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  1. Article ; Online: Toward a molecular microbial blood test for tuberculosis infection.

    Martineau, Adrian R / Chandran, Shruthi / Palukani, Winnie / Garrido, Patricia / Mayito, Jonathan / Reece, Stephen T / Tiwari, Divya

    International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

    2024  Volume 141S, Page(s) 106988

    Abstract: The World Health Organization's aim to end the global tuberculosis (TB) epidemic by 2050 cannot be achieved without taking measures to identify people with asymptomatic Mycobacterium tuberculosis (Mtb) infection and offer them an intervention to reduce ... ...

    Abstract The World Health Organization's aim to end the global tuberculosis (TB) epidemic by 2050 cannot be achieved without taking measures to identify people with asymptomatic Mycobacterium tuberculosis (Mtb) infection and offer them an intervention to reduce the risk of disease progression, such as preventive antimicrobial therapy. Implementation of this strategy is limited by the fact that existing tests for Mtb infection, which use immunosensitization to Mtb-specific antigens as a proxy for infection, have low positive predictive value for progression to TB. A blood test that detects Mtb deoxyribonucleic acid (DNA) could allow preventive therapy to be targeted at individuals with microbiological evidence of persistent infection. In this review, we summarize recent advances in the development of molecular microbial blood tests for Mtb infection and discuss potential explanations for discordance between their results and those of immunodiagnostic tests in adults with recent exposure to an infectious index case. We also present a roadmap for further development of molecular microbial blood tests for Mtb infection, and highlight the potential for research in this area to provide novel insights into the biology of Mtb infection and yield new tools to support efforts to control the global TB epidemic.
    MeSH term(s) Adult ; Humans ; Tuberculosis/microbiology ; Latent Tuberculosis/microbiology ; Mycobacterium tuberculosis/genetics ; Predictive Value of Tests ; Hematologic Tests
    Language English
    Publishing date 2024-02-28
    Publishing country Canada
    Document type Review ; Journal Article
    ZDB-ID 1331197-9
    ISSN 1878-3511 ; 1201-9712
    ISSN (online) 1878-3511
    ISSN 1201-9712
    DOI 10.1016/j.ijid.2024.106988
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  2. Article ; Online: COVID-19-associated

    Chandran, Shruthi / Avari, Malcolm / Cherian, Benny P / Suarez, Cristina

    BMJ case reports

    2021  Volume 14, Issue 6

    MeSH term(s) COVID-19 ; Humans ; Pneumonia ; Pneumonia, Staphylococcal/diagnostic imaging ; Pneumonia, Staphylococcal/drug therapy ; SARS-CoV-2 ; Staphylococcal Infections/diagnosis ; Staphylococcal Infections/drug therapy ; Staphylococcus aureus
    Language English
    Publishing date 2021-06-11
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2021-243726
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  3. Article ; Online: Socioeconomic and Demographic Risk Factors for SARS-CoV-2 Seropositivity Among Healthcare Workers in a UK Hospital: A Prospective Cohort Study.

    Lam, Tanya / Saso, Anja / Torres Ortiz, Arturo / Hatcher, James / Woodman, Marc / Chandran, Shruthi / Thistlethwayte, Rosie / Best, Timothy / Johnson, Marina / Wagstaffe, Helen / Mai, Annabelle / Buckland, Matthew / Gilmour, Kimberly / Goldblatt, David / Grandjean, Louis

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2024  Volume 78, Issue 3, Page(s) 594–602

    Abstract: Background: To protect healthcare workers (HCWs) from the consequences of disease due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is necessary to understand the risk factors that drive exposure and infection within hospitals. ... ...

