For indirect diagnosis of tuberculosis, two commercial IGRA (Interferon Gamma Release Assay) assays are available - primal QuantiFERON®-TB Gold test, new version QuantiFERON®-TB Gold Plus test (four tube, differentiation in activity CD4+ a CD8+) and T-SPOT®.TB test. Both methods are based on the same principle, but their workflows are different. In this article, both assays are compared on the collection of 284 patients. Inter-rate agreement measure showed 81.3% consistency and Cohens kappa index was calculated as 0.72. In case of discrepancy between IGRA and other methods (clinical aspects, X-ray diagnostic, etc.), results should be confirmed by second IGRA assay for correct interpretation.

• Klíčová slova
• IGRA - Mycobacterium tuberculosis - Quantiferon - T-SPOT®.TB.,
• MeSH
• dospělí MeSH
• imunoanalýza metody   MeSH
• interferon gama krev   MeSH
• lidé MeSH
• prediktivní hodnota testů MeSH
• reagenční diagnostické soupravy MeSH
• tuberkulinový test metody   MeSH
• tuberkulóza krev   diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• interferon gama MeSH
• reagenční diagnostické soupravy MeSH

Tuberculosis (TB) contact tracing and TB preventive treatment are key tools in preventing the transmission of TB with the aim of eliminating the disease. Our study seeks to demonstrate how the infection spread from an individual patient to the entire community and how proactive contact tracing facilitated prompt diagnosis and treatment. Our work was conducted as a retrospective analysis of the spread of TB infection within the Roma community in the Czech Republic, following the case of an index patient who succumbed to pulmonary TB. Several levels of care and preventive and treatment measures are outlined. Confirming the identity of the Mycobacterium tuberculosis strain was achieved using molecular methods. Among the 39 individuals examined, TB disease was detected in eight patients and TB infection was detected in six patients. The investigation of contacts within this group yielded positive results in 36% of cases, necessitating treatment. The study's findings provide evidence that actively tracing individuals at risk can lead to early detection of cases, prompt treatment, and prevention of further disease transmission. The study also indicates that the highest risk of infection occurs within the sick person's household and that young children under the age of 5 are most susceptible to falling ill.

• Klíčová slova
• BCG vaccination, Roma community, TB diagnostics, TB preventive therapy, contact tracing, public health, tuberculosis,
• MeSH
• latentní tuberkulóza * MeSH
• lidé MeSH
• plicní tuberkulóza * epidemiologie   MeSH
• předškolní dítě MeSH
• retrospektivní studie MeSH
• Romové * MeSH
• trasování kontaktů metody   MeSH
• tuberkulóza * diagnóza   epidemiologie   MeSH
• Check Tag
• lidé MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Eleven halogenated (S)-2-(phenylcarbamoyl)phenyl 2-acetamido-3-phenylpropanoates (3a-3k) were designed and synthesized as potential antimicrobial agents. They were evaluated in vitro against some mycobacterial, bacterial and fungal strains. These compounds were active against drug-sensitive and atypical mycobacterial strains with general MIC values from 0.25 to 16 μmol/L. The most active compounds were (S)-4-chloro-2-(4-(trifluoromethyl)phenylcarbamoyl)phenyl 2-acetamido-3-phenylpropanoate (3i) and (S)-4-bromo-2-(4-(trifluoromethyl)phenylcarbamoyl)phenyl 2-acetamido-3-phenylpropanoate (3k) which exhibited activity against MDR and XDR-TB strains with MICs from 1 to 2 μmol/L. 3k was shown to be less cytotoxic with higher IC50. Some compounds exhibited low MICs on Gram-positive bacteria (MICs≥0.98 μmol/L) and on fungi (MICs≥3.9 μmol/L).

