No description available.

A prospective study was undertaken to assess the diagnostic value of various rapid diagnostic tests for tuberculosis in pleural fluid, and to assess the sensitivity and speed of a radiometric mycobacterial culture system (BACTEC, Johnson Laboratories). Patients presenting to the Department of Medicine at Groote Schuur Hospital with pleural effusions for diagnostic pleural aspiration and biopsy over a 6 month period were entered into the study. Because the incidence of tuberculous effusions was observed to be high in this population (65% of 94 patients), patients from the Department of Radiotherapy with proven malignant disease and the development of new pleural effusions requiring diagnostic or therapeutic aspiration were included in the study in order to increase the number of control patients without tuberculosis. The 111 patients (17 of whom were recruited from the Department of Radiotherapy) were divided into 4 diagnostic categories: tuberculosis - 62 patients, malignant - 28 patients, miscellaneous conditions - 10 patients, and undiagnosed - 11 patients (3 of whom probably had tuberculosis). There were 59 male patients. The racial distribution was 11 whites, 51 of mixed race, and 49 blacks. Exudative pleural effusions were present in 109 patients. Closed pleural biopsies with the Abrams needle were performed on 100 patients using a modified version of the standard technique whereby larger specimens were obtained by stripping pleura off the chest wall. Seven pleural biopsies were reported as inadequate by the pathologist and the diagnostic yield of the procedure was 63%. Tuberculosis was confirmed histologically or by culture in 62 patients. The age distribution of these patients was bimodal, with most cases occuring in the third decade. The presentation was usually acute, with 60% of patients being symptomatic for less than 4 weeks. Granulomata were found on initial pleural biopsy in 52 cases (84%). Pleural biopsy culture was positive in 44 cases (71%). The radiometric culture system tested (12B BACTEC) yielded the same number (14) of positive cultures as conventional mycobacterial culture media in pleural fluid, but was almost twice as fast. Bedside inoculation of pleural fluid into 13A BACTEC bottles more than doubled the yield in the 24 patients tested (11 positive cultures compared with 4 each for conventional and 12B BACTEC media, p=0.046). The rapid diagnostic tests assessed on pleural fluid were adenosine deaminase (ADA), an antigen (BCG) capture enzymelinked immunosorbent assay (ELISA), and a specific DNA probe after amplification with the polymerase chain reaction. ADA was found to have a sensitivity of 0.77 and a specificity of 0.83 in the 109 patients tested, and values were significantly higher in tuberculosis patients compared with the other three diagnostic categories (p< 0.001 ). The ELISA test was performed on 103 patients and showed a sensitivity of only 0.26 and a specificity of 0.72. The DNA probe was performed on 43 patients, and had a sensitivity of 0.93 with a specificity of 0.43. Contamination of samples or latent tuberculous infection may have been responsible for the poor specificity of the DNA probe.

Please read the abstract in the 00 front of this document. / Thesis (PhD)--University of Pretoria, 2009. / Veterinary Tropical Diseases / unrestricted

The relevance of the use of molecular tools in the global epidemiology of Mycobacterium tuberculosis complex (MTBC) cannot be undermined. Molecular epidemiological studies of the MTBC in Nigeria are not extensive, and to date, there has only been one detailed report. More strains are therefore needed to be genotyped in order to give a clear indication of disease transmission chains and to highlight routes of infection particularly with respect to zoonotic tuberculosis. This study therefore focuses on the identification and genotyping of MTBC isolates in south western Nigeria, with emphasis on interactions occurring at the human/livestock interface. The molecular epidemiology of M. bovis strains in Hluhluwe-iMfolozi Park in South Africa was also undertaken. Prior to this study, a pilot study was initially done to establish techniques, using samples from Belgium. Mycobacterium bovis strains were first identified in Belgium using the Multiple locus [variable number of tandem repeats] (MLVA) technique and analysis was done using capillary electrophoresis. In this study, the Belgium isolates were repeated using MLVA and analysis by agaorse gel electrophoresis and the two analysis techniques compared. Human isolates (136) and livestock isolates from cattle (50), pigs (12) and goats (5) isolated in Nigeria were also used and species identification of the members of the MTBC were done using the deletion analysis PCR technique amplifying RD1mic, RD2seal, RD4 andRD9 regions as well as spoligotyping. Seventy four positive MTBC strains (humans and livestock) were genotyped using 16 VNTR loci. The discriminatory ability of the 16 loci MLVA was compared with spoligotype data on 33 MTBC strains. Mycobacterium bovis isolates from buffalo in HluhluweiMfolozi Park (HiP) South Africa, were also genotyped using the 16 loci MLVA and spoligotyping. Results indicated that agarose based MLVA is as discriminatory as the capillary based MLVA. Furthermore, the relevance of molecular techniques in the rapid identification and genotyping of members of the MTBC, especially in a tuberculosis endemic setting like Nigeria, is also highlighted. This was clearly seen in the identification of undescribed spoligopatterns of the LAM 10-CAM M. tuberculosis strains in humans as well as the identification of undescribed M. bovis spoligopatterns in livestock isolates. The prevalent M. bovis strain (SB0944) in Nigeria was also identified in a human isolate. Also, two classical M. bovis strains were identified in two human isolates obtained from cattle traders, thus suggesting the influence of close interaction between infected animals and man as a means of zoonotic tuberculosis transmission. Mycobacterium tuberculosis was also identified in three isolates, from cattle, pig and goat; with the goat isolate having a spoligopattern (EAI5) typical of strains indigenous to East Africa and India. This study demonstrated the prevalent strains of M. bovis and M. tuberculosis circulating in Nigeria with SB0944 the predominant M. bovis spoligotype and LAM10-CAM the predominant M. tuberculosis spoligotype. The MLVA results revealed the occurrence of interspecies transmission of mycobacterial species, which was seen as isolates from different animal species having identical VNTR profiles and thus belonging to the same genotype. In the HiP, two strains of M. bovis were identified, a strain previously described in cattle and buffalo in other regions of South Africa and a new undescribed strain, thus giving an indication of the circulating strains in HiP and also suggesting possible sources of introduction of novel species in HiP. The relevance of a detailed molecular epidemiological study was clearly demonstrated in both Nigeria and HiP. Strain relatedness and interactions occurring at human/livestock interface and domestic/wild life interface could also clearly be demonstrated. / Dissertation (MSc)--University of Pretoria, 2008. / Veterinary Tropical Diseases / unrestricted

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The problem of conatmination in culture media for Mycobacterium tuberculosis has not been solved completely, and for this reason the work herein presented was carried out. In this work experiments were made testing the effect of actidione in inhibiting certain ones of the higher fungi.

No / Mycobacterium tuberculosis remains the predominant bacterial scourge of mankind. Understanding of its biology and pathogenicity has been greatly advanced by the determination of whole genome sequences for this organism. Bacterial lipoproteins are a functionally diverse class of membrane-anchored proteins. The signal peptides of these proteins direct their export and post-translational lipid modification. These signal peptides are amenable to bioinformatic analysis, allowing the lipoproteins encoded in whole genomes to be catalogued. This review applies bioinformatic methods to the identification and functional characterisation of the lipoproteins encoded in the M. tuberculosis genomes. Ninety nine putative lipoproteins were identified and so this family of proteins represents ca. 2.5% of the M. tuberculosis predicted proteome. Thus, lipoproteins represent an important class of cell envelope proteins that may contribute to the virulence of this major pathogen.