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Cough-independent production of viable Mycobacterium tuberculosis in bioaerosol
Tuberculosis ( IF 3.2 ) Pub Date : 2021-01-01 , DOI: 10.1016/j.tube.2020.102038
Benjamin Patterson 1 , Wayne Bryden 2 , Charles Call 2 , Andrea McKerry 3 , Bryan Leonard 3 , Ronnett Seldon 3 , Melitta Gqada 3 , Ryan Dinkele 4 , Sophia Gessner 4 , Digby F Warner 5 , Robin Wood 6
Affiliation  

BACKGROUND Symptoms of infectious respiratory illnesses are often assumed to drive transmission. However, production and release of Mycobacterium tuberculosis (Mtb) bioaerosols is poorly understood. We report quantitation of Mtb exhaled during specific respiratory manoeuvres. METHODS Direct capture of nascent bioaerosol particles and indirect collection of aged particles was performed in 10 healthy subjects. Indirect and direct capture of exhaled viable Mtb bacilli was compared in 38 PTB patients and directly captured viable Mtb during cough and bronchiole-burst manoeuvres in 27 of the PTB patients. RESULTS Direct sampling of healthy subjects captured larger bioaerosol volumes with higher proportions of 2-5 μm particles than indirect sampling. Indirect sampling identified viable Mtb in 92.1% (35 of 38) of PTB patients during 60-min relaxed breathing, median bacillary count 7.5 (IQR: 3.25-19). Direct sampling for 10-min identified Mtb in 97.4% (37 of 38) of PTB patients with higher bacilli counts (p < 0.001), median 24.5 (IQR:11.25-37.5). A short 5-min sampling regimen of 10 coughs or 10 bronchiole-burst manoeuvres yielded a median of 11 (IQR: 4-17) and 11 (IQR: 7-17.5) Mtb bacilli, respectively (p = 0.53). CONCLUSIONS Peripheral lung bioaerosol released through deep exhalations alone contained viable Mtb suggesting non-cough transmission is possible in PTB.

中文翻译:

在生物气溶胶中不依赖咳嗽产生活的结核分枝杆菌

背景传染性呼吸道疾病的症状通常被认为是推动传播的原因。然而,人们对结核分枝杆菌 (Mtb) 生物气溶胶的产生和释放知之甚少。我们报告了特定呼吸动作期间呼出的 Mtb 的定量。方法 在 10 名健康受试者中进行了新生生物气溶胶颗粒的直接捕获和老化颗粒的间接收集。在 38 名 PTB 患者中对呼出的活 Mtb 杆菌的间接和直接捕获进行了比较,并在 27 名 PTB 患者的咳嗽和细支气管爆裂操作期间直接捕获了活 Mtb。结果 与间接采样相比,健康受试者的直接采样捕获了更大的生物气溶胶体积和更高比例的 2-5 μm 颗粒。间接抽样在 92 中确定了可行的 Mtb。在 60 分钟放松呼吸期间,1%(38 名中的 35 名)的 PTB 患者,细菌计数中位数为 7.5(IQR:3.25-19)。在 97.4%(38 名中的 37 名)具有较高杆菌计数(p < 0.001),中位数 24.5(IQR:11.25-37.5)的 PTB 患者中,10 分钟的直接采样确定了 Mtb。10 次咳嗽或 10 次细支气管爆裂动作的 5 分钟短采样方案产生的 Mtb 杆菌中位数分别为 11(IQR:4-17)和 11(IQR:7-17.5)(p = 0.53)。结论 仅通过深呼气释放的外周肺生物气溶胶含有活的 Mtb,表明 PTB 中可能存在非咳嗽传播。10 次咳嗽或 10 次细支气管爆裂动作的 5 分钟短采样方案产生的 Mtb 杆菌中位数分别为 11(IQR:4-17)和 11(IQR:7-17.5)(p = 0.53)。结论 仅通过深呼气释放的外周肺生物气溶胶含有活的 Mtb,表明 PTB 中可能存在非咳嗽传播。10 次咳嗽或 10 次细支气管爆裂动作的 5 分钟短采样方案产生的 Mtb 杆菌中位数分别为 11(IQR:4-17)和 11(IQR:7-17.5)(p = 0.53)。结论 仅通过深呼气释放的外周肺生物气溶胶含有活的 Mtb,表明 PTB 中可能存在非咳嗽传播。
更新日期:2021-01-01
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