    Abstract Background: To protect healthcare workers (HCWs) from the consequences of disease due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is necessary to understand the risk factors that drive exposure and infection within hospitals. Insufficient consideration of key socioeconomic variables is a limitation of existing studies that can lead to bias and residual confounding of proposed risk factors for infection.
    Methods: The Co-STARs study prospectively enrolled 3679 HCWs between April 2020 and September 2020. We used multivariate logistic regression to comprehensively characterize the demographic, occupational, socioeconomic, and environmental risk factors for SARS-CoV-2 seropositivity.
    Results: After adjusting for key confounders, relative household overcrowding (odds ratio [OR], 1.4 [95% confidence interval {CI}, 1.1-1.9]; P = .006), Black, Black British, Caribbean, or African ethnicity (OR, 1.7 [95% CI, 1.2-2.3]; P = .003), increasing age (ages 50-60 years: OR, 1.8 [95% CI, 1.3-2.4]; P < .001), lack of access to sick pay (OR, 1.8 [95% CI, 1.3-2.4]; P < .001).
    Conclusions: Socioeconomic and demographic factors outside the hospital were the main drivers of infection and exposure to SARS-CoV-2 during the first wave of the pandemic in an urban pediatric referral hospital. Overcrowding and out-of-hospital SARS-CoV-2 contact are less amenable to intervention. However, lack of access to sick pay among externally contracted staff is more easily rectifiable. Our findings suggest that providing easier access to sick pay would lead to a decrease in SARS-CoV-2 transmission and potentially that of other infectious diseases in hospital settings.
    Clinical trials registration: NCT04380896.
    MeSH term(s) Humans ; Middle Aged ; COVID-19/epidemiology ; Demography ; Health Personnel ; Hospitals ; Prospective Studies ; Risk Factors ; SARS-CoV-2 ; Socioeconomic Factors ; United Kingdom/epidemiology ; Black People ; Caribbean People ; African People
    Language English
    Publishing date 2024-04-01
    Publishing country United States
    Document type Clinical Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciad522
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  4. Article ; Online: Diagnostic pitfalls of urogenital tuberculosis.

    Chandran, Shruthi / Rahman, Ananna / Norris, Joseph M / Tiberi, Simon / Kunst, Heinke

    Tropical medicine & international health : TM & IH

    2021  Volume 26, Issue 7, Page(s) 753–759

    Abstract: Objectives: To describe characteristics, details of diagnosis and outcomes of urogenital tuberculosis (UGTB) in a low-prevalence country.: Methods: We conducted a retrospective observational study of 37 consecutive patients diagnosed with UGTB ... ...

    Abstract Objectives: To describe characteristics, details of diagnosis and outcomes of urogenital tuberculosis (UGTB) in a low-prevalence country.
    Methods: We conducted a retrospective observational study of 37 consecutive patients diagnosed with UGTB between 1
    Results: 68% (25/37) of patients were male and the median age was 42 years (IQR 34-55). 89% (33/37) of patients were born outside the United Kingdom with 65% (24/37) born in the South Asian region. Renal (32.4%), epididymal (24.3%) and endometrial TB (21.6%) were the most prevalent forms of UGTB. Only 13.5% of UGTB patients had concurrent pulmonary TB. The median length of time from symptom onset to treatment was 163 days, while endometrial TB had an average delay to diagnosis of 564 days. Approximately half of patients with UGTB were culture positive (51.4%). However, 70% of early morning urines (EMUs) sent in urinary TB were culture positive. 11 patients (30.6%) underwent two or more invasive procedures, such as biopsy to obtain specimen samples. The mean treatment length for all UGTB cases was 7.3 months (SD 3.1). Notably, 25% of patients with endometrial TB required surgery despite antituberculous treatment.
    Conclusions: UGTB is challenging to diagnose as early disease is often asymptomatic. Clinicians faced with non-specific symptoms, or features suggestive of urogenital malignancy amongst patients from TB-endemic areas, should maintain a high suspicion of UGTB.
    MeSH term(s) Adult ; Biopsy ; Diagnostic Imaging/methods ; Female ; Humans ; London ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Tuberculosis, Urogenital/diagnosis ; Tuberculosis, Urogenital/diagnostic imaging ; Tuberculosis, Urogenital/pathology ; Urinary Tract/diagnostic imaging ; Urinary Tract/microbiology ; Urinary Tract/pathology
    Language English
    Publishing date 2021-05-06
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 1314080-2
    ISSN 1365-3156 ; 1360-2276
    ISSN (online) 1365-3156
    ISSN 1360-2276
    DOI 10.1111/tmi.13583
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    Zs.A 4415: Show issues Location:
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  5. Article ; Online: Community transmission of multidrug-resistant tuberculosis is associated with activity space overlap in Lima, Peru.