• MeSH
• aminokyseliny chemie   MeSH
• antibakteriální látky chemická syntéza   chemie   farmakologie   MeSH
• antifungální látky chemická syntéza   chemie   farmakologie   MeSH
• Bacteria účinky léků   MeSH
• estery chemie   MeSH
• extenzivně rezistentní tuberkulóza mikrobiologie   MeSH
• houby účinky léků   MeSH
• mikrobiální testy citlivosti MeSH
• molekulární struktura MeSH
• multirezistentní tuberkulóza mikrobiologie   MeSH
• racionální návrh léčiv MeSH
• salicylanilidy chemická syntéza   chemie   farmakologie   MeSH
• stereoizomerie MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• vztahy mezi strukturou a aktivitou MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• aminokyseliny MeSH
• antibakteriální látky MeSH
• antifungální látky MeSH
• estery MeSH
• salicylanilidy MeSH

• MeSH
• alanintransaminasa krev   MeSH
• aspartátaminotransferasy krev   MeSH
• isoniazid toxicita   MeSH
• lékové postižení jater * MeSH
• lidé MeSH
• plicní tuberkulóza farmakoterapie   MeSH
• thiacetazon toxicita   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• alanintransaminasa MeSH
• aspartátaminotransferasy MeSH
• isoniazid MeSH
• thiacetazon MeSH

Tuberculosis contact investigations are a top priority in TB infection control. The aim is to prevent the spread of infectious disease, identify potential TB sources, and treat individuals who are infected or actively ill. The contact investigation process is quite simple: identify close contacts; examine their symptoms and determine their clinical status; perform a chest X-ray; administer a tuberculin skin test and/or interferon gamma release assay; and evaluate the results. This communication documents a TB contact investigation that was conducted in one family during the months after the initial TB finding. Investigations of close family contacts found active TB in 3 individuals and latent TB in 1 unvaccinated child. This confirms that contact investigations are an easy intervention that results in rapid identification of TB sources. Treatment of these patients reduces the risk of exposure and spread of infection to additional community members [1].

• Klíčová slova
• Contact investigation, Latent tuberculosis infection, Preventive chemotherapy, Tuberculosis,
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: Tuberculosis (TB) remains a significant public health problem in South Asia. Tobacco use increases the risks of TB infection and TB progression. The TB& Tobacco placebo-controlled randomised trial aims to (1) assess the effectiveness of the tobacco cessation medication cytisine versus placebo when combined with behavioural support and (2) implement tobacco cessation medication and behavioural support as part of general TB care in Bangladesh and Pakistan. This paper summarises the process and context evaluation protocol embedded in the effectiveness-implementation hybrid design. METHODS AND ANALYSIS: We are conducting a mixed-methods process and context evaluation informed by an intervention logic model that draws on the UK Medical Research Council's Process Evaluation Guidance. Our approach includes quantitative and qualitative data collection on context, recruitment, reach, dose delivered, dose received and fidelity. Quantitative data include patient characteristics, reach of recruitment among eligible patients, routine trial data on dose delivered and dose received, and a COM-B ('capability', 'opportunity', 'motivation' and 'behaviour') questionnaire filled in by participating health workers. Qualitative data include semistructured interviews with TB health workers and patients, and with policy-makers at district and central levels in each country. Interviews will be analysed using the framework approach. The behavioural intervention delivery is audio recorded and assessed using a predefined fidelity coding index based on behavioural change technique taxonomy. ETHICS AND DISSEMINATION: The study complies with the guidelines of the Declaration of Helsinki. Ethics approval for the study and process evaluation was granted by the University of Leeds (qualitative components), University of York (trial data and fidelity assessment), Bangladesh Medical Research Council and Bangladesh Drug Administration (trial data and qualitative components) and Pakistan Medical Research Council (trial data and qualitative components). Results of this research will be disseminated through reports to stakeholders and peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER: ISRCTN43811467; Pre-results.

