Mycobacterium tuberculosis Bacteremia in HIV-negative Patients

Chiu, Yu-Shin; Wang, Jann-Tay; Chang, Shan-Chwen; Tang, Jih‐Luh; Ku, Shih-Chi; Hung, Chien‐Ching; Hsueh, Po-Ren; Chen, Yee‐Chun

doi:10.1016/s0929-6646(09)60320-x

Cited by 13 publications

(9 citation statements)

References 22 publications

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“…Furthermore, anemia and HIV seropositivity have been identified as strong clinical indicators of mycobacteremia [104], [105]. While M. tb bacteremia can occur in both HIV- TB and HIV+ TB patients [106], [107], it is far more common in the latter cases [24], [108]. Host sequestration of iron in the blood is an important mechanism against bacteremia; however, due to the release of iron, persons with hemolytic disorders are more susceptible to bacteremia with pathogens such as Salmonella and Pneumococcus , [94], [109].…”

Section: Resultsmentioning

confidence: 99%

“…While the adaptation to important environments such as the lungs, macrophages and the granuloma have been investigated, scant information is available regarding M. tb adaptation to the hematogenous environment. HIV+ patients are at a significantly enhanced risk for active TB infection and progression, for manifestation of extrapulmonary and systemic forms of TB [10], [16], [17], [18], [19], [20], and for M. tb bacteremia [24], [25], [108], [124]. The enhanced risk for TB arises independently of CD4+ T cell numbers, viral load or antiretroviral treatment, although the degree of risk correlates with immune dysfunction [11], [12], [13], [15], [125], [126].…”

Section: Resultsmentioning

confidence: 99%

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Transcriptional Profiling of Mycobacterium tuberculosis Replicating Ex vivo in Blood from HIV- and HIV+ Subjects

et al. 2014

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Hematogenous dissemination of Mycobacterium tuberculosis (M. tb) occurs during both primary and reactivated tuberculosis (TB). Although hematogenous dissemination occurs in non-HIV TB patients, in ∼80% of these patients, TB manifests exclusively as pulmonary disease. In contrast, extrapulmonary, disseminated, and/or miliary TB is seen in 60–70% of HIV-infected TB patients, suggesting that hematogenous dissemination is likely more common in HIV+ patients. To understand M. tb adaptation to the blood environment during bacteremia, we have studied the transcriptome of M. tb replicating in human whole blood. To investigate if M. tb discriminates between the hematogenous environments of immunocompetent and immunodeficient individuals, we compared the M. tb transcriptional profiles during replication in blood from HIV- and HIV+ donors. Our results demonstrate that M. tb survives and replicates in blood from both HIV- and HIV+ donors and enhances its virulence/pathogenic potential in the hematogenous environment. The M. tb blood-specific transcriptome reflects suppression of dormancy, induction of cell-wall remodeling, alteration in mode of iron acquisition, potential evasion of immune surveillance, and enhanced expression of important virulence factors that drive active M. tb infection and dissemination. These changes are accentuated during bacterial replication in blood from HIV+ patients. Furthermore, the expression of ESAT-6, which participates in dissemination of M. tb from the lungs, is upregulated in M. tb growing in blood, especially during growth in blood from HIV+ patients. Preliminary experiments also demonstrate that ESAT-6 promotes HIV replication in U1 cells. These studies provide evidence, for the first time, that during bacteremia, M. tb can adapt to the blood environment by modifying its transcriptome in a manner indicative of an enhanced-virulence phenotype that favors active infection. Additionally, transcriptional modifications in HIV+ blood may further accentuate M. tb virulence and drive both M. tb and HIV infection.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Transcriptional Profiling of Mycobacterium tuberculosis Replicating Ex vivo in Blood from HIV- and HIV+ Subjects

et al. 2014

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“…Moreover, there is limited information about the epidemiological characteristics of patients who are HIV-negative with M. tuberculosis septic shock. A recent study summarized the demographic and clinical characteristics of 27 cases of TB bacteremia in non-HIV patients reported in the literature [6]. Some case reports describe miliary tuberculosis, acute empyema, or sepsis and multi-organ failure [6-9], but, to the best of our knowledge, the presence of all these conditions in a single patient has never been documented.…”

Section: Discussionmentioning

confidence: 99%

Disseminated tuberculosis presenting with polymorphonuclear effusion and septic shock in an HIV-seropositive patient: a case report

et al. 2010

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IntroductionBecause a substantial number of patients present with few or atypical symptoms, the recognition of tuberculosis remains challenging. Disseminated tuberculosis presenting with septic shock has already been described in some case reports, but, to the best of our knowledge, it has never been associated with polymorphonuclear effusion.Case presentationWe describe the case of a 27-year-old man from western Africa who was seropositive for human immunodeficiency virus. He presented with pleural and abdominal polymorphonuclear effusions and quickly developed septic shock due to disseminated Mycobacterium tuberculosis infection leading to multiple organ failure and death.ConclusionIn high-risk patients, Mycobacterium tuberculosis infection should be considered even in exceptional clinical presentations, such as septic shock and polymorphonuclear effusions.

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“…The reason for this could be the short period of time (four months) during which the dog and tuberculosis-infected owner were in close contact. M. tuberculosis is usually present for only a short period in the blood and its persistence is associated with HIV/AIDS infection in humans (Chiu et al, 2007). In our case, the presence of M. tuberculosis in the blood could be caused by weakened immunity of the dog resulting from the adenocarcinoma, which was histopathologically diagnosed.…”

Section: Discussionmentioning

confidence: 66%

Human-to-human and human-to-dog Mycobacterium tuberculosis transmission studied by IS6110 RFLP analysis: a case report

Morávková¹,

Slaný²,

Trcka³

et al. 2011

Vet. Med. - Czech

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Mycobacterium tuberculosis Bacteremia in HIV-negative Patients

Cited by 13 publications

References 22 publications

Transcriptional Profiling of Mycobacterium tuberculosis Replicating Ex vivo in Blood from HIV- and HIV+ Subjects

Transcriptional Profiling of Mycobacterium tuberculosis Replicating Ex vivo in Blood from HIV- and HIV+ Subjects

Disseminated tuberculosis presenting with polymorphonuclear effusion and septic shock in an HIV-seropositive patient: a case report

Human-to-human and human-to-dog Mycobacterium tuberculosis transmission studied by IS6110 RFLP analysis: a case report

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