在肯尼亚西部的青少年结核病患病率调查中，分枝杆菌胞内菌痰定植与结核菌素皮肤试验反应减弱有关。

Attenuated tuberculin skin test responses associated with Mycobacterium intracellulare sputum colonization in an adolescent TB prevalence survey in Western Kenya.

机构信息

Kenya Medical Research Institute, Centre for Respiratory Diseases Research (CRDR), PO Box 47855-00100, Nairobi, Kenya.

Department of Clinical Medicine and Therapeutics, Faculty of Health Sciences, University of Nairobi School of Medicine, PO Box 19676 - 00202, Nairobi, Kenya.

出版信息

Tuberculosis (Edinb). 2024 Jul;147:102514. doi: 10.1016/j.tube.2024.102514. Epub 2024 May 5.

DOI:10.1016/j.tube.2024.102514

PMID:38723342

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11168861/

Abstract

INTRODUCTION

Exposure to Non-tuberculous Mycobacteria (NTM) varies regionally and may partly explain the disparate outcomes of BCG vaccination and tuberculosis (TB) susceptibility.

METHODS

We examined NTM sputum colonization, associations with clinical characteristics, and tuberculin skin test (TST) responses in an adolescent TB prevalence survey.

RESULTS

Among 5004 adolescents screened, 2281 (45.5 %) were evaluated further. TB and NTM prevalence rates were 0.3 % and 8.0 %, respectively. Among 418 NTM isolates, 103 were unidentifiable, and 315 (75 %) comprised 15 species, the most frequent being M. intracellulare (MAC) (108, 26 %), M. scrofulaceum (96, 23 %) and M. fortuitum (51, 12 %). "NTM colonized" adolescents had less frequent chronic cough and night sweats (adjusted odds ratio [aOR] 0.62, 95 % confidence interval [CI] 0.44-0.87and aOR 0.61, CI 0.42-0.89 respectively), and lower TST induration (median 11 mm (interquartile range [IQR] 0-16) vs 13 mm (IQR 6-17; p = 0.006)) when compared to "NTM not colonized" participants. MAC, but not M. scrofulaceum or M. fortuitum, was associated with decreased TST induration (median 7.5 mm (IQR 0-15) vs 13 mm (IQR 6-17) among "MAC colonized" vs "not colonized", p = 0.001).

CONCLUSION

We observed high NTM prevalence rates with species-specific associations with TST induration, consistent with a model of species-dependent heterologous immunity among mycobacteria.

摘要

简介

非结核分枝杆菌（NTM）的暴露情况因地区而异，这可能部分解释了卡介苗接种和结核病（TB）易感性的不同结果。

方法

我们在一项青少年结核病患病率调查中研究了 NTM 痰定植情况，以及其与临床特征的关联，并检测了结核菌素皮肤试验（TST）的反应。

结果

在筛查的 5004 名青少年中，有 2281 名（45.5%）进一步进行了评估。TB 和 NTM 的患病率分别为 0.3%和 8.0%。在 418 株 NTM 分离株中，有 103 株无法鉴定，315 株（75%）由 15 个种组成，最常见的是 M. intracellulare（MAC）（108 株，26%）、M. scrofulaceum（96 株，23%）和 M. fortuitum（51 株，12%）。与“NTM 定植”的青少年相比，“NTM 未定植”的青少年慢性咳嗽和夜间盗汗的频率较低（调整后的优势比[aOR] 0.62，95%置信区间[CI] 0.44-0.87 和 aOR 0.61，CI 0.42-0.89），TST 硬结程度也较低（中位数 11 毫米（四分位距[IQR] 0-16）与 13 毫米（IQR 6-17；p=0.006））。与 M. scrofulaceum 或 M. fortuitum 不同，MAC 与 TST 硬结程度降低有关（“MAC 定植”组的中位数为 7.5 毫米（IQR 0-15）与“未定植”组的中位数 13 毫米（IQR 6-17）相比，p=0.001）。