Application of T-SPOT.TB in the Diagnosis of Cutaneous Mycobacterium marinum Infections and Evaluation of Treatment Efficacy
DOI:
https://doi.org/10.2340/actadv.v105.44119Keywords:
T-SPOT.TB, cutaneous Mycobacterium marinum infections, diagnostic valueAbstract
This study evaluated the diagnostic value and therapeutic efficacy assessment potential of the interferon-γ release assay T-SPOT.TB in cutaneous Mycobacterium marinum infections. A total of 145 patients diagnosed at the Institute of Dermatology, Chinese Academy of Medical Sciences (2020–2024), excluding tuberculosis cases, were retrospectively analysed. Clinical data including demographics, underlying diseases, pathology, microbiological culture, molecular identification, T-SPOT.TB results, treatment regimens, and outcomes were collected. T-SPOT.TB results before treatment, and at 3 and 6 months post-treatment, were compared to assess its diagnostic and monitoring utility. The baseline T-SPOT.TB positivity rate was 71% (95% CI: 63.2–77.8%). Among 17 patients retested at 3 months, positivity was 64.7% (p = 0.125), with median spot-forming cells (SFCs) significantly decreasing from 20.0 (IQR 8.5–41.0) to 8.0 (IQR 2.5–28.0) (p = 0.0007). Among 27 patients retested at 6 months, positivity was 59.3% (p = 0.344), with median SFCs decreasing from 12.0 (IQR 5.0–30.0) to 8.0 (IQR 3.0–13.0) (p = 0.0006). No significant difference in positivity rates was observed between 3 and 6 months post-treatment. The T-SPOT.TB assay shows significant diagnostic value for cutaneous M. marinum infections and facilitates early diagnosis. Declining SFC counts post-treatment provide useful reference for evaluating therapeutic response.
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Tsiolakkis G, Liontos A, Filippas-Ntekouan S, Matzaras R, Theodorou E, Vardas M, et al. Mycobacterium marinum: a case-based narrative review of diagnosis and management. Microorganisms 2023; 11: 1799. DOI: https://doi.org/10.3390/microorganisms11071799
Canetti D, Riccardi N, Antonello RM, Nozza S, Sotgiu G. Mycobacterium marinum: A brief update for clinical purposes. Eur J Intern Med 2022; 105: 15–19. DOI: https://doi.org/10.1016/j.ejim.2022.07.013
Linell F, Norden A. Mycobacterium balnei, a new acid-fast bacillus occurring in swimming pools and capable of producing skin lesions in humans. Acta Tuberc Scand Suppl 1954; 33: 1–84.
Norden A, Linell F. A new type of pathogenic Mycobacterium. Nature 1951; 168: 826. DOI: https://doi.org/10.1038/168826a0
Holden IK, Kehrer M, Andersen AB, Wejse C, Svensson E, Johansen IS. Mycobacterium marinum infections in Denmark from 2004 to 2017: A retrospective study of incidence, patient characteristics, treatment regimens and outcome. Sci Rep 2018; 8: 6738. DOI: https://doi.org/10.1038/s41598-018-24702-7
Aubry A, Mougari F, Reibel F, Cambau E. Mycobacterium marinum. Microbiol Spectr 2017; 5: 10.1128/microbiolspec.tnmi7-0038-2016. DOI: https://doi.org/10.1128/microbiolspec.TNMI7-0038-2016
Mei Y, Zhang W, Shi Y, Jiang H, Chen Z, Chokkakula S, et al. Cutaneous tuberculosis and nontuberculous mycobacterial infections at a national specialized hospital in China. Acta Derm Venereol 2019; 99: 997–1003. DOI: https://doi.org/10.2340/00015555-3283
Kunduracılar H. Identification of mycobacteria species by molecular methods. Int Wound J 2020; 17: 245–250. DOI: https://doi.org/10.1111/iwj.13238
Lv Z, Zhang M, Zhang H, Lu X. Utility of real-time quantitative polymerase chain reaction in detecting mycobacterium tuberculosis. Biomed Res Int 2017; 2017: 1058579. DOI: https://doi.org/10.1155/2017/1058579
Mori T, Sakatani M, Yamagishi F, Takashima T, Kawabe Y, Nagao K, et al. Specific detection of tuberculosis infection: an interferon-gamma-based assay using new antigens. Am J Respir Crit Care Med 2004; 170: 59–64. DOI: https://doi.org/10.1164/rccm.200402-179OC
Liao CH, Chou CH, Lai CC, Huang YT, Tan CK, Hsu HL, et al. Diagnostic performance of an enzyme-linked immunospot assay for interferon-gamma in extrapulmonary tuberculosis varies between different sites of disease. J Infect 2009; 59: 402–408. DOI: https://doi.org/10.1016/j.jinf.2009.10.001
Orgeur M, Brosch R. Evolution of virulence in the Mycobacterium tuberculosis complex. Curr Opin Microbiol 2018; 41: 68–75. DOI: https://doi.org/10.1016/j.mib.2017.11.021
Nachimuthu N, Yatam Ganesh S. Diagnosis of mycobacterium marinum infection based on seroconversion of QuantiFERON-TB gold test. Cureus 2020; 12: e9208. DOI: https://doi.org/10.7759/cureus.9208
