Chinese Journal of Antituberculosis

Discussion on the method for improving TB case detection in poor area

Li Junjuan¹, Zhang Jianli², Fan Lihong¹,Wang Lifang¹,Li Guogang¹

Chinese Journal of Antituberculosis. 2009, 31(9): 501-504.

Abstract ( 1348 )

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ObjectiveTo discuss the TB control model fit for poor area to improve the case detection in that area. MethodsAccording to the feature of the poor area，combining with DOTS strategy, with the help of The Global Fund, increasing the government investment, establishing multi-sectoral participation, strengthening grass-roots prevention and control system, implementing the cooperation between hospital and TB control institute, establishing the township TB sputum examination station, implementing variety of forms of TB propaganda, implementing the incentive policy for TB case finding and management. ResultsFrom 2003 to 2007, the investment of local government was 1.52 times of that in five years, the proportion of TB cases received propaganda was increased by 24.4%, the referral rate and the overall arrival rate of general hospital were 18.4% and 26.0% higher respectively. The consulting rate of TB suspects was promoted form 1.8‰ to 3.2‰, the new smear positive registration rate was improved, 440 TB cases were detected in township TB sputum examination station, and the cure rate of new smear positive cases was above 94% from 2003 to 2007. ConclusionsThe integrated model of control TB from increasing investment of government, establishing multi-sectoral participation, strengthening grass-roots prevention and control system, implementing the cooperation between hospital and TB control institute, establishing the township TB sputum examination station, implementing variety of forms of TB propaganda and implementing the incentive policy for TB case finding and management in poor area has got a desired Results of TB case detection and treatment.

The results of the second-line drug susceptibility testing in the MDR-TB patients

Hong Feng, Xing Qing, Zhu Jianhua , Yang Xinyu, Wang Sumin

Chinese Journal of Antituberculosis. 2009, 31(9): 505-506.

Abstract ( 1502 )

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ObjectiveTo understand the M. tuberculosis resistance to 5 second-line anti-TB drugs in the MDR-TB patients from 2006 to 2007, and provide the evidence for making the treatment regimens. MethodsThe absolute concentration method was used in drug susceptibility testing with 5 second-line anti-TB drugs in 43 confirmed MDR-TB cases. ResultsIn 43 MDR-TB cases, 2.3% was XDR-TB cases, 14% was resistant to LFX, 9.3% was resistant to AK, PAS and Pto respectively, and 2.3% was CM. 69.8% of the MDR-TB strains were sensitive to the 5 second-line anti-TB drugs. ConclusionsThe second-line anti-TB drug susceptibility testing will help us to make the standard and individual treatment regimens for the MDR-TB cases.

Analysis on diagnosis and treatment for 7 cases with pulmonary tuberculosis complicated with lower respiratory tract infection with hypermastigote

Zhou Yiping, Chen Xiaoke, Huang Lie, Lu Xuedong, Liu Hui, Chen Xia

Chinese Journal of Antituberculosis. 2009, 31(9): 507-510.

Abstract ( 1561 )

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ObjectiveTo investigate clinical diagnosis and treatment for patients with pulmonary tuberculosis complicated with lower respiratory tract infection with hypermastigote. MethodThe clinical manifestations, imaging findings, laboratory Results and treatment were studied for 7 patients with pulmonary tuberculosis complicated with lower respiratory tract infection with hypermastigote. ResultsThe main symptoms were cough and fever. The fever and obvious night sweat were still existing after regular anti-tuberculosis treatment. Sediment smear examination of bronchoalveolar lavage fluid was helpful to increase the positive rate of hypermastigote. Metronidazole had good therapeutic effect with improving fever and night sweat. ConclusionThe patients with pulmonary tuberculosis complicated with lower respiratory tract infection with hypermastigote is not rare in Shenzhen area. Improving understanding, early diagnosis and timely treatment will bring better prognosis.

