| Cough Aerosols of Mycobacterium tuberculosis Predict New Infection: A Household Contact Study. | |
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MedLine Citation:
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PMID: 23306539 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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RATIONALE: Airborne transmission of Mycobacterium tuberculosis results from incompletely characterized host, bacterial and environmental factors. Sputum smear microscopy is associated with considerable variability in transmission. OBJECTIVES: To evaluate the use of cough-generated aerosols of M. tuberculosis to predict recent transmission. METHODS: Pulmonary tuberculosis (TB) patients underwent a standard evaluation and collection of cough aerosol cultures of M. tuberculosis. We assessed household contacts for new M. tuberculosis infection. We used multivariable logistic regression analysis with cluster adjustment to analyze predictors of new infection. MEASUREMENTS AND MAIN RESULTS: From May 2009 to January 2011, we enrolled 96 sputum culture-positive index TB cases and their 442 contacts. Only 43 (45%) TB patients yielded M. tuberculosis in aerosols. Contacts of TB patients who produced high aerosols (≥10 colony forming units - CFU) were more likely to have a new infection compared to contacts from low aerosol (1-9 CFU) and aerosol negative cases (69%, 25% and 30%, respectively) (P=0.009). A high aerosol TB patient was the only predictor of new M. tuberculosis infection in both unadjusted (odds ratio 5.18, 95% confidence interval 1.52-17.61) and adjusted analyses (OR 4.81, 1.20-19.23). Contacts of TB patients with no aerosols vs. low/high aerosols had differential tuberculin skin test (TST) and interferon-gamma release assay (IGRA) responses. CONCLUSIONS: Cough aerosols of M. tuberculosis are produced by a minority of TB patients but predict transmission better than sputum smear microscopy or culture. Cough aerosols may help identify the most infectious TB patients and thus, improve the cost-effectiveness of TB control programs. |
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Authors:
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Edward C Jones-López; Olive Namugga; Francis Mumbowa; Martin Ssebidandi; Olive Mbabazi; Stephanie Moine; Gerald Mboowa; Matthew P Fox; Nancy Reilly; Irene Ayakaka; Soyeon Kim; Alphonse Okwera; Moses Joloba; Kevin P Fennelly |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-10 |
Journal Detail:
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Title: American journal of respiratory and critical care medicine Volume: - ISSN: 1535-4970 ISO Abbreviation: Am. J. Respir. Crit. Care Med. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Medicine, Boston Medical Center, Boston, Massachusetts, United States. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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