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Objective To investigate whether the economic recession affected the control of tuberculosis in the European Union. Methods Multivariate regression models were used to quantify the association between gross domestic product, public health expenditure and tuberculosis case detection rates, using data from 21 European Union member states (1991-2012). The estimated changes in case detection attributable to the recession were combined with mathematical models of tuberculosis transmission, to project the potential influence of the recession on tuberculosis epidemiology until 2030. Findings Between 1991 and 2007, detection rates for sputum-smear-positive tuberculosis in the European Union were stable at approximately 85%. During the economic recession (2008-2011) detection rates declined by a mean of 5.22% (95% confidence interval, CI: 2.54-7.90) but treatment success rates showed no significant change (P=0.62). A fall in economic output of 100 United States dollars per capita was associated with a 0.22% (95% CI: 0.05-0.39) mean reduction in the tuberculosis case detection rate. An equivalent fall in spending on public health services was associated with a 2.74% (95% CI: 0.31-5.16) mean reduction in the detection rate. Mathematical models suggest that the recession and consequent austerity policies will lead to increases in tuberculosis prevalence and tuberculosis-attributable mortality that are projected to persist for over a decade. Conclusion Across the European Union, reductions in spending on public health services appear to have reduced tuberculosis case detection and to have increased the long-term risk of a resurgence in the disease. [TEXT NOT REPRODUCIBLE IN ASCII] [TEXT NOT REPRODUCIBLE IN ASCII] Objectif Enqueter pour determiner si la recession economique a affecte la lutte antituberculeuse dans l'Union europeenne. Methodes Des modeles de regression multivariee ont ete utilises pour quantifier l'association entre le produit interieur brut, les depenses de sante publique et les taux de detection des cas de tuberculose, a partir de donnees provenant de 21 Etats membres de l'Union europeenne (periode de 1991 a 2012). Les changements estimes dans la detection des cas de tuberculose imputables a la recession ont ete combines a des modeles mathematiques de transmission de la tuberculose afin de faire des projections concernant l'influence potentielle de la recession sur l'epidemiologie dela tuberculose jusqu'a 2030. Resultats Entre 1991 et 2007, les taux de detection des cas de tuberculose a frottis d'expectoration positif dans l'Union europeenne sont restes stables, a environ 85 %. Pendant la recession economique (de 2008 a 2011), les taux de detection ont baisse en moyenne de 5,22 % (intervalle de confiance de 95 %, IC : 2,54-7,90), mais les taux de reussite des traitements n'ont connu aucun changement significatif (P = 0,62). Une baisse de la production economique de 100 dollars US par habitant a ete associee a une reduction moyenne du taux de detection des cas de tuberculose de 0,22% (intervalle de confiance de 95 %, IC : 0,05-0,39). Une reduction equivalente dans les depenses consacreesaux services de sante publique a ete associee a une reduction moyenne du taux de detection de 2,74 % (intervalle de confiance de 95 %, IC: 0,31-5,16). Les modeles mathematiques suggerent que la recession et les politiques d'austerite qui en ont resulte entraineront des augmentations de la prevalence de la tuberculose et de la mortalite imputable a la tuberculose qui, d'apres les projections realisees, devraient durer pendant plus de dix ans. Conclusion Dans l'Union europeenne, les reductions des depenses consacreesaux services de sante publique ont fait decliner la detection des cas de tuberculose et ont majore le risque a long terme de resurgence de cette maladie. [TEXT NOT REPRODUCIBLE IN ASCII] Objetivo Investigar si la recesion economica ha afectado al control de la tuberculosis en la Union Europea. Metodos Se utilizaron modelos de regresion multivariados para cuantificar la asociacion entre el producto interior bruto, el gasto en salud publica y las tasas de deteccion de casos de tuberculosis a partir de los datos de 21 estados miembro de la Union Europea (1991-2012). Los cambios estimados en la deteccion de casos atribuibles a la recesion se combinaron con modelos matematicos de transmision de la tuberculosis para proyectar la influencia potencial de la recesion en la epidemiologia de la tuberculosis hasta el 2030. Resultados Entre 1991 y 2007, las tasas de deteccion de la tuberculosis con resultado positivo en el analisis de esputo en la Union Europea se mantuvieron estables en torno al 85%. Durante la recesion economica (2008-2011), las tasas de deteccion se redujeron en un promedio del 5,22% (intervalo de confianza, IC, del 95%: 2,54-7,90), pero las tasas de exito en el tratamiento no mostraron ningun cambio significativo (P = 0,62). Una caida en los resultados economicos de 100 dolares estadounidenses per capita fue asociada a una reduccion media del 0,22% (IC del 95%: 0,05-0,39) en la tasa de deteccion de casos de tuberculosis. Una caida equivalente en el gasto en los servicios de salud publica se asocio a una reduccion media del 2,74% (IC del 95%: 0,31 -5,16) en la tasa de deteccion. Los modelos matematicos sugieren que la recesion y las politicas de austeridad consiguientes conduciran a un aumento de la prevalencia de la tuberculosis y de la mortalidad atribuible a esta enfermedad que se espera que persista durante mas de una decada. Conclusion En la Union Europea, los recortes en el gasto en servicios de salud publica parecen haber reducido la deteccion de casos de tuberculosis y haber incrementado el riesgo a largo plazo de un resurgimiento de la enfermedad., Lutte antituberculeuse et recession economique : etude longitudinale des donnees de 21 pays europeens pour la periode de 1991 a 2012 Control de la tuberculosis y recesion economica: estudio longitudinal [...]

