Transmission of Mycobacterium tuberculosis From Patients Who Are Nucleic Acid Amplification Test Negative

Yingda L. Xie, Wendy A. Cronin, Michael Proschan, Richard Oatis, Silvia Cohn, Scott R. Curry, Jonathan E Golub, Clifton E. Barry, Susan E. Dorman

Research output: Contribution to journalArticle

Abstract

Background: Among adults with signs and symptoms of pulmonary tuberculosis (TB), recognition of transmissible TB has implications for airborne infection isolation and public health activities. Sputum smear-negative TB patients account for around one-fifth of tuberculosis transmission. The tuberculosis transmission risk of TB patients with negative results on nucleic acid amplification test (NAAT) of respiratory specimens has not been established. We sought to estimate the tuberculosis transmission risk of NAAT-negative TB patients. Methods: We retrospectively reviewed Maryland TB program data collected from 2004 to 2009, during which time NAAT using the Mycobacterium Tuberculosis Direct Test (MTD) was performed routinely. Patients with sputum Mycobacterium tuberculosis (M.tb) isolates having matching genotypes were assigned to clusters. Transmission sequence was approximated by collection order of individuals' first culture-positive specimens. Minimum transmission risks of NAAT (MTD)-negative TB patients and of smear-negative TB patients were estimated based on individuals' positions within clusters. Results: Among 809 patients with culture-confirmed TB, M.tb genotypes were available for 782 (96.7%). For NAA-negative TB patients, the minimum transmission risk estimate was 5.1% (95% CI 0-11.4). For smear-negative TB patients, the minimum transmission risk estimate was 11.2% (95% CI 7.2-15.3). Conclusions: Minimum transmission risk of NAAT-negative TB patients was lower than that of smear-negative TB patients. However, transmission risk of NAA-negative TB patients appears to not be negligible.

Original languageEnglish (US)
Pages (from-to)1653-1659
Number of pages7
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume67
Issue number11
DOIs
StatePublished - Nov 13 2018

Fingerprint

Nucleic Acid Amplification Techniques
Mycobacterium tuberculosis
Tuberculosis
Sputum
Genotype

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Transmission of Mycobacterium tuberculosis From Patients Who Are Nucleic Acid Amplification Test Negative. / Xie, Yingda L.; Cronin, Wendy A.; Proschan, Michael; Oatis, Richard; Cohn, Silvia; Curry, Scott R.; Golub, Jonathan E; Barry, Clifton E.; Dorman, Susan E.

In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol. 67, No. 11, 13.11.2018, p. 1653-1659.

Research output: Contribution to journalArticle

Xie, Yingda L. ; Cronin, Wendy A. ; Proschan, Michael ; Oatis, Richard ; Cohn, Silvia ; Curry, Scott R. ; Golub, Jonathan E ; Barry, Clifton E. ; Dorman, Susan E. / Transmission of Mycobacterium tuberculosis From Patients Who Are Nucleic Acid Amplification Test Negative. In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2018 ; Vol. 67, No. 11. pp. 1653-1659.
@article{767df41879cc40faa4b9b0af41e6299c,
title = "Transmission of Mycobacterium tuberculosis From Patients Who Are Nucleic Acid Amplification Test Negative",
abstract = "Background: Among adults with signs and symptoms of pulmonary tuberculosis (TB), recognition of transmissible TB has implications for airborne infection isolation and public health activities. Sputum smear-negative TB patients account for around one-fifth of tuberculosis transmission. The tuberculosis transmission risk of TB patients with negative results on nucleic acid amplification test (NAAT) of respiratory specimens has not been established. We sought to estimate the tuberculosis transmission risk of NAAT-negative TB patients. Methods: We retrospectively reviewed Maryland TB program data collected from 2004 to 2009, during which time NAAT using the Mycobacterium Tuberculosis Direct Test (MTD) was performed routinely. Patients with sputum Mycobacterium tuberculosis (M.tb) isolates having matching genotypes were assigned to clusters. Transmission sequence was approximated by collection order of individuals' first culture-positive specimens. Minimum transmission risks of NAAT (MTD)-negative TB patients and of smear-negative TB patients were estimated based on individuals' positions within clusters. Results: Among 809 patients with culture-confirmed TB, M.tb genotypes were available for 782 (96.7{\%}). For NAA-negative TB patients, the minimum transmission risk estimate was 5.1{\%} (95{\%} CI 0-11.4). For smear-negative TB patients, the minimum transmission risk estimate was 11.2{\%} (95{\%} CI 7.2-15.3). Conclusions: Minimum transmission risk of NAAT-negative TB patients was lower than that of smear-negative TB patients. However, transmission risk of NAA-negative TB patients appears to not be negligible.",
author = "Xie, {Yingda L.} and Cronin, {Wendy A.} and Michael Proschan and Richard Oatis and Silvia Cohn and Curry, {Scott R.} and Golub, {Jonathan E} and Barry, {Clifton E.} and Dorman, {Susan E.}",
year = "2018",
month = "11",
day = "13",
doi = "10.1093/cid/ciy365",
language = "English (US)",
volume = "67",
pages = "1653--1659",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "11",

