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Schön, Thomas
Alternative names
Publications (10 of 37) Show all publications
Niward, K., Ängeby, K., Chryssanthou, E., Paues, J., Bruchfeld, J., Jureen, P., . . . Schön, T. (2016). Susceptibility testing breakpoints for Mycobacterium tuberculosis categorize isolates with resistance mutations in gyrA as susceptible to fluoroquinolones: implications for MDR-TB treatment and the definition of XDR-TB.. Journal of Antimicrobial Chemotherapy, 71(2), 333-338
Open this publication in new window or tab >>Susceptibility testing breakpoints for Mycobacterium tuberculosis categorize isolates with resistance mutations in gyrA as susceptible to fluoroquinolones: implications for MDR-TB treatment and the definition of XDR-TB.
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2016 (English)In: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 71, no 2, p. 333-338Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Fluoroquinolones (FQs) are important in the treatment of MDR-TB and in the definition of XDR-TB. Our objective was to investigate how discrepancies in the phenotypic and genotypic methods for antimicrobial susceptibility testing could affect the interpretation of antimicrobial susceptibility test results.

METHODS: We analysed MICs of ofloxacin and levofloxacin in Middlebrook 7H10 broth (7H10) as well as sequencing of the quinolone resistance-determining region of the gyrA gene and the MTBDRsl assay in 75 resistant isolates, including MDR and XDR strains of Mycobacterium tuberculosis.

RESULTS: Among 75 resistant isolates, 27 had mutations associated with FQ resistance. Among isolates with resistance mutations in gyrA, 26% (seven of 27) were susceptible to levofloxacin and ofloxacin by phenotypic testing at 1 mg/L and 2 mg/L. The most common mutation was in codon 94 and these isolates had significantly increased MICs of levofloxacin (2-8 mg/L) compared with isolates with mutations in codon 90 (0.25-2 mg/L, P < 0.05). The sensitivity and specificity for the MTBDRsl assay compared with gyrA sequencing were 96% and 98%, respectively.

CONCLUSION: Current critical concentrations may classify up to 26% of isolates with gyrA mutations as susceptible to FQs due to a close relationship between susceptible and resistant populations. These results should be considered while improving clinical breakpoints for M. tuberculosis and may have an impact on the definition of XDR-TB.

National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-124557 (URN)10.1093/jac/dkv353 (DOI)000372427600008 ()26538509 (PubMedID)
Note

Funding agencies: Heart and Lung Foundation; Swedish Society of Antimicrobial Chemotherapy (SSAC); Swedish Medical Association; Marianne and Marcus Wallenberg Foundation

Available from: 2016-02-03 Created: 2016-02-03 Last updated: 2019-04-24
Abate, E., Belayneh, M., Idh, J., Diro, E., Elias, D., Britton, S., . . . Schön, T. (2015). Asymptomatic Helminth Infection in Active Tuberculosis Is Associated with Increased Regulatory and Th-2 Responses and a Lower Sputum Smear Positivity. PLoS Neglected Tropical Diseases, 9(8), Article ID e0003994.
Open this publication in new window or tab >>Asymptomatic Helminth Infection in Active Tuberculosis Is Associated with Increased Regulatory and Th-2 Responses and a Lower Sputum Smear Positivity
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2015 (English)In: PLoS Neglected Tropical Diseases, ISSN 1935-2727, E-ISSN 1935-2735, Vol. 9, no 8, article id e0003994Article in journal (Refereed) Published
Abstract [en]

Background The impact of intestinal helminth infection on the clinical presentation and immune response during active tuberculosis (TB) infection is not well characterized. Our aim was to investigate whether asymptomatic intestinal helminth infection alters the clinical signs and symptoms as well as the cell mediated immune responses in patients with active TB.

Methodology Consecutive, newly diagnosed TB patients and healthy community controls (CCs) were recruited in North-west Ethiopia. TB-score, body mass index and stool samples were analyzed. Cells from HIV-negative TB patients (HIV-/TB) and from CCs were analyzed for regulatory T-cells (Tregs) and cytokine responses using flow cytometry and ELISPOT, respectively.

