ArticleNature medicine2020
Bacterial and host determinants of cough aerosol culture positivity in patients with drug-resistant versus drug-susceptible tuberculosis.
Article in Nature medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effects of Respiratory Isolation for Tuberculosis to Reduce Community-based Transmission: A Systematic Review.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Pooled it
- Outlook for CRISPR-based tuberculosis assays now in their infancy.Frontiers in immunology · 2023Pooled it
- Comparison of two diagnostic intervention packages for community-based active case finding for tuberculosis: an open-label randomized controlled trial.Nature medicine · 2023Trial
- Predictors of culture status in patients with persistent smear-positive pulmonary tuberculosis at two months of treatment.BMC infectious diseases · 2026Article
- Risk factors and prediction modeling for drug-resistant tuberculosis in Shenzhen: a 9-year retrospective study.Frontiers in public health · 2026Article
- Molecular Epidemiology ofMicroorganisms · 2025Review
- Detection of AerosolizedOpen forum infectious diseases · 2025Article
- Sensitive pathogen DNA detection by a multi-guide RNA Cas12a assay favoring trans- versus cis-cleavage.Nature communications · 2025Article
- AveloMask, a novel breath aerosol collection kit for airborneJournal of clinical microbiology · 2025Article
- Overview of the Epidemiology, Diagnosis, and Clinical Care Considerations for People Living with and at Risk for Tuberculosis in the United States.The Nursing clinics of North America · 2025Review
- Dynamic of infectious aerosols generated by cough from patients with pulmonary tuberculosis.Journal of aerosol science · 2025Article
- Community-Based Tuberculosis Isolation Decisions Require Individualization Based on Effectiveness and Duration of Treatment, Community Risks, and Patient Harms.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Quantification of tuberculosis exposure in a high-burdened setting.Scientific reports · 2025Article
- Differentially culturableJournal of medical microbiology · 2025Article
- Candidate transmission survival genome ofProceedings of the National Academy of Sciences of the United States of America · 2025Article
- Pulmonary Tuberculosis Infectiousness of Persons Identified Through Active and Passive Case-finding in a High-burden Setting.Open forum infectious diseases · 2025Article
- Assessing Infectiousness and the Impact of Effective Treatment to Guide Isolation Recommendations for People With Pulmonary Tuberculosis.The Journal of infectious diseases · 2025Review
- Viewpoint on WHO implementation guidance on tuberculosis infection prevention and control.The European respiratory journal · 2024Article
- Community-Wide Active Case Finding for Tuberculosis: Time to Use the Evidence We Have.Tropical medicine and infectious disease · 2024Review
- Mycobacterium tuberculosis cough aerosol culture status associates with host characteristics and inflammatory profiles.Nature communications · 2024Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
A burgeoning epidemic of drug-resistant tuberculosis (TB) threatens to derail global control efforts. Although the mechanisms remain poorly clarified, drug-resistant strains are widely believed to be less infectious than drug-susceptible strains. Consequently, we hypothesized that lower proportions of patients with drug-resistant TB would have culturable Mycobacterium tuberculosis from respirable, cough-generated aerosols compared to patients with drug-susceptible TB, and that multiple factors, including mycobacterial genomic variation, would predict culturable cough aerosol production. We enumerated the colony forming units in aerosols (≤10 µm) from 452 patients with TB (227 with drug resistance), compared clinical characteristics, and performed mycobacterial whole-genome sequencing, dormancy phenotyping and drug-susceptibility analyses on M. tuberculosis from sputum. After considering treatment duration, we found that almost half of the patients with drug-resistant TB were cough aerosol culture-positive. Surprisingly, neither mycobacterial genomic variants, lineage, nor dormancy status predicted cough aerosol culture positivity. However, mycobacterial sputum bacillary load and clinical characteristics, including a lower symptom score and stronger cough, were strongly predictive, thereby supporting targeted transmission-limiting interventions. Effective treatment largely abrogated cough aerosol culture positivity; however, this was not always rapid. These data question current paradigms, inform public health strategies and suggest the need to redirect TB transmission-associated research efforts toward host-pathogen interactions.
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Registered trials
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.