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Bocchino M.,University of Naples Federico II | Chairadonna P.,UOC di Microbiologia e Virologia | Matarese A.,University of Naples Federico II | Bruzzese D.,University of Naples Federico II | And 7 more authors.
Respiratory Medicine | Year: 2010

The usefulness of IFN-γ release assays to monitor the efficacy of anti-tuberculosis (TB) treatment is controversial. Sixty patients affected by culture-confirmed pulmonary TB (M = 36; mean age: 39.2 yr; Italians = 28) were serially tested in a low prevalence setting by means of QuantiFERON-TB GOLD In-Tube (QFT-IT) at baseline and after a successful six-month therapy regimen (T6). A sub-group of 40 cases was also tested at 1 and 3 months. Overall, 88.3% of patients scored a QFT-IT positive result at baseline, with the higher proportion of TB-specific IFN-γ responses in foreign-born patients (p = 0.04). TB-specific responses were highly variable over time, the within-person variability being correlated with baseline IFN-γ levels (r = 0.731; p < 0.001). Overall, 61.6% of cases still tested QFT-IT positive at the completion of therapy. Average IFN-γ levels increased over time, being persistently significantly higher in Italian patients than in foreign-born cases both at baseline (p = 0.03) and at T6 (p = 0.02). Reversion mainly occurred in patients (26.6%) with baseline IFN-γ levels close to the conventional cut-off value. No indeterminate results were recorded at any study time point. In conclusion, QFT-IT adds no significant information to clinicians for treatment monitoring when applied in routine clinical practice in a low prevalence setting. Kinetics of T cell responses upon TB treatment and reversion (and conversion) thresholds need to be addressed. Diversity of IFN-γ responses among patients of different geographic origin is an issue to be investigated further. © 2010 Published by Elsevier Ltd.

D'Antonio S.,U.O.C. di Broncopneumologia e Tisiologia | Alma M.G.,U.O.C. di Broncopneumologia e Tisiologia | Altieri A.M.,U.O.C. di Broncopneumologia e Tisiologia | Barbaro A.,U.O.C. di Broncopneumologia e Tisiologia | And 3 more authors.
Rassegna di Patologia dell'Apparato Respiratorio | Year: 2012

The authors present a case of mycobacteriosis from Mycobacterium abscessus started with pericardial effusion and diagnosed with pulmonary biopsy and typing of acid-fast bacilli done with enlargement of 16S-23S (rRNA) region. Due to the gravity of the case, the therapeutic protocol used included claritromycin 500 mg tablets twice a day for twelve months, amikacin 750 mg vial once a day for one month reduced then to one vial three times a week for 5 months and cefaclor monohidrate 750 mg capsules twice a day for twelve months with good compliance for the prescribed treatment, resolution of pericarditis and progressive improvement of general condition confirmed from HRCT of the chest performed at the end of the treatment.

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