COVID‐19 in Tuberculosis patients: a report of three cases

The clinical features and treatment of pulmonary tuberculosis patients with COVID‐19 is unclear and understudied. Here, three pulmonary tuberculosis patients with COVID‐19 infection were prospectively followed from hospital admission to discharge. We provide information and experience with treatment of pulmonary tuberculosis cases with confirmed COVID‐19 infection

Evaluation of WHO catalog of mutations and five WGS analysis tools for drug resistance prediction of Mycobacterium tuberculosis isolates from China

ABSTRACT The continuous advancement of molecular diagnostic techniques, particularly whole-genome sequencing (WGS), has greatly facilitated the early diagnosis of drug-resistant tuberculosis patients. Nonetheless, the interpretation of results from various types of mutations in drug-resistant-associated genes has become the primary challenge in the field of molecular drug-resistance diagnostics. In this study, our primary objective is to evaluate the diagnosis accuracy of the World Health Organization (WHO) catalog of mutations and five WGS analysis tools (PhyResSE, Mykrobe, TB Profiler, Gen-TB, and SAM-TB) in drug resistance to 10 anti-Mycobacterium tuberculosis (MTB) drugs. We utilized the data of WGS collected between 2014 and 2017 in Zhejiang Province, consisting of 110 MTB isolates as detailed in our previous study. Based on phenotypic drug susceptibility testing (DST) results using the proportion method on Löwenstein-Jensen medium with antibiotics, we evaluated the predictive accuracy of genotypic DST obtained by these tools. The results revealed that the WHO catalog of mutations and five WGS analysis tools exhibit robust predictive capabilities concerning resistance to isoniazid, rifampicin, ethambutol, streptomycin, amikacin, kanamycin, and capreomycin. Notably, Mykrobe, SAM-TB, and TB Profiler demonstrate the most accurate predictions for resistance to pyrazinamide, prothionamide, and para-aminosalicylic acid, respectively. These findings are poised to significantly guide and influence future clinical treatment strategies and resistance monitoring protocols.IMPORTANCEWhole-genome sequencing (WGS) has the potential for the early diagnosis of drug-resistant tuberculosis. However, the interpretation of mutations of drug-resistant-associated genes represents a significant challenge as the amount and complexity of WGS data. We evaluated the accuracy of the World Health Organization catalog of mutations and five WGS analysis tools in predicting drug resistance to first-line and second-line anti-TB drugs. Our results offer clinicians guidance on selecting appropriate WGS analysis tools for predicting resistance to specific anti-TB drugs

Mutual Regulation of ntcA and hetR during Heterocyst Differentiation Requires Two Similar PP2C-Type Protein Phosphatases, PrpJ1 and PrpJ2, in Anabaena sp. Strain PCC 7120 ▿

The filamentous cyanobacterium Anabaena sp. strain PCC 7120 can form heterocysts for N2 fixation. Initiation of heterocyst differentiation depends on mutual regulation of ntcA and hetR. Control of hetR expression by NtcA is partially mediated by nrrA, but other factors must be involved in this regulation. Anabaena has two closely related PP2C-type protein phosphatases, PrpJ1 (formerly PrpJ) and PrpJ2; PrpJ1 is involved in heterocyst maturation. In this study, we show that PrpJ2, like PrpJ1, has Mn2+-dependent phosphatase activity. We further demonstrate that whereas prpJ2 is dispensable for cell growth under different nitrogen regimens tested, a double mutant with both prpJ1 and prpJ2 disrupted did not initiate heterocyst differentiation. Ectopic expression of hetR in the double mutant could rescue the failure to initiate heterocyst development, but the heterocysts formed, like those of a prpJ1 single mutant, were not mature. The expression of prpJ2 was enhanced during heterocyst development, and the upregulation of the gene was directly under the control of NtcA. Upregulation of both ntcA and hetR was affected in the double mutant. We propose that PrpJ1 and PrpJ2 together are required for mutual regulation of ntcA and hetR and are thus involved in regulation of the initiation of heterocyst differentiation

Application Value of SAT-TB Combined with Acid-Fast Staining in the Diagnosis and Treatment of Pulmonary Tuberculosis