The status of HIV infection among TB patients in Zhengzhou

Ma Shiwen¹, Liu Jianmin, Zhang Gengrong, Ma Liping, Zhen Xin’an, Liu Wantong

Chinese Journal of Antituberculosis. 2009, 31(9): 511-514.

Abstract ( 1626 )

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ObjectiveTo understand the state of HIV infection in patients of tuberculosis in Zhengzhou, and to provide evidence for TB/HIV co-infection control. MethodsThe primary screening of HIV infection was done by ELISA, those with positive result in primary screening were given final screening of HIV infection by WB and investigated by questionnaire. Results1. The rate of HIV infection was 0.6% (9 cases) in 1583 new tuberculosis patients. 2. HIV infection rate was 0.6% and 0.2% in male and female in 13～60 years. TB/HIV patients were mainly young people, accounting for 88.9%. 3. HIV infection rate was 0.6% and 0.43% for the patients registered in rural and urban area, 0.7% for permanent residents and 0.4% for migrant. 4. The transmission routes of HIV: 4 cases (44.4%) through transfusion, 2 cases (22.2%) through sexual contact. 5. New patients were main population with positive HIV. 6. The rates of HIV infection were 0.8% and 0.5% respectively in sputum smear positive and negative cases without statistic difference (P=0.24>0.05). ConclusionsHIV infection rate in TB patients in Zhen Zhou is 0.6%; new patient is main population with positive HIV; the people of HIV infection in TB patients were mainly young adults.

Logistic regression analysis on new smear positive pulmonary tuberculosis with limited access to health care in Guizhou

Li Yang, Chen Huijuan

Chinese Journal of Antituberculosis. 2009, 31(9): 516-518.

Abstract ( 1306 )

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ObjectiveTo explore the factors related to new smear positive pulmonary tuberculosis with limited access to health care in Guizhou province. Methods11697 new smear positive pulmonary tuberculosis patients registered from 51 counties in Guizhou province were investigated by questionnaire and Logistic regression was used for data analysis. ResultsThe patient’s age, home address, fatigue, cough, night sweat, other symptoms, diagnostic medical institutions and lesions were included in the regression model for multi-factor analysis, with odds ratios and 95% CI 0.907(0.880～0.936)， 0.243(0.215～0.275)， 0.709(0.605～0.830)， 0.665(0.459～0.964)， 1.558(1.137～2.136)， 0.721(0.603～0.861)， 2.984(2.381～3.740) and 0.792(0.729～0.862) respectively. ConclusionsYoung and middle-aged patients, living in rural areas, neglected symptoms, diagnosis in non-TB control institution, double side lesions or cavities when diagnosed were important factors related to new smear positive pulmonary tuberculosis with limited access to health care.

Analysis on HIV screening from Tuberculosis patients in special hospital

Chen Zifang, Wei Haidong, Lao Haili, Zhou Lei

Chinese Journal of Antituberculosis. 2009, 31(9): 519-521.

Abstract ( 1316 )

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ObjectiveTo understand the infectious rate of HIV among TB patients and analyze the epidemiological characteristics of TB/HIV co-infected patients. MethodsTB patients in hospital during Jun.1.2005 to Dec.31.2008 were screened by HIV antibiotic test with ELISA. Results3924 TB patients were screened and 4 HIV positive cases, the positive rate was 1.02‰. ConclusionsHIV antibody testing of TB patients in tuberculosis hospital is necessary, which has important significance on the control of TB/HIV co-infection.

Analysis on primary drug resistant rate in hospitalized patients with pulmonary tuberculosis in different periods

Bu Jianling,Gao Weiwei,Xie Li,Zhao Yanlin

Chinese Journal of Antituberculosis. 2009, 31(9): 523-525.

