Bhattacharya, D.B.

Chauhan, D.

Couvin, D.

Katoch, M.D.K.

Katoch, V.M.

Kumar, P.

Lakshmi, D.

Rastogi, D.N.

Rodrigues, C.

Sankar, M.

Singh, D.

Singh, J.

Singh, S.

Swaminathan, S.

Taori, D.G.

International Journal of Infectious Diseases

Elsevier - Publisher Connector 

412 17th International Congress on Infectious Diseases / International Journal of Infectious Diseases 45S (2016) 1–477
Type: Poster Presentation
Final Abstract Number: 43.141
Session: Poster Session III
Date: Saturday, March 5, 2016
Time: 12:45-14:15
Room: Hall 3 (Posters & Exhibition)
Prevalence and predictors of tuberculosis
among adults with newly diagnosed HIV/AIDS
Y. Shen1,∗, H. Lu2
1 Shanghai Public Health Clinical Center, Fudan
University, Shanghai, Shanghai, China
2 Shanghai Public Health Clinical Center, Fudan
University , Shanghai, China
Background: Tuberculosis and HIV co-infection not only
presents a challenge in diagnosis and therapy but also constitutes
a high burden on healthcare systems. A survey was designed to
study the prevalence of and risk factors for tuberculosis among
antiretroviral-naive HIV-infected adults.
Methods & Materials: A cross-sectional study was conducted
among 2866 HIV patients from 10 provinces in China during
2009 to 2010. Clinical and laboratory investigations including
chest X-ray, acid fast staining and culture were used to identify
tuberculosis cases. Blood samples were collected to determine
CD4+ lymphocyte count. A structured questionnaire was used to
collect socio-demographic characteristics of study subjects. Fac-
tors associated with the presence of tuberculosis were analysed
by logistic regression.
Results: Among the2866patients, 75.3%weremale.Median age
was 40 years. 29.8% had tuberculosis, 23.0%
had pulmonary tuberculosis and 11.9% had extrapulmonary
tuberculosis. The prevalences of smear-positive pulmonary tuber-
culosis and of culture-positive pulmonary tuberculosis were
11.8% and 17.2% , respectively. Tuberculosis was more prevalent
among men, ethnic minority patients, patients with CD4 count of
<200/mm3, andpatientswhowere<50yearsof age. Theprevalence
of tuberculosis differed signiﬁcantly according to province and HIV
transmission route. Tuberculosis was more common in patients
with fever, cough,night sweats, fatigue,weight loss, lossof appetite,
abnormal pulmonary imaging ﬁndings, and history of tuberculo-
sis. In multivariate analysis, having been diagnosed in provinces
Henan (OR=46.863), Jiangxi (OR=8.103), Shanghai (OR=2.273)
and Xinjiang(OR=25.451), male sex (OR=1.333), ethnic minority
(OR=1.620), lower CD4 count (OR=1.382), abnormal pulmonary
imaging (OR=3.539), fever (OR=3.947), cough (OR=2.223), night
sweats (OR=4.461), weight loss (OR=1.830), and history of tuber-
culosis (OR=3.712) were associated with increased adjusted odds
of tuberculosis among HIV patients.
Conclusion: Tuberculosis is highly prevalent among Chinese
adults with newly diagnosed HIV/AIDS. Geographical areas, male
sex, ethnicminority, lower CD4 count, having abnormal pulmonary
imaging ﬁndings, history of tuberculosis, and presenting with non-
speciﬁc symptoms including fever, cough, night sweats or weight
loss were found to be the predicting factors for tuberculosis among
HIV-infected patients.
http://dx.doi.org/10.1016/j.ijid.2016.02.879
Type: Poster Presentation
Final Abstract Number: 43.142
Session: Poster Session III
Date: Saturday, March 5, 2016
Time: 12:45-14:15
Room: Hall 3 (Posters & Exhibition)
Molecular characterization of mycobacterium
tuberculosis strains isolated in India
J. Singh1,∗, P. Kumar2, M. Sankar3, S. Singh2, D.
Couvin4, D.N. Rastogi5, V.M. Katoch6, D.
Chauhan7, M.D.K. Katoch8, C. Rodrigues9, D.
Lakshmi10, D.G. Taori11, D.B. Bhattacharya12, D.
Singh13, S. Swaminathan14
1 All India Institute Of Medical Sciences, New Delhi,
New Delhi, India
2 All India Institute of Medical Sciences, New Delhi,
India
3 All India Institute of Medical Sciences, New Delhi,
Delhi, India
4 CIRAD, Montpellier, France
5 Institute Pasteur de la Guadeloupe, Abymes, France
6 Secretary to Govt.of India, New Delhi-, Delhi, India