Results A significantly higher ratio of helminth co-infection was observed in TB patients without HIV (Helm+/HIV-/TB) compared to HIV negative CCs, (40% (121/306) versus 28% (85/306), p = 0.003). Helm+/HIV-/TB patients showed significantly increased IL-5 secreting cells compared to Helm-/HIV-/TB (37 SFU (IQR:13-103) versus 2 SFU (1-50); p = 0.02, n = 30). Likewise, levels of absolute Tregs (9.4 (3.2-16.7) cells/mu l versus 2.4 (1.1-4.0) cells/mu l; p = 0.041) and IL-10 secreting cells (65 SFU (7-196) versus 1 SFU (0-31); p = 0.014) were significantly higher in Helm+/HIV-/TB patients compared to Helm-/HIV-/TB patients. In a multivariate analysis, a lower rate of sputum smear positivity for acid fast bacilli, lower body temperature, and eosinophilia were independently associated with helminth infection in TB patients.

Conclusions Asymptomatic helminth infection is associated with increased regulatory T-cell and Th2-type responses and a lower rate of sputum smear positivity. Further studies are warranted to investigate the clinical and immunological impact of helminth infection in TB patients.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2015
National Category
Microbiology in the medical area
Identifiers
urn:nbn:se:liu:diva-121763 (URN)10.1371/journal.pntd.0003994 (DOI)000360708200058 ()26248316 (PubMedID)
Note

Funding Agencies|SAREC/SIDA; EU/EDCTP [JP 10800.006]; Swedish Research Council; Swedish Heart and Lung Foundation (Oscar II Jubilee Foundation); Wallenberg Foundation; Armauer Hansen Research Institute

Available from: 2015-10-06 Created: 2015-10-05 Last updated: 2018-01-11
Abate, E., Elias, D., Getachew, A., Alemu, S., Diro, E., Britton, S., . . . Schön, T. (2015). Effects of albendazole on the clinical outcome and immunological responses in helminth co-infected tuberculosis patients: a double blind randomised clinical trial. International Journal of Parasitology, 45(2-3), 133-140
Open this publication in new window or tab >>Effects of albendazole on the clinical outcome and immunological responses in helminth co-infected tuberculosis patients: a double blind randomised clinical trial
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2015 (English)In: International Journal of Parasitology, ISSN 0020-7519, E-ISSN 1879-0135, Vol. 45, no 2-3, p. 133-140Article in journal (Refereed) Published
Abstract [en]

Despite several review papers and experimental studies concerning the impact of chronic helminth infection on tuberculosis in recent years, there is a scarcity of data from clinical field studies in highly endemic areas for these diseases. We believe this is the first randomised clinical trial investigating the impact of albendazole treatment on the clinical and immunological outcomes of helminth co-infected tuberculosis patients. A randomised, double-blind, placebo-controlled trial of albendazole (400 mg per day for 3 days) in helminth-positive tuberculosis patients was conducted in Gondar, Ethiopia. The primary outcome was clinical improvement (Delta TB score) after 2 months. Among secondary outcomes were changes in the levels of eosinophils, CD4+ T cells, regulatory T cells, IFN-gamma, IL-5 and IL-10 after 3 months. A total of 140 helminth co-infected tuberculosis patients were included with an HIV co-infection rate of 22.8%. There was no significant effect on the primary outcome (Delta TB score: 5.6 +/- 2.9 for albendazole versus 5.9 +/- 2.5 for placebo, P = 0.59). The albendazole-treated group showed a decline in eosinophil cells (P = 0.001) and IL-10 (P = 0.017) after 3 months. In an exploratory analysis after 12 weeks, the albendazole treated group showed a trend towards weight gain compared with the placebo group (11.2 +/- 8.5 kg versus 8.2 +/- 8.7 kg, P = 0.08)). The reductions in eosinophil counts and IL-10 show that asymptomatic helminth infection significantly affects host immunity during tuberculosis and can be effectively reversed by albendazole treatment. The clinical effects of helminth infection on chronic infectious diseases such as tuberculosis merit further characterisation. (C) 2014 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Helminth; Tuberculosis; Albendazole; Deworming; HIV; Ethiopia
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-116974 (URN)10.1016/j.ijpara.2014.09.006 (DOI)000350936200006 ()25486494 (PubMedID)
Note

Funding Agencies|Swedish Research Council; Swedish Heart and Lung Foundation; King Oscar II Jubilee Foundation; SIDA/SAREC; European and Developing Countries Clinical Trials Partnership (EDCTP) [JP]; Groschinsky Memorial Foundation; Marianne and Marcus Wallenberg foundation

