New developments in pathogenesis and treatment of tuberculosis

From the NEJM:

New diarylquinoline that inhibits mycobacterial ATP synthase, shows promising activity against MDR tuberculosis

57.8% of the new TB cases in U.S. diagnosed in foreign-born persons, rate 9.8 times higher that among U.S.-born persons. 400,000 immigrants and 50-70,000 refugees arrive in U.S. annually, TB rate is 20.6 cases per 100,000 population. WHO: Asia and sub-Saharan Africa accounted for 84.1% of the estimated 8.8 million new cases of TB worldwide in 2005

Contrary to prevailing wisdom, TB granuloma may facilitate, rather than contain, the spread of infection

NEJM editorial: Unorthodox Approach to the Development of a New Antituberculosis Therapy

BCG vaccine may prevent TB infection, not just active disease
Neonatal BCG vaccination induces IL-10 production by CD4(+) CD25(+) T cells.
Xpert MTB/RIF is a rapid diagnostic test for tuberculosis with high sensitivity (90%) and specificity (99%). Lancet, 2011.
Image source: PPD, CDC, public domain.

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