7 National JALMA Institute for Leprosy & Other
Mycobacterial Diseases, Agra, UP, India
8 National JALMA Institute for Leprosy & Other
Mycobacterial Diseases, Tajganj, Agra 282001, Agra,
India
9 P. D. Hinduja National Hospital & Medical Research
Centre, Mumbai, India
10 Nizam’s Institute of Medical Sciences, Hyderabad,
India
11 Central India Institute of Medical Sciences,
Nagpur, India
12 IPGME&R, Kolkata, India
13 National Institute of TB and Respiratory Diseases,
New Delhi, India
14 National Institute for Research in Tuberculosis
(ICMR), Chennai, India
Background: Genotypic analyses of Mycobacterium tuberculosis
are essential inunderstanding its epidemiologyand transmission in
a region. Spoligotypingand24LociMIRU-VNTRarewidelyusedPCR
based rapidmethods for genotypingM. tuberculosis complex (MTB)
strains. Only few in-depth analyses of the population structure of
MTB is known from India. In this study we executed genotyping of
M. tuberculosis complex clinical isolates fromdifferent geographical
regions of India.
Methods & Materials: A total of 628 M. tuberculosis iso-
lates were collected from 9 different locations of India viz: New
Delhi (n=64,10.2%); Agra (n=59,9.4%); Punjab (n=61,9.7%); Mum-
bai (n=112,17.8%); Nagpur (n=52,8.3%); Hyderabad (n=94,15%);
Chennai (n=50,8%); Kolkata (n=75,12%), and Assam (n=61,9.7%). All
the isolates were subjected to Spoligotyping and 24 loci MIRU-
VNTR and their patterns were analysed using SIT VIT WEB2 and
MIRU-VNTR plus respectively. Clustering and diversity analysis
(Huner-Gaston Diversity Index) were also performed.
Results: Spoligotyping analysis detected 102 distinct spoligo-
patterns. A total of 536(85.3%) isolates couldbegrouped into85SITs
which matched the pre-existing database. For 34(5.4%) ungrouped
isolates 17 new SITs were created, and for the remaining 58(9.2%)
isolates no SIT number could be ascertained and thesewere consid-
17th International Congress on Infectious Diseases / International Journal of Infectious Diseases 45S (2016) 1–477 413
ered as ‘orphan’. All the 58 orphan strains were analysed using 24
loci MIRU-VNTR and appropriate genotypes were identiﬁed. Over-
all using both techniques, CAS familywas predominant, comprising
of 253(40.3%) isolates, followed by EAI in 172(27.4%), Beijing in
110(17.5%), Manu in 41(6.5%), T in 31(4.9%), H in 11(1.8%), X in 4
(0.6%), Africanum in 4(0.6%) andUral in one. Using theHuntereGas-
ton diversity index (HGI), the allelic diversity of the loci MIRU10,
MIRU 16, MIRU 23, MIRU27, MIRU31, Mtub04, Mtub21, Mtub30,
QUB11b, QUB26 and QUB4156 were highly discriminant.
Conclusion: CAS was most predominant in Northern and west-
ernpartsof Indiaviz:Agra,Delhi, Punjab,Mumbai andNagpurwhile
EAIwaspredominant in Chennai, Hyderabad.Highest prevalence of
Beijing was found in Assam and Kolkata. Our data clearly demarks
theprevalenceof speciﬁcM. tuberculosisgenotypesamongdifferent
geographical regions.
The authors like to thank Dr. Rajpal Singh, Dr. HF Daginawala,
Dr. Bandana Choudhury and Dr. Uma Devi for providing the MTB
isolates.
http://dx.doi.org/10.1016/j.ijid.2016.02.880
Type: Poster Presentation
Final Abstract Number: 43.143
Session: Poster Session III
Date: Saturday, March 5, 2016
Time: 12:45-14:15
Room: Hall 3 (Posters & Exhibition)
Interleukin-6: a potential biomarker of the
success of tuberculosis treatment
P.P. Singh
NATIONAL INSTITUTE OF PHARMACEUTICAL
EDUCATION AND RESEARCH, Mohali, PUNJAB, India
Background: The present measure of the success of TB
treatment is fraught with problems. A cytokine biomarker(s), a
qualitative and quantitative reﬂection of the treatment success,
is thus warranted. Because TB treatment is expected to affect
macrophage and mycobacteria interactions and, consequently
cytokine(s) elaboration, a biomarker(s) seems crucial to assess its
success.
Methods & Materials: We studied the effect of anti-TB drugs
isoniazid (INH), rifampicin (RIF), streptomycin (STP) and ethambu-
tol (EMB) on IL-1, IL-6, IL-10, IL-12 p40 and IL-12 p70 elaboration
by mouse peritoneal macrophages (PMs) infected with M. tuber-
culosis H37Rv for 6 h, 24 h, 4 days and 7 days, in vitro, by using a