Available from: 2015-04-10 Created: 2015-04-10 Last updated: 2017-12-04
Davies Forsman, L., Giske, C. G., Bruchfeld, J., Schön, T., Jureen, P. & Angeby, K. (2015). Meropenem-Clavulanic Acid Has High In Vitro Activity against Multidrug-Resistant Mycobacterium tuberculosis. Antimicrobial Agents and Chemotherapy, 59(6), 3630-3632
Open this publication in new window or tab >>Meropenem-Clavulanic Acid Has High In Vitro Activity against Multidrug-Resistant Mycobacterium tuberculosis
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2015 (English)In: Antimicrobial Agents and Chemotherapy, ISSN 0066-4804, E-ISSN 1098-6596, Vol. 59, no 6, p. 3630-3632Article in journal (Refereed) Published
Abstract [en]

We investigated the activity of meropenem-clavulanic acid (MEM-CLA) against 68 Mycobacterium tuberculosis isolates. We included predominantly multi- and extensively drug-resistant tuberculosis (MDR/XDR-TB) isolates, since the activity of MEM-CLA for resistant isolates has previously not been studied extensively. Using Middlebrook 7H10 medium, all but four isolates showed an MIC distribution of 0.125 to 2 mg/liter for MEM-CLA, below the non-species-related breakpoint for MEM of 2 mg/liter defined by EUCAST. MEM-CLA is a potential treatment option for MDR/XDR-TB.

Place, publisher, year, edition, pages
American Society for Microbiology, 2015
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-120749 (URN)10.1128/AAC.00171-15 (DOI)000358623200091 ()25824227 (PubMedID)
Note

Funding Agencies|Swedish Society of Medicine [SLS 169241]; Marianne and Marcus Wallenberg Foundation; Swedish Heart and Lung Foundation (Oscar II Jubilee Foundation); Swedish Society of Antimicrobial Chemotherapy; Research Council of Southeast Sweden (FORSS)

Available from: 2015-08-24 Created: 2015-08-24 Last updated: 2017-12-04
Skogmar, S., Schön, T., Tolera Balcha, T., Sturegard, E., Jansson, M. & Bjorkman, P. (2015). Plasma Levels of Neopterin and C-Reactive Protein (CRP) in Tuberculosis (TB) with and without HIV Coinfection in Relation to CD4 Cell Count. PLoS ONE, 10(12), e0144292
Open this publication in new window or tab >>Plasma Levels of Neopterin and C-Reactive Protein (CRP) in Tuberculosis (TB) with and without HIV Coinfection in Relation to CD4 Cell Count
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2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 12, p. e0144292-Article in journal (Refereed) Published
Abstract [en]

Background While the risk of TB is elevated in HIV-positive subjects with low CD4 cell counts, TB may in itself be associated with CD4 lymphocytopenia. We investigated markers of immune activation (neopterin) and inflammation (CRP) in TB patients with and without HIV coinfection and their association with CD4 cell levels, and determined their predictive capacity as alternative markers of advanced immunosuppression. Methods Participants selected from a cohort of adults with TB at Ethiopian health centers (195 HIV +/TB+, 170 HIV-/TB+) and 31 controls were tested for plasma levels of neopterin and CRP. Baseline levels of neopterin and CRP were correlated to CD4 cell count before and after anti-TB treatment (ATT). The performance to predict CD4 cell strata for both markers were investigated using receiver operating curves. Results Levels of both biomarkers were elevated in TB patients (neopterin: HIV+/TB+ 54 nmol/l, HIV-/TB+ 23 nmol/l, controls 3.8 nmol/l; CRP: HIV+/TB+ 36 mu g/ml, HIV-/TB+ 33 mu g/ml, controls 0.5 mu g/ml). Neopterin levels were inversely correlated (-0.53, p&lt;0.001) to CD4 cell count, whereas this correlation was weaker for CRP (-0.25, p&lt;0.001). Neither of the markers had adequate predictive value for identification of subjects with CD4 cell count &lt;100 cells/mm(3) (area under the curve [AUC] 0.64 for neopterin, AUC 0.59 for CRP). Conclusion Neopterin levels were high in adults with TB, both with and without HIV coinfection, with inverse correlation to CD4 cell count. This suggests that immune activation may be involved in TB-related CD4 lymphocytopenia. However, neither neopterin nor CRP showed promise as alternative tests for immunosuppression in patients coinfected with HIV and TB.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2015
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-123757 (URN)10.1371/journal.pone.0144292 (DOI)000365926300176 ()26630153 (PubMedID)
Note