    Bui, David P / Chandran, Shruthi S / Oren, Eyal / Brown, Heidi E / Harris, Robin B / Knight, Gwenan M / Grandjean, Louis

    BMC infectious diseases

    2021  Volume 21, Issue 1, Page(s) 275

    Abstract: Background: Transmission of multidrug-resistant tuberculosis (MDRTB) requires spatial proximity between infectious cases and susceptible persons. We assess activity space overlap among MDRTB cases and community controls to identify potential areas of ... ...

    Abstract Background: Transmission of multidrug-resistant tuberculosis (MDRTB) requires spatial proximity between infectious cases and susceptible persons. We assess activity space overlap among MDRTB cases and community controls to identify potential areas of transmission.
    Methods: We enrolled 35 MDRTB cases and 64 TB-free community controls in Lima, Peru. Cases were whole genome sequenced and strain clustering was used as a proxy for transmission. GPS data were gathered from participants over seven days. Kernel density estimation methods were used to construct activity spaces from GPS locations and the utilization distribution overlap index (UDOI) was used to quantify activity space overlap.
    Results: Activity spaces of controls (median = 35.6 km
    Conclusions: Activity space overlap is associated with MDRTB clustering. MDRTB transmission may be occurring in small, overlapping activity spaces in community settings. GPS studies may be useful in identifying new areas of MDRTB transmission.
    MeSH term(s) Adult ; Community-Acquired Infections/epidemiology ; Community-Acquired Infections/transmission ; Female ; Geographic Information Systems ; Humans ; Male ; Middle Aged ; Peru/epidemiology ; Social Networking ; Tuberculosis, Multidrug-Resistant/epidemiology ; Tuberculosis, Multidrug-Resistant/transmission ; Young Adult
    Language English
    Publishing date 2021-03-18
    Publishing country England
    Document type Journal Article
    ISSN 1471-2334
    ISSN (online) 1471-2334
    DOI 10.1186/s12879-021-05953-8
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  6. Article ; Online: Deleterious Effects of Cold Air Inhalation on Coronary Physiological Indices in Patients With Obstructive Coronary Artery Disease.

    Williams, Rupert P / Asrress, Kaleab N / Lumley, Matthew / Arri, Satpal / Patterson, Tiffany / Ellis, Howard / Manou-Stathopoulou, Vasiliki / Macfarlane, Catherine / Chandran, Shruthi / Moschonas, Kostantinos / Oakeshott, Pippa / Lockie, Timothy / Chiribiri, Amedeo / Clapp, Brian / Perera, Divaka / Plein, Sven / Marber, Michael S / Redwood, Simon R

    Journal of the American Heart Association

    2019  Volume 7, Issue 14, Page(s) e008837

    Abstract: Background Cold air inhalation during exercise increases cardiac mortality, but the pathophysiology is unclear. During cold and exercise, dual-sensor intracoronary wires measured coronary microvascular resistance ( MVR ) and blood flow velocity ( CBF ), ... ...