}

TY - JOUR

T1 - Transmission of Mycobacterium tuberculosis From Patients Who Are Nucleic Acid Amplification Test Negative

AU - Xie, Yingda L.

AU - Cronin, Wendy A.

AU - Proschan, Michael

AU - Oatis, Richard

AU - Cohn, Silvia

AU - Curry, Scott R.

AU - Golub, Jonathan E

AU - Barry, Clifton E.

AU - Dorman, Susan E.

PY - 2018/11/13

Y1 - 2018/11/13

N2 - Background: Among adults with signs and symptoms of pulmonary tuberculosis (TB), recognition of transmissible TB has implications for airborne infection isolation and public health activities. Sputum smear-negative TB patients account for around one-fifth of tuberculosis transmission. The tuberculosis transmission risk of TB patients with negative results on nucleic acid amplification test (NAAT) of respiratory specimens has not been established. We sought to estimate the tuberculosis transmission risk of NAAT-negative TB patients. Methods: We retrospectively reviewed Maryland TB program data collected from 2004 to 2009, during which time NAAT using the Mycobacterium Tuberculosis Direct Test (MTD) was performed routinely. Patients with sputum Mycobacterium tuberculosis (M.tb) isolates having matching genotypes were assigned to clusters. Transmission sequence was approximated by collection order of individuals' first culture-positive specimens. Minimum transmission risks of NAAT (MTD)-negative TB patients and of smear-negative TB patients were estimated based on individuals' positions within clusters. Results: Among 809 patients with culture-confirmed TB, M.tb genotypes were available for 782 (96.7%). For NAA-negative TB patients, the minimum transmission risk estimate was 5.1% (95% CI 0-11.4). For smear-negative TB patients, the minimum transmission risk estimate was 11.2% (95% CI 7.2-15.3). Conclusions: Minimum transmission risk of NAAT-negative TB patients was lower than that of smear-negative TB patients. However, transmission risk of NAA-negative TB patients appears to not be negligible.

AB - Background: Among adults with signs and symptoms of pulmonary tuberculosis (TB), recognition of transmissible TB has implications for airborne infection isolation and public health activities. Sputum smear-negative TB patients account for around one-fifth of tuberculosis transmission. The tuberculosis transmission risk of TB patients with negative results on nucleic acid amplification test (NAAT) of respiratory specimens has not been established. We sought to estimate the tuberculosis transmission risk of NAAT-negative TB patients. Methods: We retrospectively reviewed Maryland TB program data collected from 2004 to 2009, during which time NAAT using the Mycobacterium Tuberculosis Direct Test (MTD) was performed routinely. Patients with sputum Mycobacterium tuberculosis (M.tb) isolates having matching genotypes were assigned to clusters. Transmission sequence was approximated by collection order of individuals' first culture-positive specimens. Minimum transmission risks of NAAT (MTD)-negative TB patients and of smear-negative TB patients were estimated based on individuals' positions within clusters. Results: Among 809 patients with culture-confirmed TB, M.tb genotypes were available for 782 (96.7%). For NAA-negative TB patients, the minimum transmission risk estimate was 5.1% (95% CI 0-11.4). For smear-negative TB patients, the minimum transmission risk estimate was 11.2% (95% CI 7.2-15.3). Conclusions: Minimum transmission risk of NAAT-negative TB patients was lower than that of smear-negative TB patients. However, transmission risk of NAA-negative TB patients appears to not be negligible.

UR - http://www.scopus.com/inward/record.url?scp=85056501821&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056501821&partnerID=8YFLogxK

U2 - 10.1093/cid/ciy365

DO - 10.1093/cid/ciy365

M3 - Article

C2 - 29697779

AN - SCOPUS:85056501821

VL - 67

SP - 1653

EP - 1659

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 11

ER -