• Klíčová slova
• clinical trials, epidemiology, organisation of health services, public health, qualitative research, tuberculosis,
• MeSH
• dospělí MeSH
• kouření * škodlivé účinky   MeSH
• lidé MeSH
• randomizované kontrolované studie jako téma MeSH
• tabákové výrobky MeSH
• tuberkulóza * epidemiologie   MeSH
• výzkumný projekt MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• protokol klinické studie MeSH
• Geografické názvy
• Bangladéš MeSH
• Pákistán MeSH

QuantiFERON-TB Gold (QFT) is an indirect diagnostic test for latent tuberculosis (TB) infection and active TB. This study aimed to evaluate and compare QFT and the tuberculin skin test (TST) for the diagnosis of active TB disease, not bacteriologically verified at the time of therapy initiation. Seventy-three patients with suspected active TB were examined. Further diagnostic steps confirmed the diagnosis of active TB in 53 persons. QFT was positive in 43 persons (81%), negative in seven (13%), and indeterminate results were found in three (6%). The sensitivity of the test was 86% in those with valid results, significantly higher than that for the TST (62%), and the correlation between the two tests was not high (55%). The QFT test is a useful addition to existing methods for the diagnosis of active TB.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• reagenční diagnostické soupravy * MeSH
• tuberkulinový test MeSH
• tuberkulóza diagnóza   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• reagenční diagnostické soupravy * MeSH

AIM: Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. METHODS: TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing. RESULTS: 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months. CONCLUSION: Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop.

• Klíčová slova
• Drug-resistance, Europe, Infection control, PCR, Tuberculosis,
• MeSH
• antituberkulotika terapeutické užití   MeSH
• bakteriální léková rezistence genetika   MeSH
• dekontaminace metody   MeSH
• extenzivně rezistentní tuberkulóza diagnóza   farmakoterapie   MeSH
• izolace pacientů metody   MeSH
• kontrola infekce metody   MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• multirezistentní tuberkulóza diagnóza   farmakoterapie   MeSH
• Mycobacterium tuberculosis genetika   MeSH
• průzkumy a dotazníky MeSH
• rifampin terapeutické užití   MeSH
• rozvojové země MeSH
• ultrafialové záření MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• antituberkulotika MeSH
• rifampin MeSH

• MeSH
• incidence MeSH
• lidé MeSH
• tuberkulóza * epidemiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Ukrajina epidemiologie   MeSH

OBJECTIVES: Rapidly diagnosing drug-resistant TB is crucial for improving treatment and transmission control. WGS is becoming increasingly accessible and has added value to the diagnosis and treatment of TB. The aim of the study was to perform WGS to determine the rate of false-positive results of phenotypic drug susceptibility testing (pDST) and characterize the molecular mechanisms of resistance and transmission of mono- and polyresistant Mycobacterium (M.) tuberculosis. METHODS: WGS was performed on 53 monoresistant and 25 polyresistant M. tuberculosis isolates characterized by pDST. Sequencing data were bioinformatically processed to infer mutations encoding resistance and determine the origin of resistance and phylogenetic relationship between isolates studied. RESULTS: The data showed the variable sensitivity and specificity of WGS in comparison with pDST as the gold standard: isoniazid 92.7% and 92.3%; streptomycin 41.9% and 100.0%; pyrazinamide 15% and 94.8%; and ethambutol 75.0% and 98.6%, respectively. We found novel mutations encoding resistance to streptomycin (in gidB) and pyrazinamide (in kefB). Most isolates belonged to lineage 4 (80.1%) and the overall clustering rate was 11.5%. We observed lineage-specific gene variations encoding resistance to streptomycin and pyrazinamide. CONCLUSIONS: This study highlights the clinical potential of WGS in ruling out false-positive drug resistance following phenotypic or genetic drug testing, and recommend this technology together with the WHO catalogue in designing an optimal individualized treatment regimen and preventing the development of MDR TB. Our results suggest that resistance is primarily developed through spontaneous mutations or selective pressure.

• Publikační typ
• časopisecké články MeSH