    Abstract Background Cold air inhalation during exercise increases cardiac mortality, but the pathophysiology is unclear. During cold and exercise, dual-sensor intracoronary wires measured coronary microvascular resistance ( MVR ) and blood flow velocity ( CBF ), and cardiac magnetic resonance measured subendocardial perfusion. Methods and Results Forty-two patients (62±9 years) undergoing cardiac catheterization, 32 with obstructive coronary stenoses and 10 without, performed either (1) 5 minutes of cold air inhalation (5°F) or (2) two 5-minute supine-cycling periods: 1 at room temperature and 1 during cold air inhalation (5°F) (randomized order). We compared rest and peak stress MVR , CBF , and subendocardial perfusion measurements. In patients with unobstructed coronary arteries (n=10), cold air inhalation at rest decreased MVR by 6% ( P=0.41), increasing CBF by 20% ( P<0.01). However, in patients with obstructive stenoses (n=10), cold air inhalation at rest increased MVR by 17% ( P<0.01), reducing CBF by 3% ( P=0.85). Consequently, in patients with obstructive stenoses undergoing the cardiac magnetic resonance protocol (n=10), cold air inhalation reduced subendocardial perfusion ( P<0.05). Only patients with obstructive stenoses performed this protocol (n=12). Cycling at room temperature decreased MVR by 29% ( P<0.001) and increased CBF by 61% ( P<0.001). However, cold air inhalation during cycling blunted these adaptations in MVR ( P=0.12) and CBF ( P<0.05), an effect attributable to defective early diastolic CBF acceleration ( P<0.05) and associated with greater ST -segment depression ( P<0.05). Conclusions In patients with obstructive coronary stenoses, cold air inhalation causes deleterious changes in MVR and CBF . These diminish or abolish the normal adaptations during exertion that ordinarily match myocardial blood supply to demand.
    MeSH term(s) Blood Flow Velocity/physiology ; Cardiac Catheterization ; Cold Temperature ; Coronary Angiography ; Coronary Circulation/physiology ; Coronary Stenosis/diagnosis ; Coronary Stenosis/physiopathology ; Coronary Vessels/physiopathology ; Electrocardiography ; Exercise Test/methods ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging, Cine ; Male ; Middle Aged ; Oxygen Consumption/physiology ; Retrospective Studies
    Language English
    Publishing date 2019-02-14
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.118.008837
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  7. Article ; Online: Long-term outcomes of the global tuberculosis and COVID-19 co-infection cohort.