Funding Agencies|Swedish Civil Contingency Agency; Swedish International Development Cooperation Agency; Region Skane; Swedish Medical Association

Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2017-11-30
Wedajo, W., Schön, T., Bedru, A., Kiros, T., Hailu, E., Mebrahtu, T., . . . Aseffa, A. (2014). A 24-well plate assay for simultaneous testing of first and second line drugs against Mycobacterium tuberculosis in a high endemic setting. BMC Research Notes, 7(1), 512
Open this publication in new window or tab >>A 24-well plate assay for simultaneous testing of first and second line drugs against Mycobacterium tuberculosis in a high endemic setting
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2014 (English)In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 7, no 1, p. 512-Article in journal (Refereed) Published
Abstract [en]

Background: Early detection of drug resistance is one of the priorities of tuberculosis (TB) control programs as drug resistance is increasing. New molecular assays are only accessible for a minority of the second line drugs and their availability in high endemic settings is also hampered by high cost and logistic challenges. Therefore, we evaluated a previously developed method for drug susceptibility testing (DST) including both first- and second line anti-TB drugs for use in high endemic areas. Results: Baseline mycobacterial isolates from 78 consecutive pulmonary TB patients from Addis Ababa, Ethiopia who were culture positive for Mycobacterium tuberculosis at the end of a two-month directly observed treatment short course (DOTS) were included. The isolates were simultaneously tested for isoniazid, rifampicin, ethambutol, streptomycin, amikacin, kanamycin, capreomycin, ofloxacin, moxifloxacin, ethionamide and para-aminosalicylic acid susceptibility using the indirect proportion method adopted for 24-well agar plates containing Middlebrook 7H10 medium. Applying the 24-well plate assay, 43 (55.1%) isolates were resistant to one or more of the first line drugs tested (isoniazid, rifampicin and ethambutol). MDR-TB was identified in 20.5% of this selected group and there was a perfect correlation for rifampicin resistance with the results from the genotype MTBDRplus assay. All isolates were susceptible to aminoglycosides and fluoroquinolones in agreement with the genotype MTBDRsl assay. The only tested second line drug associated to resistance was ethionamide (14.1% resistant). The method was reproducible with stable results for internal controls (one multi-drug resistant (MDR) and one pan-susceptible strain (H37Rv) and DST results could be reported at two weeks. Conclusions: The 24-well plate method for simultaneous DST for first- and second line drugs was found to be reproducible and correlated well to molecular drug susceptibility tests. It is likely to be useful in high-endemic areas for surveillance as well as for the detection of second line drug resistance in targeted groups such as in those who fail empirical MDR treatment.

Place, publisher, year, edition, pages
BioMed Central / Springer Verlag (Germany), 2014
Keywords
Epidemiological cut off value (ECOFF); Ethiopia; Multi drug resistant (MDR) tuberculosis; Susceptibility testing
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-116375 (URN)10.1186/1756-0500-7-512 (DOI)25108648 (PubMedID)2-s2.0-84906573226 (Scopus ID)
Available from: 2015-03-27 Created: 2015-03-26 Last updated: 2018-01-11
Larsson, M. C., Lerm, M., Ängeby, K., Nordvall, M., Jureen, P. & Schön, T. (2014). A luciferase-based assay for rapid assessment of drug activity against Mycobacterium tuberculosis including monitoring of macrophage viability. Journal of Microbiological Methods, 106, 146-150
Open this publication in new window or tab >>A luciferase-based assay for rapid assessment of drug activity against Mycobacterium tuberculosis including monitoring of macrophage viability
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2014 (English)In: Journal of Microbiological Methods, ISSN 0167-7012, E-ISSN 1872-8359, Vol. 106, p. 146-150Article in journal (Refereed) Published
Abstract [en]