Objectives. This study is aimed at evaluating the clinical application value of RNA simultaneous amplification and testing method for Mycobacterium tuberculosis (SAT-TB) combined with acid-fast staining in the diagnosis and treatment of pulmonary tuberculosis (PTB). Methods. This paper included 168 suspected and confirmed PTB sufferers admitted to The Sixth People’s Hospital of Wenzhou from December 2018 to December 2019, whose sputum was collected and tested using SAT-TB, smear acid-fast staining method, and the BACTEC MGIT 960 system. With the MGIT 960 culture test method as the gold standard, the application value of SAT-TB, acid-fast staining, or SAT-TB combined with acid-fast staining in the diagnosis and treatment of PTB was assessed. Results. With the MGIT 960 culture as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of SAT-TB for the diagnosis of PTB were 57.3%, 92.5%, 84.3%, and 73.5%, respectively. The conformity was 76.8%, and the Kappa value was 0.515, suggesting a statistically significant difference (χ2=7.314, p0.05) and a relatively high consistency degree. Conclusion. SAT-TB combined with acid-fast staining had a similar detection rate to that of the MGIT 960 culture test with a high consistency degree, which could be applied in the diagnosis of PTB efficiently and accurately

Randomized control study of the use of faropenem for treating patients with pulmonary tuberculosis

ABSTRACT: Objectives: Faropenem has antituberculosis activity in vitro but its utility in treating patients with tuberculosis (TB) is unclear. Methods: We conducted an open-label, randomized trial in China, involving newly diagnosed, drug-susceptible pulmonary TB. The control group was treated with the standard 6-month regimen. The experimental group replaced ethambutol with faropenem for 2 months. The primary outcome was the treatment success rate after 6 months of treatment. Noninferiority was confirmed if the lower limit of a 95% one-sided confidence interval (CI) of the difference was greater than −10%. Results: A total of 227 patients eligible for the study were enrolled in the trial group and the control group in a ratio of 1:1. Baseline characteristics of participants were similar in both groups. In the modified intention-to-treat population, 88.18% of patients in the faropenem group achieved treatment success, and 85.98% of those in the control group were successfully treated, with a difference of 2.2% (95% CI, −6.73-11.13). In the per-protocol population, treatment success was 96.04% in the faropenem group and 95.83% in the control group, with a difference of 2.1% (95% CI, −5.31-5.72). The faropenem group showed noninferiority to the control group in the 6-month treatment success rates. The faropenem group had significantly fewer adverse events (P <0.01). Conclusions: Our study proved that oral faropenem regimen can be used for the treatment of TB, with fewer adverse events. (Chinese Clinical Trial Registry, ChiCTR1800015959)

Enhancement of edge turbulence concomitant with ELM suppression during boron powder injection in EAST

Data supporting the manuscript "Enhancement of edge turbulence concomitant with ELM suppression during boron powder injection in EAST" published in Plasma of Physics, 2021.The dataset includes the data shown in the figures of the accepted paper [Z. Sun et al, 2021, Plasma of Physics]

Integrated ELM and divertor power flux control using RMPs with low input torque in EAST in support of the ITER research plan

Experiments have been carried out at the EAST tokamak to study ITER-relevant scenario integration issues, related to edge localized mode (ELM) control in H-mode plasmas by the application of three-dimensional (3D) resonant magnetic perturbations (RMPs), which have a large impact on the execution of the ITER research plan. The EAST experiments have successfully demonstrated ELM suppression at normalized torque inputs similar to ITER. The application of RMP fields with high toroidal mode number (n = 4) reduces the impact of ELM control on energy and particle confinement compared to those use lower n (n = 1, 2) RMPs. Injection of successive pellets is found to be effective in increasing the plasma density in ELM-suppressed H-modes and reducing the divertor power without triggering large ELMs at EAST. Access to high recycling and radiative divertor conditions while maintaining ELM suppression has been demonstrated in EAST by the use of gas fuelling and neon impurity seeding. Both approaches have been found to be effective in reducing power fluxes to the divertor strike points in near-separatrix lobes for both n = 2 and n = 4 RMPs. However, reduction of power fluxes in off-separatrix lobes is only effective for n = 4 RMP application, which is consistent with magnetic topology modelling (including plasma response) results showing a shallow penetration into the confined plasma region of field lines connected to these lobes compared to n = 2. The EAST results support the use of high n 3D fields for ELM suppression in ITER high QDT scenarios since they provide optimum integration features regarding energy and particle confinement, pellet fuelling, radiative divertor operation while eliminating ELM transient power loads and being compatible with low torque inpu