    Casco, Nicolas / Jorge, Alberto Levi / Palmero, Domingo Juan / Alffenaar, Jan-Willem / Fox, Greg J / Ezz, Wafaa / Cho, Jin-Gun / Denholm, Justin / Skrahina, Alena / Solodovnikova, Varvara / Arbex, Marcos Abdo / Alves, Tatiana / Rabahi, Marcelo Fouad / Pereira, Giovana Rodrigues / Sales, Roberta / Silva, Denise Rossato / Saffie, Muntasir M / Salinas, Nadia Escobar / Miranda, Ruth Caamaño /
    Cisterna, Catalina / Concha, Clorinda / Fernandez, Israel / Villalón, Claudia / Vera, Carolina Guajardo / Tapia, Patricia Gallegos / Cancino, Viviana / Carbonell, Monica / Cruz, Arturo / Muñoz, Eduardo / Muñoz, Camila / Navarro, Indira / Pizarro, Rolando / Cristina Sánchez, Gloria Pereira / Vergara Riquelme, Maria Soledad / Vilca, Evelyn / Soto, Aline / Flores, Ximena / Garavagno, Ana / Bahamondes, Martina Hartwig / Merino, Luis Moyano / Pradenas, Ana María / Revillot, Macarena Espinoza / Rodriguez, Patricia / Salinas, Angeles Serrano / Taiba, Carolina / Valdés, Joaquín Farías / Subiabre, Jorge Navarro / Ortega, Carlos / Palma, Sofia / Castillo, Patricia Perez / Pinto, Mónica / Bidegain, Francisco Rivas / Venegas, Margarita / Yucra, Edith / Li, Yang / Cruz, Andres / Guelvez, Beatriz / Victoria Plaza, Regina / Tello Hoyos, Kelly Yoana / Cardoso-Landivar, José / Van Den Boom, Martin / Andréjak, Claire / Blanc, François-Xavier / Dourmane, Samir / Froissart, Antoine / Izadifar, Armine / Rivière, Frédéric / Schlemmer, Frédéric / Manika, Katerina / Diallo, Boubacar Djelo / Hassane-Harouna, Souleymane / Artiles, Norma / Mejia, Licenciada Andrea / Gupta, Nitesh / Ish, Pranav / Mishra, Gyanshankar / Patel, Jigneshkumar M / Singla, Rupak / Udwadia, Zarir F / Alladio, Francesca / Angeli, Fabio / Calcagno, Andrea / Centis, Rosella / Codecasa, Luigi Ruffo / De Lauretis, Angelo / Esposito, Susanna M R / Formenti, Beatrice / Gaviraghi, Alberto / Giacomet, Vania / Goletti, Delia / Gualano, Gina / Matteelli, Alberto / Migliori, Giovanni Battista / Motta, Ilaria / Palmieri, Fabrizio / Pontali, Emanuele / Prestileo, Tullio / Riccardi, Niccolò / Saderi, Laura / Saporiti, Matteo / Sotgiu, Giovanni / Spanevello, Antonio / Stochino, Claudia / Tadolini, Marina / Torre, Alessandro / Villa, Simone / Visca, Dina / Kurhasani, Xhevat / Furjani, Mohammed / Rasheed, Najia / Danila, Edvardas / Diktanas, Saulius / Ridaura, Ruy López / Luna López, Fátima Leticia / Torrico, Marcela Muñoz / Rendon, Adrian / Akkerman, Onno W / Chizaram, Onyeaghala / Al-Abri, Seif / Alyaquobi, Fatma / Althohli, Khalsa / Aguirre, Sarita / Teixeira, Rosarito Coronel / De Egea, Viviana / Irala, Sandra / Medina, Angélica / Sequera, Guillermo / Sosa, Natalia / Vázquez, Fátima / Llanos-Tejada, Félix K / Manga, Selene / Villanueva-Villegas, Renzo / Araujo, David / Sales Marques, Raquel DuarteTânia / Socaci, Adriana / Barkanova, Olga / Bogorodskaya, Maria / Borisov, Sergey / Mariandyshev, Andrei / Kaluzhenina, Anna / Vukicevic, Tatjana Adzic / Stosic, Maja / Beh, Darius / Ng, Deborah / Ong, Catherine W M / Solovic, Ivan / Dheda, Keertan / Gina, Phindile / Caminero, José A / De Souza Galvão, Maria Luiza / Dominguez-Castellano, Angel / García-García, José-María / Pinargote, Israel Molina / Fernandez, Sarai Quirós / Sánchez-Montalvá, Adrián / Huguet, Eva Tabernero / Murguiondo, Miguel Zabaleta / Bart, Pierre-Alexandre / Mazza-Stalder, Jesica / D'Ambrosio, Lia / Kamolwat, Phalin / Bakko, Freya / Barnacle, James / Bird, Sophie / Brown, Annabel / Chandran, Shruthi / Killington, Kieran / Man, Kathy / Papineni, Padmasayee / Ritchie, Flora / Tiberi, Simon / Utjesanovic, Natasa / Zenner, Dominik / Hearn, Jasie L / Heysell, Scott / Young, Laura

    The European respiratory journal

    2023  Volume 62, Issue 5

    Abstract: Background: Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19.: Methods: We collected data from ...

    Abstract Background: Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19.
    Methods: We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both.
    Results: Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19
    Conclusions: In our global cohort, death was the outcome in >10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes.
    MeSH term(s) Humans ; Male ; COVID-19/complications ; HIV Infections/complications ; Coinfection ; Risk Factors ; Tuberculosis, Miliary ; Retrospective Studies
    Language English
    Publishing date 2023-11-29
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639359-7
    ISSN 1399-3003 ; 0903-1936
    ISSN (online) 1399-3003
    ISSN 0903-1936
    DOI 10.1183/13993003.00925-2023
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