The intracellular (IC) effect of drugs against Mycobacterium tuberculosis (Mtb) is not well established but increasingly important to consider when combining current and future multidrug regimens into the best possible treatment strategies. For this purpose, we developed an IC model based on a genetically modified Mtb H37Rv strain, expressing the Vibrio harvei luciferase (H37Rv-lux) infecting the human macrophage like cell line THP-1. Cells were infected at a low multiplicity of infection (1:1) and subsequently exposed to isoniazid (INH), ethambutol (EMB), amikacin (AMI) or levofloxacin (LEV) for 5 days in a 96-well format. Cell viability was evaluated by Calcein AM and was maintained throughout the experiment. The number of viable H37Rv-lux was determined by luminescence and verified by a colony forming unit analysis. The results were compared to the effects of the same drugs in broth cultures. AMI, EMB and LEV were significantly less effective intracellularly (MIC90: greater than4 mg/L, 8 mg/L and 2 mg/L, respectively) compared to extracellularly (MIC90: 0.5 mg/L for AMI and EMB; 0.25 mg/L for LEV). The reverse was the case for INH (IC: 0.064 mg/L vs EC: 0.25 mg/L). In conclusion, this luciferase based method, in which monitoring of cell viability is included, has the potential to become a useful tool while evaluating the intracellular effects of anti-mycobacterial drugs.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Tuberculosis; Levofloxacin; Drug susceptibility testing; Intracellular; Luminescence; Minimal inhibitory concentration
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-112299 (URN)10.1016/j.mimet.2014.08.015 (DOI)000343358200024 ()25194234 (PubMedID)
Note

Funding Agencies|Swedish Heart and Lung Foundation (Oscar II Jubilee Foundation); Marianne and Marcus Wallenberg Foundation; Research Council of Southeast Sweden (FORSS)

Available from: 2014-11-24 Created: 2014-11-24 Last updated: 2018-01-11Bibliographically approved
Balcha, T. T., Winqvist, N., Sturegard, E., Skogmar, S., Reepalu, A., Jemal, Z. H., . . . Bjorkman, P. (2014). Detection of lipoarabinomannan in urine for identification of active tuberculosis among HIV-positive adults in Ethiopian health centres. Tropical medicine & international health, 19(6), 734-742
Open this publication in new window or tab >>Detection of lipoarabinomannan in urine for identification of active tuberculosis among HIV-positive adults in Ethiopian health centres
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2014 (English)In: Tropical medicine & international health, ISSN 1360-2276, E-ISSN 1365-3156, Vol. 19, no 6, p. 734-742Article in journal (Refereed) Published
Abstract [en]

ObjectiveTo assess the diagnostic performance of urine lipoarabinomannan (LAM) detection for TB screening in HIV-positive adults in Ethiopia. MethodsTesting for LAM was performed using the Determine TB-LAM lateral flow assay on urine samples from participants in a prospective cohort with baseline bacteriological categorisation for active TB in sputum. Characteristics of TB patients with regard to LAM status were determined. Participants were followed for 6months to evaluate survival, retention in care and incident TB. ResultsPositive LAM results were found in 78/757 participants. Among 128 subjects with definite (confirmed by culture and/or Xpert MTB/RIF) TB, 33 were LAM-positive (25.8%); the respective figure for clinically diagnosed cases was 2/20 (10%). Five of the remaining 43 LAM-positive individuals had died during the 6-month follow-up period, whereas 38 remained in care without clinical signs of TB. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 25.8%, 92.9%, 42.3% and 86.0%, respectively. Among TB patients, LAM positivity was associated with higher WHO clinical stage, lower body mass index (BMI), CD4 cell and haemoglobin levels, and with increased mortality. A combination algorithm of urine LAM testing and sputum smear microscopy detected 49 (38.2%) of definite TB cases; among those with CD4 count 100cells/mm(3), this proportion was 66.7%. ConclusionsThe performance of urine LAM testing for TB detection was poor in this population. However, this was improved among subjects with CD4 count 100cells/mm(3). In combination with sputum microscopy urine, LAM could be considered for targeted TB screening in this subgroup.

Place, publisher, year, edition, pages
Wiley, 2014
Keywords
antiretroviral therapy; TB; lipoarabinomannan; Determine TB-LAM; health centres; Ethiopia; ART; tuberculose; lipoarabinomannane; determine TB-LAM; centres de sante; Ethiopie; TAR; TB; Lipoarabinomanano; Determinacion TB-LAM; centros sanitarios; Etiopia
National Category
Clinical Medicine Microbiology in the medical area
Identifiers
urn:nbn:se:liu:diva-107447 (URN)10.1111/tmi.12308 (DOI)000335234000013 ()
Available from: 2014-06-12 Created: 2014-06-12 Last updated: 2018-01-11
Skogmar, S., Balcha, T. T., Jemal, Z. H., Bjork, J., Deressa, W., Schön, T. & Bjorkman, P. (2014). Development of a clinical scoring system for assessment of immunosuppression in patients with tuberculosis and HIV infection without access to CD4 cell testing - results from a cross-sectional study in Ethiopia. Global Health Action, 7(23105)
Open this publication in new window or tab >>Development of a clinical scoring system for assessment of immunosuppression in patients with tuberculosis and HIV infection without access to CD4 cell testing - results from a cross-sectional study in Ethiopia
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2014 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, no 23105Article in journal (Refereed) Published
Abstract [en]