multiplex suspension cytokine array system.
Results: INH, at 6 h, at 0.4g/ml (MIC: 0.2g/ml) and not at 0.1
and 0.2 g/ml, and at 24 h and on D 4 and D 7, at all the tested
concentrations, signiﬁcantly (p <0.001) suppressed IL-6 elabora-
tion. RIF, at 6 h, lacked any effect on IL-6 elaboration at 0.4 g/ml
(MIC: 0.8g/ml), whereas at 0.8 and 1.6g/ml, and at all the tested
concentrations at 24 h and on D 4 and D 7, signiﬁcantly (p <0.001)
inhibited IL-6 elaboration. STP, at all the time-points, at 2.5 g/ml
(MIC: 5 g/ml), lacked any effect on IL-6 elaboration; however, at
5 and 10 g/ml it caused signiﬁcant (p <0.001) inhibition. Surpris-
ingly, EMB at 4, 8 and 16 g/ml (MIC: 8 g/ml) suppressed IL-6
elaboration at all the time-points studied. M. tuberculosis-infected
untreated controls, in contrast to the uninfected ones, irrespective
of the time-points, elaborated signiﬁcantly (p <0.001) high con-
centrations of IL-6 (infected controls, 365±30.41–777.5±74.45
pg/ml; uninfected controls, 15.25±1.77–21±1.41 pg/ml) only.
Curiously, all the other cytokines (IL-1, IL-10, IL-12 p40 and IL-12
p70) were unaffected by the drug treatments.
Conclusion: M. tuberculosis -infected PMs, in vitro, elaborated
IL-6 as the only major cytokine, which was signiﬁcantly inhibited
by anti-TB drugs. Therefore, IL-6 can be developed as a potential
biomarker or biosignature to assess the success of the treatment of
TB.
http://dx.doi.org/10.1016/j.ijid.2016.02.881
Type: Poster Presentation
Final Abstract Number: 43.144
Session: Poster Session III
Date: Saturday, March 5, 2016
Time: 12:45-14:15
Room: Hall 3 (Posters & Exhibition)
Diagnosis of human tuberculosis: identiﬁcation
of new biomarker(s) and biosignature(s)
P.P. Singh1,∗, S. Sinha2, M. Goyal2
1 NATIONAL INSTITUTE OF PHARMACEUTICAL
EDUCATION AND RESEARCH, Mohali, PUNJAB, India
2 All India Institute of Medical Sciences, New Delhi,
India
Background: Globally, human tuberculosis (TB), continues to
be one of the deadliest public health problem, despite some recent
ground success. According to Global TB Report 2014 World over,
TB is showing a gradual declining trend, and during the period
2000 to 2013, an estimated 37 million lives were saved largely
due to improvements in its diagnosis and treatment. Nevertheless,
because deaths due to TB are considered preventable, it is only nec-
essary that work must continue to further improve on both these
fronts. TB is a chronic inﬂammatory disease caused by the faculta-
tive intra-macrophage pathogen Mycobacterium tuberculosis, and
their resultant interaction is known to elaborate a wide array of
cytokines (stand-alone as biomarkers, and as a group, as biosig-
natures), which, in turn, are believed to be the reﬂection of the
diseases progression and its status at a particular point in time.
Methods & Materials: We, thus studied the serum levels of
interleukin-2 (IL-2), IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-
 (TNF-), GM-CSF and interferon- (IFN-) in TB patients, at Day
0, after one month, and after six month, by using a multiplex (Bio-
plex) suspension cytokine array. The standard curves for all the
cytokines were generated as per the protocol of the supplier.
Results: Results showed that after six month, only IL-2, IL-4, IL-
6, IL-8, TNF-, GM-CSF and IFN- showed a major increase; IL-10
showed the least increase only in a fewpatients. On the other hand,
IL-6, IL-8 and GM-CSF showed amaximum increase (IL-6, 140-fold;
IL-8, 180-fold;GM-CSF, 140-fold). The remaining cytokines showed
relatively lesser increase (IL-4, 1.1-fold; IL-10, 5-fold; IFN-, 80-fold
and TNF-, 65-fold).
Conclusion:We conclude that as stand-alone IL-6, IL-8 andGM-
CSF may function as potential biomarkers or together, as a group,
may be considered as a biosignature for the diagnosis of TB.
http://dx.doi.org/10.1016/j.ijid.2016.02.882


Molecular characterization of mycobacterium tuberculosis strains isolated in India 

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Molecular characterization of mycobacterium tuberculosis strains isolated in India

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