Abstract ( 1328 )

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ObjectiveTo provide reasonable evidence of chemotherapy for new patients with pulmonary tuberculosis based on analyzing the prevalence of primary drug-resistant patients hospitalized in different periods. MethodsWe divided patients hospitalized in different period into two groups: patients in group Ⅰ were hospitalized from 1986 to 1988, and patients in group Ⅱ hospitalized from 2004 to 2005. Primary drug resistance data was analyzed retrospectively in these patients. Results1) Primary drug resistant rate: the rate of primary drug resistance were 27.2%(25/92) in group Ⅰ and 39.6%(65/164) in group Ⅱ. There was significant statistical difference on the rate of primary drug resistance(χ²=4.00,P=0.045). 2)Primary multi-drug resistant rate: the rate of primary multi-drug resistance were 1.1%(1/92) in group Ⅰ and 15.9% (26/164) in group Ⅱ. There was significant statistical difference on the frequency of primary multi-drug resistance(χ²=13.57,P=0.000 23). ConclusionThe rate of primary drug resistant and MDR-TB among hospitalized patients showed an increasing trend. It showed that initial patients with pulmonary tuberculosis should be detected by culture and drug susceptible test to identify patients with drug resistant timely and received a reasonable regimen.

Construction and expression of the prokyaryotic expression plasmid of M.tb glcB gene and protein purification

Chen Xi, Jia Hongyan, Gu Shuxiang，Li Zihui,Liu Zhongquan,Zheng Xiaojing,Xing Aiying,Du Boping,Zhang Jizeng,Zhang Zongde

Chinese Journal of Antituberculosis. 2009, 31(9): 526-529.

Abstract ( 1521 )

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ObjectiveTo obtain recombinant GlcB protein efficiently expressed in E. coli. MethodsThe M. tuberculosis (M.tb) glcB gene was amplified by PCR and then cloned into plasmid pTA2. After sequencing, the glcB gene was cloned into plasmid pET30a(+), and expressed in E. coli BL21 (DE3). ResultsWhen E. coli BL21 (DE3) containing recombinant plasmid pET30a(+):glcB was induced by 0.4mmol/L of IPTG for 4h, the quantity of recombinant protein expressed in E. coli was maximum. The recombinant protein GlcB with molecular weight 92KD was expressed in incusion bodies of E. coli, and amounted to 50% of total bacterial protein. The purity of the protein purified through the Ni-NTA resin reached 90%. ConclusionsThe prokaryotic expression plasmid pET30a(+):glcB was constructed successfully, and the recombinant protein GlcB was obtained.

Application of MTT-based assay for rapid cytotoxicity screening of new antituberculosis drugs

Zheng Meiqin，Lu Yu，Fu Lei，Zhao Weijie

Chinese Journal of Antituberculosis. 2009, 31(9): 530-533.

Abstract ( 1845 )

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ObjectiveTo establish MTT-based assay for rapid cytotoxicity screening of new antituberculosis drug and determine the IC₅₀ of clofazimine derivatives. MethodsThe different concentration of Vero and HepG2 cells were prepared with culture medium and seeded into a 96-well microplate.The plate was incubated for 2h to 4h, then 10μl of MTT was added into each well. The plate was reincubated for 4h, and the absorbance was determined. The optimal wavelength was selected based on the optical density values measured at 405nm, 450nm, 492nm and 630nm. Simultaneously, the appropriated cell concentration ranges were characterized according to the curves of cell number vs OD. The cells were seeded into 96-well plates at the appropriated cell concentration and exposed to threefold serial dilutions of the compounds solutions for 48h.The optical density was read at 492nm after incubating with MTT for 4h. The regression curves were estimated from the data with the software origin 7.0. ResultsThe optimal wavelength for MTT was 492nm. The concentrations of cells in 2.5×10⁴～4×10⁵ cells/ml were appropriate for MTT. The IC₅₀s of the 131 compounds tested to Vero cell were approximate to HepG2 cell. The IC₅₀s of 10 compounds were higher than the maximum testing concentration, it suggests that the cytotoxicity was rather low. ConclusionsThe evaluation of Vero cell proliferation effect by MTT-based assay can provide an economical and rapid primary cytotoxicity screening of new antituberculosis drug.