Background: Currently, antiretroviral therapy (ART) is recommended for all HIV-positive patients with tuberculosis (TB). The timing of ART during the course of anti-TB treatment is based on CD4 cell counts. Access to CD4 cell testing is not universally available; this constitutes an obstacle for the provision of ART in low-income countries. Objective: To determine clinical variables associated with HIV co-infection in TB patients and to identify correlations between clinical variables and CD4 cell strata in HIV/TB co-infected subjects, with the aim of developing a clinical scoring system for the assessment of immunosuppression. Design: Cross-sectional study of adults with TB (with and without HIV co-infection) recruited in Ethiopian outpatient clinics. Clinical variables potentially associated with immunosuppression were recorded using a structured questionnaire, and they were correlated to CD4 cell strata used to determine timing of ART initiation. Variables found to be significant in multivariate analysis were used to construct a scoring system. Results: Among 1,116 participants, the following findings were significantly more frequent in 307 HIV-positive patients compared to 809 HIV-negative subjects: diarrhea, odynophagia, conjunctival pallor, herpes zoster, oral candidiasis, skin rash, and mid-upper arm circumference (MUAC) less than20 cm. Among HIV-positive patients, conjunctival pallor, MUAC less than20 cm, dyspnea, oral hairy leukoplakia (OHL), oral candidiasis, and gingivitis were significantly associated with less than350 CD4 cells/mm(3). A scoring system based on these variables had a negative predictive value of 87% for excluding subjects with CD4 cell counts less than100 cells/mm(3); however, the positive predictive value for identifying such individuals was low (47%). Conclusions: Clinical variables correlate with CD4 cell strata in HIV-positive patients with TB. The clinical scoring system had adequate negative predictive value for excluding severe immunosuppression. Clinical scoring systems could be of use to categorize TB/HIV co-infected patients with regard to the timing of ART initiation in settings with limited access to laboratory facilities.

Place, publisher, year, edition, pages
Co-Action Publishing: Creative Commons Attribution / Co-Action Publishing, 2014
Keywords
HIV; tuberculosis; Ethiopia; scoring system; CD4 cell; timing of ART
National Category
Microbiology in the medical area Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-105039 (URN)10.3402/gha.v7.23105 (DOI)000331405300001 ()
Available from: 2014-03-06 Created: 2014-03-06 Last updated: 2018-01-11
Woksepp, H., Ryberg, A., Billstrom, H., Hällgren, A., Nilsson, L. E., Marklund, B.-I., . . . Schön, T. (2014). Evaluation of High-Resolution Melting Curve Analysis of Ligation-Mediated Real-Time PCR, a Rapid Method for Epidemiological Typing of ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter Species) Pathogens. Journal of Clinical Microbiology, 52(12), 4339-4342
Open this publication in new window or tab >>Evaluation of High-Resolution Melting Curve Analysis of Ligation-Mediated Real-Time PCR, a Rapid Method for Epidemiological Typing of ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter Species) Pathogens
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2014 (English)In: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 52, no 12, p. 4339-4342Article in journal (Refereed) Published
Abstract [en]

A single-tube method, ligation-mediated real-time PCR high-resolution melt analysis (LMqPCR HRMA), was modified for the rapid typing of Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE) pathogens. A 97% agreement (60/62 isolates) was achieved in comparison to pulsed-field gel electrophoresis (PFGE) results, which indicates that LMqPCR HRMA is a rapid and accurate screening tool for monitoring nosocomial outbreaks.

Place, publisher, year, edition, pages
American Society for Microbiology, 2014
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-113004 (URN)10.1128/JCM.02537-14 (DOI)000345222900033 ()25232168 (PubMedID)
Note

Funding Agencies|Marianne and Marcus Wallenberg Foundation; FORSS (The Research Council of Southeast Sweden)

Available from: 2015-01-12 Created: 2015-01-08 Last updated: 2018-01-11
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