and fewer sample tubes are required per analysis. The new Quan-T-Cell TB may therefore be a good alternative to the established QuantiFERON IGRA for TBI screening. Further assay optimization is underway, including evaluation studies based on larger patient and control cohorts.

• Klíčová slova
• Mycobacterium tuberculosis, IFN-γ, IGRA, Interferon-gamma release assay, T-cell response, Tuberculosis disease, Tuberculosis infection,
• MeSH
• dítě MeSH
• dospělí MeSH
• interferon gama MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Mycobacterium tuberculosis * imunologie   MeSH
• předškolní dítě MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• T-lymfocyty * imunologie   MeSH
• test pomocí interferonu gama * metody   MeSH
• tuberkulóza * diagnóza   imunologie   mikrobiologie   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• Názvy látek
• interferon gama MeSH

OBJECTIVES: The aim of this study is to determine the incidence of Mycoplasma pneumoniae pneumonia (MPP) in children and adolescents in Prague, Czech Republic, between January and July 2024, and to compare the findings with data from the preceding period. METHODS: A retrospective analysis of data of paediatric patients at our single tertiary care facility was conducted. Two distinct patient cohorts were subjected to analysis: the first comprising individuals who had been hospitalised between January 2019 and July 2024, and the second consisting of outpatients who had been treated during the periods of January to July 2023 and January to July 2024. RESULTS: A 12.3-fold increase in the number of outpatients diagnosed with MPP was observed between January and July 2024 in comparison to the same period in 2023, with 111 cases reported in 2024 versus 9 cases in 2023. A total of 23 patients were hospitalised with MPP between January 2019 and July 2024, with 15 of these hospitalisations having occurred between January and July 2024. The median age was 12 years, with an age range of 1 to 17 years. The majority of cases presented with a high fever, chest pain, and required oxygen support. A failure of the clarithromycin treatment was observed, resulting in 19.48% of doxycycline prescriptions being issued due to a prior failure of clarithromycin treatment. During the monitoring period, no cases of treatment failure with doxycycline were documented. CONCLUSION: The present study demonstrates an emerging trend of increased incidence of Mycoplasma pneumoniae pneumonia in the paediatric population during the initial seven months of 2024 in the Czech Republic. Doxycycline has been demonstrated to be the optimal antibiotic for the treatment of MPP and in accordance with the prevailing practice in other states it should be included in the therapeutic regimen even in children under the age of eight. The authors put forward recommendations for the implementation of measures aimed at reducing the negative impact of MPP on public health.

• Klíčová slova
• Mycoplasma pneumoniae, Mycoplasma pneumoniae pneumonia, atypical pneumonia, children, doxycycline, incidence, paediatric population,
• MeSH
• antibakteriální látky * terapeutické užití   MeSH
• centra terciární péče MeSH
• dítě MeSH
• hospitalizace statistika a číselné údaje   MeSH
• incidence MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• Mycoplasma pneumoniae MeSH
• mykoplazmová pneumonie * epidemiologie   farmakoterapie   MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• antibakteriální látky * MeSH

Authors present a pilot study of the development of innovative flow cytometry-based assay with a potential for use in tuberculosis diagnostics. Currently available tests do not provide robust discrimination between latent tuberculosis infection (TBI) and tuberculosis disease (TB). The desired application is to distinguish between the two conditions by evaluating the production of a combination of three cytokines: IL-2 (interleukin-2), IFNɣ (interferon gamma) and TNFɑ (tumor necrosis factor alpha) in CD4+ and CD8+ T cells. The study was conducted on 68 participants, divided into two arms according to age (paediatric and adults). Each arm was further split into three categories (non-infection (NI), TBI, TB) based on the immune reaction to Mycobacterium tuberculosis (M.tb) after a close contact with pulmonary TB. Each blood sample was stimulated with specific M.tb antigens present in QuantiFERON tubes (TB1 and TB2). We inferred TBI or TB based on the predominant cytokine response of the CD4+ and/or CD8+ T cells. Significant differences were detected between the NI, TBI and the TB groups in TB1 in the CD4+TNFɑ+parameter in children. Along with IL-2, TNFɑ seems to be the most promising diagnostic marker in both CD4+and CD8+ T cells. However, more detailed analyses on larger cohorts are needed to confirm the observed tendencies.

• Klíčová slova
• Flow cytometry-based assay, Interferon gamma release assay (IGRA), TB disease, TB immunity, TB infection,
• MeSH
• biologické markery analýza   metabolismus   MeSH
• CD4-pozitivní T-lymfocyty imunologie   metabolismus   MeSH
• CD8-pozitivní T-lymfocyty imunologie   metabolismus   MeSH
• diferenciální diagnóza MeSH
• dítě MeSH
• dospělí MeSH
• interferon gama * analýza   imunologie   metabolismus   MeSH
• interleukin-2 * analýza   imunologie   metabolismus   MeSH
• kojenec MeSH
• latentní tuberkulóza * krev   diagnóza   imunologie   mikrobiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Mycobacterium tuberculosis imunologie   izolace a purifikace   MeSH
• pilotní projekty MeSH
• plicní tuberkulóza * krev   diagnóza   imunologie   mikrobiologie   MeSH
• prediktivní hodnota testů MeSH
• předškolní dítě MeSH
• prospektivní studie MeSH
• průtoková cytometrie * metody   statistika a číselné údaje   MeSH
• senioři MeSH
• studie proveditelnosti MeSH
• test pomocí interferonu gama statistika a číselné údaje   MeSH
• TNF-alfa * analýza   imunologie   metabolismus   MeSH
• tuberkulinový test statistika a číselné údaje   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery MeSH
• IL2 protein, human MeSH Prohlížeč
• interferon gama * MeSH
• interleukin-2 * MeSH
• TNF-alfa * MeSH