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Nontuberculous mycobacteria (NTM) are emerging as notable causative agents of opportunistic infections. To examine clinical significance, species distribution, and temporal trends of NTM in Denmark, we performed a nationwide register-based study of all unique persons with NTM isolated in the country during 1991–2022. We categorized patients as having definite disease, possible disease, or isolation by using a previously validated method. The incidence of pulmonary NTM increased throughout the study period, in contrast to earlier findings. Mycobacterium malmoense, M. kansasii, M. szulgai, and M. avium complex were the most clinically significant species based on microbiologic findings; M. avium dominated in incidence. This study shows the need for surveillance for an emerging infection that is not notifiable in most countries, provides evidence to support clinical decision-making, and highlights the importance of not considering NTM as a single entity. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) presents a serious health problem with approximately a quarter of the world's population infected with Mycobacterium tuberculosis (M. tuberculosis) in an asymptomatic latent state of which 5-10% develops active TB at some point in their lives. The antimicrobial protein cathelicidin has broad antimicrobial activity towards viruses and bacteria including M. tuberculosis. Vitamin D increases the expression of cathelicidin in many cell types including macrophages, and it has been suggested that the vitamin Dmediated antimicrobial activity against M. tuberculosis is dependent on the induction of cathelicidin. However, unraveling the immunoregulatory effects of vitamin D in humans is hampered by the lack of suitable experimental models. We have previously described a family in which members suffer from hereditary vitamin D-resistant rickets (HVDRR). The family carry a mutation in the DNAbinding domain of the vitamin D receptor (VDR). This mutation leads to a nonfunctional VDR, meaning that vitamin D cannot exert its effect in family members homozygous for the mutation. Studies of HVDRR patients open unique possibilities to gain insight in the immunoregulatory roles of vitamin D in humans. Here we describe the impaired ability of macrophages to produce cathelicidin in a HVDRR patient, who in her adolescence suffered from extrapulmonary TB. The present case is a rare experiment of nature, which illustrates the importance of vitamin D in the pathophysiology of combating M. tuberculosis. [ABSTRACT FROM AUTHOR]

Objective To examine the risk factors for Mycobacterium tuberculosis infection (MTI) among Greenlandic children for the purpose of identifying those at highest risk of infection. Methods Between 2005 and 2007, 1797 Greenlandic schoolchildren in five different areas were tested for MTI with an interferon gamma release assay (IGRA) and a tuberculin skin test (TST). Parents or guardians were surveyed using a standardized self-administered questionnaire to obtain data on crowding in the household, parents' educational level and the child's health status. Demographic data for each child--i.e. parents' place of birth, number of siblings, distance between siblings (next younger and next older), birth order and mother's age when the child was born--were also extracted from a public registry. Logistic regression was used to check for associations between these variables and MTI, and all results were expressed as odds ratios (ORs) and 95% confidence intervals (Cls). Children were considered to have MTI if they tested positive on both the IGRA assay and the TST. Findings The overall prevalence of MTI was 8.5% (152/1797). MTI was diagnosed in 26.7% of the children with a known TB contact, as opposed to 6.4% of the children without such contact. Overall, the MTI rate was higher among Inuit children (0R:4.22; 95% CI: 1.55-11.5) and among children born less than one year after the birth of the next older sibling (0R:2.48; 95% Ch 1.33- 4.63). Self-reported TB contact modified the profile to include household crowding and low mother's education. Children who had an older MTI-positive sibling were much more likely to test positive for MTI themselves (OR: 14.2; 95% CI: 5.75-35.0) than children without an infected older sibling. Conclusion Ethnicity, sibling relations, number of household residents and maternal level of education are factors associated with the risk of TB infection among children in Greenland. The strong household clustering of MTI suggests that family sources of exposure are important. Objectif Examiner les facteurs de risque d'une infection a Mycobacterium tuberculosis (MTI) parmi les enfants groenlandais afin d'identifier ceux qui presentent le risque d'infection le plus eleve. Methodes Entre 2005 et 2007, 1797 ecoliers groenlandais de cinq regions differentes ont ete testes pour le depistage de l'infection a MTI au moyen d'un test de detection de