ATS Reading List

Mycobacterial Diseases

Non-tuberculous mycobacterium

Griffith DE, Aksamit T, Brown-Elliott BA, et al. The official ATS/IDSA statement: Diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007; 175:367-416. More comprehensive than its 1997 predecessor, this statement provides a general overview of NTM pathogenesis, presentation, and diagnosis as well as easily retrieved treatment recommendations on specific organisms.
PMID: 17277290

Latent tuberculosis

Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection — United States, 2010. Centers for Disease Control and Prevention. MMWR 2010;59:1-25. Offers the latest guidelines on the use of IGRAs in the diagnosis of TB. Access at the CDC website.

Getahun H, Matteelli A, Abubakar , et alI.  Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries. Eur Resp J. 2015; 46:1563-76. This guideline provides recommendations regarding the optimal screening processes, diagnostic algorithm, and treatment approach for latent tuberculosis infection in higher income countries with low incidence of disease.
PMID: 26405286
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International Union against Tuberculosis Committee on Prophylaxis. Efficacy of various durations of isoniazid preventive therapy for tuberculosis: five years of follow-up in the IUAT trial. Bull WHO 1982;60:555-64. Noteworthy for being the only study of the efficacy and safety of different durations of INH prophylaxis.
PMID: 6754120
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Horsburgh CR Jr, Goldberg S, Bethel J, et al. Latent TB treatment acceptance and completion in the United States and Canada. Chest 2010; 137:401-9. This study is noteworthy for finding that fewer than half of 2,000 people initiating treatment completed treatment. These findings point toward the need for simpler treatment regimens and may influence clinical suspicion when evaluating patients with possible active tuberculosis.
PMID: 19793865
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Jereb JA, Goldberg SV, Powell K, et al. Recommendations for use of an isoniazid-rifapentine regimen with direct observation to treat latent Mycobacterium tuberculosis infection. MMWR Morb Mortal Wkly Rep 2011;60:1650-3. A significant advancement in the treatment of latent tuberculosis due to its three-month duration, this advantage may be partially offset by rifapentine shortages, drug costs, the need for directly observed therapy, and a high daily pill burden.
PMID: 22157884
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Active Tuberculosis- Diagnosis

Bock NN, McGowan JE, Ahn J, et al. Clinical predictors of tuberculosis as a guide for respiratory isolation policy. Am J Respir Crit Care Med 1996; 154:1468-72. Study found upper lobe infiltrate, presence of cavity, self-report of prior positive PPD, and history of TB exposure were predictive of active disease while history of INH prophylaxis was negatively predictive. Basing isolation solely on these criteria, however, would have resulted in failure to isolate 19% of active cases.
PMID: 8912766

Conde MB, Loivos AC, Rezende VM, et al. Yield of sputum induction in the diagnosis of pleural tuberculosis. Am J Respir Crit Care Med 2003;167:723-5. Prospective study of 84 patients with pleural tuberculosis found induced sputum culture was helpful in patients with no infiltrate on CXR; 55% of patients with effusion and otherwise clear CXR were culture positive, although only 12% had a rapid diagnosis via positive smears.
PMID: 12598215

CDC. Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. Morbid Mortal Wkly Rep. 2009; 58:7-10. These guidelines are noteworthy for first recommending the use of NAA tests in the initial evaluation of suspected TB. Subsequent research found use of NAA is useful in confirming, as well as excluding, TB in smear-positive cases and can provide earlier diagnosis in smear-negative/culture-positive patients.
PMID: 19145221
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Active Tuberculosis- Treatment

Nahid P, Dorman SE, Alipanah N, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America clinical practice guidelines: treatment of drug-susceptible tuberculosis. Clin Infect Dis. 2016; 63:853-67. This update to the 2003 guideline focuses primarily on non-drug resistant disease and emphasizes the importance of case management and avoiding excessive delay of ART in HIV-positive patients initiating treatment of active tuberculosis.
PMID: 27621353
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CDC. Emergence of Mycobacterium tuberculosis with extensive resistance to second-line drugs--worldwide, 2000-2004. Morb Mortal Wkly Rep. 2006; 55:301-5. This report summarizes the results of a survey distributed to a multinational network of Tb laboratories between 2000-2004. Of 17,690 TB isolates, 20% were MDR and 2% were XDR. XDR TB has emerged worldwide as a threat to public health and TB control, raising concerns of a future epidemic of virtually untreatable TB.
PMID: 16557213
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Last Reviewed: June 2017