Resistant TB Is a Serious Threat to Global Health Tuberculosis (TB) remains the leading cause of death from a largely preventable and curable infectious disease, with an estimated 1.7 million [...]

Siderocalin is a secreted protein that binds to siderophores to prevent bacterial iron acquisition. While it has been shown to inhibit the growth of Mycobacterium tuberculosis ( M.tb) in extracellular cultures, its effect on this pathogen within macrophages is not clear. Here, we show that siderocalin expression is upregulated following M.tb infection of mouse macrophage cell lines and primary murine alveolar macrophages. Furthermore, siderocalin added exogenously as a recombinant protein or overexpressed in the RAW264.7 macrophage cell line inhibited the intracellular growth of the pathogen. A variant form of siderocalin, which is expressed only in the macrophage cytosol, inhibited intracellular M.tb growth as effectively as the normal, secreted form, an observation that provides mechanistic insight into how siderocalin might influence iron acquisition by the bacteria in the phagosome. Our findings are consistent with an important role for siderocalin in protection against M.tb infection and suggest that exogenously administered siderocalin may have therapeutic applications in tuberculosis. [ABSTRACT FROM AUTHOR]

Background. The incidence and severity of invasive group A streptococcal infection demonstrate great variability over time, which at least, in part, seems to be related to group A streptococcal type distribution among the human population. Methods. An enhanced surveillance study of invasive group A streptococcal infection (746 isolates) was performed in Sweden from April 2002 through December 2004. Non-invasive isolates from either the throat or skin (773 isolates) were collected in parallel for comparison. Clinical and epidemiological data were obtained from 88% of patients with invasive disease and were related to isolate characteristics, including T type, emm sequence type, and the presence of 9 superantigen genes, as well as pulsed-field gel electrophoresis pattern comparisons of selected isolates. Results. The annual incidence was 3.0 cases per 100,000 population. Among the patients with invasive disease, 11% developed streptococcal toxic shock syndrome, and 9.5% developed necrotizing fasciitis. The overall case fatality rate was 14.5%, and 39% of the patients with streptococcal toxic shock syndrome died ( P<.001). The T3/13/B3264 cluster accounted for 33% of invasive and 25% of noninvasive isolates. Among this most prevalent type cluster, emm types 89 and 81 dominated. Combined results from pulsed-field gel electrophoresis, emm typing, and superantigen gene profiling identified subgroups within specific emm types that are significantly more prone to cause invasive disease than were other isolates of the same type. Conclusions. This study revealed a changing epidemiology of invasive group A streptococcal infection in Sweden, with emergence of new emm types that were previously not described. The results also suggest that some clones may be particularly prone to cause invasive disease. [ABSTRACT FROM AUTHOR]