l'interferon gamma (IGRA) et d'un test cutane a la tuberculine (TST). Une enquete a ete proposee aux parents ou aux tuteurs a l'aide d'un auto-questionnaire standardise en vue d'obtenir des donnees sur la composition des menages, le niveau d'education des parents et l'etat de sante de l'enfant. Des donnees demographiques relatives a chaque enfant--a savoir le lieu de naissance des parents, le nombre de freres et soeurs, la difference d'age entre les freres et soeurs (suivant et precedent), l'ordre de naissance et l'age de la mere a la naissance de l'enfant--ont egalement ete extraites d'un registre public. Le principe de regression logistique a ete applique pour verifier les eventuelles associations entre ces variables et l'infection a MTI. Tous les resultats etaient exprimes en odds-ratios (OR) et en intervalle de confiance a 95% (IC). Les enfants etaient consideres comme atteints de MTI si le test IGRA et le TST etaient tous les deux positifs. Resultats La prevalence globale de l'infection a MTI etait de 8,5% (152/1797). On a diagnostique une infection a MTI chez 26,7% des enfants ayant ete en contact de facon averee avec une personne atteinte de tuberculose, pour 6,4% d'enfants n'ayant pas eu un tel contact. Globalement, le taux d'infection a MTI etait plus eleve chez les enfants inuits (OR: 4,22; IC a 95%: de 1,55 a 11,5) et chez les enfants nes moins d'un an apres la naissance de l'enfant precedent (OR: 2,48; IC a 95%: de 1,33 a 4,63). Un contact declare avec une personne tuberculeuse modifiait le profil, ainsi qu'un nombre eleve de personnes au foyer et une education peu elevee de la mere. Les enfants ayant un frere ou une sceur plus age atteint d'une infection a MTI risquaient davantage d'avoir eux-memes un resultat positif au depistage de MTI (OR: 14,2; IC a 95%: de 5,75 a 35.0) que les enfants n'ayant ni frere ni soeur infecte. Conclusion L'ethnicite, les relations avec les freres et soeurs, le nombre de personnes vivant au foyer et le niveau d'education maternelle sont des facteurs associes au risque d'infection par la tuberculose parmi les enfants du Groenland. La forte concentration de l'infection a MTI dans les foyers indique que les sources familiales d'exposition sont importantes. Objetivo Examinar los factores de riesgo de la infeccion por Mycobacterium tuberculosis (IMT) en ninos groenlandeses con el fin de identificar a aquellos estan expuestos a un mayor riesgo. Metodos Entre 2005 y 2007, se analizo a 1797 ninos en edad escolar de Groenlandia en cinco zonas diferentes para detectar la presencia de la IMT mediante un analisis de liberacion de interferon gamma (IGRA, por sus siglas en ingles) y una prueba cutanea de tuberculina (PCT). Los padres o tutores respondieron a un cuestionario autoadministrado y normalizado para obtener datos sobre el numero de habitantes del hogar, el nivel educativo de los padres y el estado de salud del nino. Tambien se extrajeron datos demograficos de cada nino de un registro publico (es decir, el lugar de nacimiento de los padres, el numero de hermanos, la diferencia entre hermanos (entre el que le sigue y el que le precede), el orden de nacimiento y la edad de la madre cuando nacio el nino). Se utilizo una regresion Iogistica para comprobar las asociaciones entre estas variables y la IMT. Asimismo, todos los resultados se expresaron como cocientes de probabilidades (CP) e intervalos de confianza (IC) del 95%. Se establecio que los ninos tenian la IMT en caso de resultado positivo tanto del analisis IGRA como de la PCT. Resultados La prevalencia global de la IMT fue del 8,5% (152/1797). Se diagnostico la IMT en el 26,7% de los ninos de los que se tenia constancia de un contacto con la tuberculosis, en contraposicion con el 6,4% de estos ninos que no habian tenido dicho contacto. En general, la tasa de la IMT resulto ser mas elevada en ninos inuit (CP: 4,22; IC de195%: 1,55-11,5) y entre ninos nacidos menos de un ano despues del nacimiento del hermano que les precede (CP: 2,48; IC del 95%: 1,33-4,63). La notificacion de un contacto con la tuberculosis modificaba el perfil para incluir el numero de habitantes del hogar y el bajo nivel educativo de la madre. Los ninos que tenian un hermano mayor cuya prueba de IMT fue positiva tenian muchas mas probabilidades de que su prueba tambien ofreciese un resultado positivo (CP: 14,2; IC del 95%: 5,75-35,0) en comparacion con los niSos que no tenian un hermano mayor infectado. Conclusion La etnia, las relaciones fraternales, el numero de habitantes del hogar y el nivel de educacion materno son factores asociados al riesgo de sufrir una infeccion de tuberculosis en ninos de Groenlandia. La gran concentracion en el hogar de la IMT sugiere que las fuentes familiares de exposicion son importantes., Introduction Although Greenland has experienced steady improvement in general living standards since World War II, tuberculosis (TB) remains a major health problem throughout the country. (1,2) Overall TB incidence in [...]

