Utility of QuantiFERON®-TB Gold In-Tube Test Compared with Tuberculin Skin Test in Diagnosing Tuberculosis in Indian Children with Malnutrition

This prospective cohort study was conducted to compare the accuracy of QuantiFERON®-TB (QFT) Gold In-Tube test and tuberculin skin test (TST) in diagnosing tuberculosis (TB) in predominantly bacille Calmette–Guerin-vaccinated children with a high incidence of malnutrition. The sensitivity of the QFT versus the TST was 69.6% versus 52.9% for WHO-defined TB, with specificity of 86% versus 78.3%, respectively. The concordance of the TST and QFT was 79% overall (κ = 0.430), 62.5% in those with WHO-defined TB and 85.7% in those without TB. Majority of the QFT+/TST − discordance was seen in children with TB, whereas majority of the TST+/QFT − discordance was seen in those without TB. The TST was more likely to be negative in children with moderate-to-severe malnutrition (P = 0.003) compared to the QFT, which was more likely to be positive in younger children. The significantly better performance of the QFT in malnourished children and those at younger ages supports its use for TB diagnosis in these subpopulations.     

Erythema induratum of Bazin in a 10‐year‐old boy

Erythema induratum of Bazin (EIB) is a form of tuberculid resulting from hypersensitivity to tuberculosis antigen. EIB occurs most commonly in middle‐aged women and is not typically seen in children. Here, we present a rare case of EIB, presenting as a chronic nodular panniculitis, in a 10‐year‐old Korean boy.     

Adjuvant chemotherapy could improve the survival of pulmonary sarcomatoid carcinoma: A systematic review and meta-analysis

BackgroundComplete surgical removal is currently considered to be the best treatment option for pulmonary sarcomatoid carcinoma (PSC) especially in early stage operable disease; however, the reported recurrence-free survival is low. Benefits of adjuvant chemotherapy in PSC patients are still controversial, and there is no obvious agreement on the optimal treatment modalities of this disease. Therefore, we aimed to investigate the prognosis in terms of overall survival (OS) in patients with PSC who received adjuvant chemotherapy.MethodsThe review protocol was registered in PROSPERO (CRD42022306084). Patients with PSC who underwent surgical therapy with or without adjuvant chemotherapy were included into the meta-analysis. Hazard ratios (HR) with 95% confidence intervals (CIs) for OS were pooled and ROBINS-I tool was used to assess risk of bias of the included studies.ResultsWe identified four retrospective cohort studies with 6768 records from MEDLINE, Embase, and CENTRAL databases up to 9th September 2021, and altogether 1835 patients were included to the analysis. The present meta-analysis shows that patients receiving adjuvant chemotherapy had a significantly longer OS than patients who underwent surgical treatment alone (HR = 0.5657, 95%CI: 0.4391–0.7290, p < 0.0001).ConclusionsDespite the limited information on the chemotherapy regimens in the included studies, patients with PSC may benefit from adjuvant chemotherapy. More publications are required to evaluate and compare efficient adjuvant chemotherapy protocols in PSC cases.     

2009-2019年西安市肺结核流行特征及治疗转归分析

目的 了解2009-2019年西安市肺结核的流行特征及治疗转归情况，为完善西安市肺结核防治策略提供依据。方法 收集2009-2019年《传染病信息管理系统》中登记的肺结核患者病案信息数据，通过描述性研究方法对肺结核流行病学特征和治疗转归情况进行分析。结果 2009-2019年间西安市肺结核年平均发病率为49.06/10万。郊县、郊区、城区肺结核年平均发病率分别为54.13/10万、47.46/10万和46.19/10万；男性发病率是女性的1.85倍。职业分布排在前5位的为农民（47.48%），家政、家务及待业（14.65%），离退人员（9.55%），学生（8.63%）和工人（5.23%）。利福平敏感或耐药性未知患者的成功治疗率平均为98.03%，利福平耐药患者治疗成功率为51.47%。结论 西安市近年来肺结核发病率和治疗率呈增长趋势，利福平耐药患者治疗成功率较低，要加强对重点人群的健康促进工作，加大肺结核发现力度及患者治疗管理工作。     

一起学校耐药肺结核聚集性疫情的调查

目的 对北京市朝阳区某学校一起耐药肺结核疫情进行分析,为今后耐药结核病疫情的处置提供参考。方法 对病例进行流行病学调查,对病例密切接触者采用PPD试验、X线胸片和CT相结合的方式筛查。结果 2018年10月—2019年6月,该校共发生36例肺结核病例,发病率为4.5%。其中5例耐多药,3例耐利福平。36例病例分布在四个班,15a班27例、15b班4例、15c班2例、17d班3例。各班发病率分别为56.3%、8.3%、5.7%、7.1%,差异有统计学意义(P<0.01)。8例耐药病例中6例为15a班学生,占耐药病例总数的75.0%。经CT筛查68名密切接触者中确诊23例肺结核患者,检出率33.8%。结论 该起学校聚集性疫情为全国首起耐药肺结核聚集性疫情,首发病例未及时就医,传染源隐匿存在时间长,是导致该起疫情发生的主要原因。疫情处置中开展密切接触者筛查对于及时发现新病例非常重要。