Evidence map›Paper›PMID 26176604›Full record

ArticlePloS one2015

High Genotypic Discordance of Concurrent Mycobacterium tuberculosis Isolates from Sputum and Blood of HIV-Infected Individuals.

Willy Ssengooba, Frank G Cobelens, Lydia Nakiyingi, Gerald Mboowa, Derek T Armstrong, Yukari C Manabe, Moses L Joloba, Bouke C de Jong

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Article
  7. Need for caution when interpreting XpertThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2021
    Article
  8. Diversity ofTuberculosis research and treatment · 2021
    Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

Willy SsengoobaDepartment of Medical Microbiology, College of Health Sciences Makerere University, Kampala, Uganda; Department of Global Health and Amsterdam Institute of Global Health and Development, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands; Unit of Mycobacteriology Institute of Tropical Medicine, Antwerp, Belgium.
Frank G CobelensDepartment of Global Health and Amsterdam Institute of Global Health and Development, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands; KNCV Tuberculosis Foundation, The Hague, Netherlands.
Lydia NakiyingiInfectious Diseases Institute, College of Health Sciences Makerere University, Kampala, Uganda.
Gerald MboowaDepartment of Medical Microbiology, College of Health Sciences Makerere University, Kampala, Uganda.
Derek T ArmstrongJohns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Yukari C ManabeInfectious Diseases Institute, College of Health Sciences Makerere University, Kampala, Uganda; Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Moses L JolobaDepartment of Medical Microbiology, College of Health Sciences Makerere University, Kampala, Uganda; Infectious Diseases Institute, College of Health Sciences Makerere University, Kampala, Uganda.
Bouke C de JongUnit of Mycobacteriology Institute of Tropical Medicine, Antwerp, Belgium; Division of Infectious Diseases, New York University, New York, NY, United States of America.
Makerere University · UGJohns Hopkins University · US

Funding

Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Richard E. Chaisson · 2012 to 2026
$67.0M
NIAID NIH HHS P30 AI094189
6 · The paper itself

Abstract

backgroundAmong HIV-infected individuals with CD4 less than 200 cells/mm3, tuberculosis often has an atypical presentation, is more likely to be disseminated and is diagnostically challenging. We sought to understand the genotypic discordance of concurrent sputum and blood M. tuberculosis (MTB) isolates from HIV-infected individuals.

methodsFrom a prospective diagnostic accuracy study with 182 HIV-infected culture-positive TB adults, isolates were obtained from 51 of 66 participants who were MTB culture-positive by both sputum and blood. Isolates were subjected to susceptibility testing to 1st line drugs, spoligotyping and 24 locus- MIRU-VNTR.

resultsThe median age of the participants was 31 (IQR; 27-38) years and 51% were male. The median CD4 count was 29 (IQR; 10-84) cells/mm3 with 20% taking ART; 8.0% were previously treated for TB, and 63% were AFB smear-negative. The isolates belonged to two of the main global MTB-lineages; East-African-Indian (L3) 17 (16.7%) and Euro-American (L4) 85 (83.3%). We identified 26 (51.0%) participants with discordant MTB-genotypes between sputum and blood, including two patients with evidence of mixed infection in either compartment. Having discordant MTB-genotypes was not predicted by the MTB-lineage in either blood or sputum, CD4 cell count, or any other clinical characteristic.

conclusionsThere is a high genotypic discordance among M. tuberculosis concurrently isolated from sputum and blood of HIV-infected individuals. These findings suggest that infection with more than one strain of M. tuberculosis occurs in at least half of patients with advanced HIV infection.

Indexed as

AdultFemaleGenetic VariationGenotypeHIV InfectionsHumansMaleMycobacterium tuberculosisPhylogenySputum

Identifiers

PMID26176604
PMCPMC4503667
OpenAlexW1516446164

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.