Primary observation of fast detection acid-fast bacilli by centrifuging the liquefied sputa and collecting bacteria

Wang Shuxia,Liu Chengyong,Yan Jiawei,Cheng Song,Zhang Ruimei,Hou Yuanpei

Chinese Journal of Antituberculosis. 2009, 31(9): 535-537.

Abstract ( 1615 )

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ObjectiveTo study the clinical value of fast detection acid-fast bacilli by centrifuging the liquefied sputa and collecting bacteria. MethodsCompared the positive rate of outpatient sputum samples which detected by centrifuging the liquefied sputa and collecting bacteria with that by conventional smear method simultaneously, and evaluated this method in comparison with L-J medium used to detect the sputum samples of inpatients. ResultsThe positive rate of 240 outpatient sputum samples by centrifuging the liquefied sputa and collecting bacteria and by conventional smear method were 40.8% and 25.8%, respectively. There was significant difference. Using L-J medium as the control, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 90.9%, 93.8%, 97.6%, 78.9% and 91.7% respectively. ConclusionsThe centrifuging the liquefied sputa and collecting bacteria is a clinical testing method, which is easy to be standardized, simplified and accurated.

Clinical study of enzyme-linked immunospot assay in detection of Mycobacterium tuberculosis infection

Zou Shenghua，Zhang Lishui，Huang Mingxiang，Mao Wenjie

Chinese Journal of Antituberculosis. 2009, 31(9): 539-542.

Abstract ( 5751 )

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ObjectiveTo evaluate the clinical application of T-SPOT.TB in the rapid diagnosis of active tuberculosis．MethodsThe blood samples were detected interferon-gamma (IFN-γ) released by T lymphocytes, which were activated by specific M．tuberculosis antigens using T-SPOT.TB， and comparing with smear and acid-fast staining, BACTEC 960 culture and real-time PCR. Results155 of 164 M．tuberculosis patients were positive，the sensitivity of T-SPOT.TB was 94.5％（155/164）,significantly higher than other methods.5 cases were positive in 60 cases with non-tuberculosis respiratory disease, and 20 healthy subjects were negative, the specificity of the method was 93.8% (75/80)．ConclusionsT-SPOT.TB is a sensitive and specific method for rapid diagnosis of tuberculosis，especially suitable for early distinguishing TB with NTM.

Immune effect of heparin-binding hemagglutinin adhesin on pulmonary tuberculosis and extra-pulmonary tuberculosis

Nie Lihui, Sun Zhaogang, Zhang Xuxia, Li Chanyou

Chinese Journal of Antituberculosis. 2009, 31(9): 544-547.

Abstract ( 1617 )

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ObjectiveTo investigate the immune effect of heparin-binding hemagglutinin adhesin (HBHA) on different states of tuberculosis infection and its diagnosis value. MethodsNative HBHA were used to stimulate peripheral blood mononuclear cells (PBMCs) from the different cases including negative control, latent tuberculosis (LTB), pulmonary tuberculosis, and extra-pulmonary tuberculosis, the interferon-gamma (IFN-γ) in the supernatant of culture was detected by ELISA method. Nonparametric test was used to analyse the data. ResultsThe median level of HBHA-specific IFN-γ in the four groups were 49.5 pg/ml, 781.9 pg/ml, 341.8 pg/ml, 214.4 pg/ml, respectively. The IFN-γ level in LTB group was higher than other groups. The IFN-γ level in pulmonary tuberculosis group and extra-pulmonary tuberculosis group after stimulation with HBHA showed no significant difference (U＝1901.5，P＝0.448). ConclusionsHBHA-specific IFN-g release may identify tuberculosis infection cases from normal cases.

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