Objective: Mycoplasma genitalium (M. genitalium) is a sexually transmitted pathogen associated with urethritis, cervicitis, and pelvic inflammatory disease. Previous studies have shown a strong association between M. genitalium and HIV infection, therefore screening and treatment for M. genitalium has been suggested as part of HIV prevention strategies. The objective of this study was to determine the prevalence of M. genitalium in women living with HIV (WLWH) in Denmark, and to compare the result with data on symptoms from the lower abdomen, sexual habits and immune status. 234 women, recruited from Danish HIV centres as part of a larger observational study on aspects of living with HIV as a woman (the SHADE study), were included. Results: We tested cervical samples for M. genitalium by specific PCR. We found three samples positive (1.3%). The women were between 30 and 50 years old, all were of Asian origin, sexually active, and on antiretroviral treatment with supressed HIV RNA and CD4 count >350 cells/μL. None reported symptoms from the lower abdomen. The prevalence of M. genitalium infection in WLWH in Denmark is low, thus systematic screening for M. genitalium in this group does not seem relevant. [ABSTRACT FROM AUTHOR]

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BackgroundDenmark possesses an exceptional historical data collection on tuberculosis (TB) from 1876 to the present, providing a unique opportunity to assess TB epidemiology over 147 years in Denmark.AimOur aim was to describe the TB disease burden in Denmark in relation to historical events, living conditions and health interventions during the past 147 years.MethodsWe performed a nationwide register-based ecological study including all persons with TB in Denmark from 1876 through 2022, correlating the TB incidence to social, economic and health indicators.ResultsIn Denmark, the overall TB incidence and mortality declined markedly over the past 147 years, only marginally influenced by specific TB interventions such as sanatoria, Bacillus Calmette-Guèrin (BCG) vaccination, mass screenings and antibiotics. Parallel to this decline, the country experienced improved living conditions, as illustrated by decreased infant mortality and increased life expectancy and wealth. In 1978, Denmark became a low-incidence country for TB with risk groups predominantly affected, and with a continuous change in demographics towards fewer Danish-born cases and relatively more migrant cases.ConclusionsThe decline over time in TB incidence and mortality in Denmark preceded specific TB interventions and can, first of all, be attributed to improved living conditions. TB has now become a rare disease in Denmark, predominantly occurring in particular risk groups. Future elimination of TB will require a combination of specific health interventions in these risk groups combined with a continued focus on improving socioeconomic status and living conditions.

A yellow-pigmented, scotochromogenic, slowly growing mycobacterial strain, designated T1921(T), was isolated from the disseminated osteomyelitic lesions of a 7-year-old child with an underlying partial gamma interferon receptor alpha-1 deficiency. Hybridization by the line probe assay indicated the presence of a Mycobacterium species. Sequencing of the 16S rRNA gene, the internally transcribed spacer (ITS) region and the hsp65 and rpoB genes revealed that strain T1921(T) could be differentiated from all recognized species of the genus Mycobacterium. Phylogenetic analysis based on the 16S rRNA gene indicated that strain T1921(T) was related most closely to Mycobacterium intracellulare, whereas analysis based on the ITS and hsp65 and rpoB genes indicated that it was most closely related to Mycobacterium avium. Phenotypic tests were not able to differentiate strain T1921(T) from similar slowly growing mycobacteria. Strain T1921(T) is considered to represent a novel species of the genus Mycobacterium, for which the name Mycobacterium arosiense sp. nov. is proposed. The type strain is T1921(T) (=DSM 45069(T) =ATCC BAA-1401(T)).