Wentworth AB, Drage LA, Wengenack NL, Wilson JW, Lohse CM. Increased incidence of cutaneous nontuberculous mycobacterial infection, 1980 to 2009: a population-based study. Mayo Clin Proc 2013; 88: 38–45. DOI: https://doi.org/10.1016/j.mayocp.2012.06.029
Bouceiro-Mendes R, Ortins-Pina A, Fraga A, Marques T, Viveiros M, Machado D, et al. Mycobacterium marinum lymphocutaneous infection. Dermatol Online J 2019; 25: 13030/qt5bb78905. DOI: https://doi.org/10.5070/D3252042893
Wang XY, Jia QN, Li J, Zheng HY. Investigating cutaneous tuberculosis and nontuberculous mycobacterial infections a Department of Dermatology, Beijing, China: a comprehensive clinicopathological analysis. Front Cell Infect Microbiol 2024; 14: 1451602. DOI: https://doi.org/10.3389/fcimb.2024.1451602
Franco-Paredes C, Marcos LA, Henao-Martínez AF, Rodríguez-Morales AJ, Villamil-Gómez WE, Gotuzzo E, et al. Cutaneous Mycobacterial Infections. Clin Microbiol Rev 2018; 32: e00069-18. DOI: https://doi.org/10.1128/CMR.00069-18
Johnson MG, Stout JE. Twenty-eight cases of Mycobacterium marinum infection: retrospective case series and literature review. Infection 2015; 43: 655–662. DOI: https://doi.org/10.1007/s15010-015-0776-8
Feng Y, Xu H, Wang H, Zhang C, Zong W, Wu Q. Outbreak of a cutaneous Mycobacterium marinum infection in Jiangsu Haian, China. Diagn Microbiol Infect Dis 2011; 71: 267–272. DOI: https://doi.org/10.1016/j.diagmicrobio.2011.07.003
Delghandi MR, El-Matbouli M, Menanteau-Ledouble S. Mycobacteriosis and infections with non-tuberculous mycobacteria in aquatic organisms: a review. Microorganisms 2020; 8: 1368. DOI: https://doi.org/10.3390/microorganisms8091368
Chen Y, Jiang H, Zhang W, Chen Z, Mei Y, Chen H, et al. Diagnostic Value of T-SPOT.TB test in cutaneous mycobacterial infections. Acta Derm Venereol 2018; 98: 989–990. DOI: https://doi.org/10.2340/00015555-3011
Chen Y, Jiang J, Jiang H, Chen J, Wang X, Liu W, et al. Mycobacterium gordonae in patient with facial ulcers, nosebleeds, and positive T-SPOT.TB test, China. Emerg Infect Dis 2017; 23: 1204–1206. DOI: https://doi.org/10.3201/eid2307.162033
Kobashi Y, Obase Y, Fukuda M, Yoshida K, Miyashita N, Oka M. Clinical reevaluation of the QuantiFERON TB-2G test as a diagnostic method for differentiating active tuberculosis from nontuberculous mycobacteriosis. Clin Infect Dis 2006; 43: 1540–1546. DOI: https://doi.org/10.1086/509327
Lai CC, Tan CK, Lin SH, Liu WL, Liao CH, Huang YT, et al. Diagnostic value of an enzyme-linked immunospot assay for interferon-γ in cutaneous tuberculosis. Diagn Microbiol Infect Dis 2011; 70: 60–64. DOI: https://doi.org/10.1016/j.diagmicrobio.2010.11.012
Strobel K, Sickenberger C, Schoen C, Kneitz H, Kolb-Mäurer A, Goebeler M. Diagnosis and therapy of Mycobacterium marinum: a single-center 21-year retrospective analysis. J Dtsch Dermatol Ges 2022; 20: 1211–1218. DOI: https://doi.org/10.1111/ddg.14847
Yeo PM, Lee SX, Tan YE, Sng LH, Ang CC. Epidemiology, risk factors, and outcomes of adult cutaneous non-tuberculous mycobacterial infection over a 10-year period in Singapore. Int J Dermatol 2019; 58: 679–687. DOI: https://doi.org/10.1111/ijd.14356
Chung J, Ince D, Ford BA, Wanat KA. Cutaneous infections due to nontuberculosis mycobacterium: recognition and management. Am J Clin Dermatol 2018; 19: 867–878. DOI: https://doi.org/10.1007/s40257-018-0382-5
Wang XY, Jia QN, Li J. Treatment of non-tuberculosis mycobacteria skin infections. Front Pharmacol 2023; 14: 1242156. DOI: https://doi.org/10.3389/fphar.2023.1242156
Pai M, Denkinger CM, Kik SV, Rangaka MX, Zwerling A, Oxlade O, et al. Gamma interferon release assays for detection of mycobacterium tuberculosis infection. Clin Microbiol Rev 2014; 27: 3–20. DOI: https://doi.org/10.1128/CMR.00034-13
Xin H, Cao X, Zhang H, Liu J, Pan S, Li X, et al. Dynamic changes of interferon gamma release assay results with latent tuberculosis infection treatment. Clin Microbiol Infect 2020; 26: 1555.e1551–1555.e1557. DOI: https://doi.org/10.1016/j.cmi.2020.02.009
Pourakbari B, Mamishi S, Benvari S, Sauzullo I, Bedini A, Valentini P, et al. Can interferon-γ release assays be useful for monitoring the response to anti-tuberculosis treatment? A systematic review and meta-analysis. Arch Immunol Ther Exp (Warsz) 2020; 68: 4. DOI: https://doi.org/10.1007/s00005-020-00568-4
Clifford V, He Y, Zufferey C, Connell T, Curtis N. Interferon gamma release assays for monitoring the response to treatment for tuberculosis: a systematic review. Tuberculosis (Edinb) 2015; 95: 639–650. DOI: https://doi.org/10.1016/j.tube.2015.07.002
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