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T cell-based tracking of multidrug resistant tuberculosis infection after brief exposure

T cell-based tracking of multidrug resistant tuberculosis infection after brief exposure
T cell-based tracking of multidrug resistant tuberculosis infection after brief exposure
Molecular epidemiology indicates significant transmission of Mycobacterium tuberculosis after casual contact with infectious tuberculosis cases. We investigated M. tuberculosis transmission after brief exposure using a T cell-based assay, the enzyme-linked-immunospot (ELISPOT) for IFN-gamma. After childbirth, a mother was diagnosed with sputum smear-positive multidrug-resistant tuberculosis. Forty-one neonates and 47 adults were present during her admission on the maternity unit; 11 weeks later, all underwent tuberculin skin testing (TST) and ELISPOT. We correlated test results with markers of exposure to the index case. The participants, who were asymptomatic and predominantly had no prior tuberculosis exposure, had 6.05 hours mean exposure (range: 0-65 hours) to the index case. Seventeen individuals, including two newborns, were ELISPOT-positive, and ELISPOT results correlated significantly with three of four predefined measures of tuberculosis exposure. For each hour sharing room air with the index case, the odds of a positive ELISPOT result increased by 1.05 (95% CI: 1.02-1.09, p = 0.003). Only four adults were TST-positive and TST results did not correlate with exposure. Thus, ELISPOT, but not TST, suggested quite extensive nosocomial transmission of multidrug-resistant M. tuberculosis after brief exposure. These results help to explain the apparent importance of casual contact for tuberculosis transmission, and may have implications for prevention.
contact tracing, nosocomial, T cell, tuberculin skin test, tuberculosis
1073-449X
288-295
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
Ewer, Katie
7492f401-c61a-4b20-b8d9-adfa7b39c11a
Losi, Monica
6f2acb9f-04c8-45fc-9921-7b0a0f439129
Bergamini, Barbara M
74b01cbe-4778-4ed8-b7cf-f1ac4559be2f
Roversi, Pietro
bb4e8839-5d4e-436a-bec6-7a3f7cd47f8b
Deeks, Jonathan
998ba22f-f7f2-46bf-891f-02ec367881cf
Fabbri, Leonardo M
d8d9ee69-fdaa-4c34-b52f-b05d9ccd29fe
Lalvani, Ajit
ac754f14-ec6b-4a5b-8a72-6bb1e114b626
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
Ewer, Katie
7492f401-c61a-4b20-b8d9-adfa7b39c11a
Losi, Monica
6f2acb9f-04c8-45fc-9921-7b0a0f439129
Bergamini, Barbara M
74b01cbe-4778-4ed8-b7cf-f1ac4559be2f
Roversi, Pietro
bb4e8839-5d4e-436a-bec6-7a3f7cd47f8b
Deeks, Jonathan
998ba22f-f7f2-46bf-891f-02ec367881cf
Fabbri, Leonardo M
d8d9ee69-fdaa-4c34-b52f-b05d9ccd29fe
Lalvani, Ajit
ac754f14-ec6b-4a5b-8a72-6bb1e114b626

Richeldi, Luca, Ewer, Katie, Losi, Monica, Bergamini, Barbara M, Roversi, Pietro, Deeks, Jonathan, Fabbri, Leonardo M and Lalvani, Ajit (2004) T cell-based tracking of multidrug resistant tuberculosis infection after brief exposure. American Journal of Respiratory and Critical Care Medicine, 170 (3), 288-295. (doi:10.1164/rccm.200403-307OC). (PMID:15130907)

Record type: Article

Abstract

Molecular epidemiology indicates significant transmission of Mycobacterium tuberculosis after casual contact with infectious tuberculosis cases. We investigated M. tuberculosis transmission after brief exposure using a T cell-based assay, the enzyme-linked-immunospot (ELISPOT) for IFN-gamma. After childbirth, a mother was diagnosed with sputum smear-positive multidrug-resistant tuberculosis. Forty-one neonates and 47 adults were present during her admission on the maternity unit; 11 weeks later, all underwent tuberculin skin testing (TST) and ELISPOT. We correlated test results with markers of exposure to the index case. The participants, who were asymptomatic and predominantly had no prior tuberculosis exposure, had 6.05 hours mean exposure (range: 0-65 hours) to the index case. Seventeen individuals, including two newborns, were ELISPOT-positive, and ELISPOT results correlated significantly with three of four predefined measures of tuberculosis exposure. For each hour sharing room air with the index case, the odds of a positive ELISPOT result increased by 1.05 (95% CI: 1.02-1.09, p = 0.003). Only four adults were TST-positive and TST results did not correlate with exposure. Thus, ELISPOT, but not TST, suggested quite extensive nosocomial transmission of multidrug-resistant M. tuberculosis after brief exposure. These results help to explain the apparent importance of casual contact for tuberculosis transmission, and may have implications for prevention.

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More information

e-pub ahead of print date: 6 May 2004
Published date: 1 August 2004
Keywords: contact tracing, nosocomial, T cell, tuberculin skin test, tuberculosis
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 368949
URI: https://eprints.soton.ac.uk/id/eprint/368949
ISSN: 1073-449X
PURE UUID: 4d12a8ea-037f-4cd4-aeb4-8b1dcaab3821

Catalogue record

Date deposited: 09 Oct 2014 10:49
Last modified: 18 Jul 2017 01:41

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