{"doi":"10.1073/pnas.2314813121","title":"Aerosolization of viable <i>Mycobacterium tuberculosis</i> bacilli by tuberculosis clinic attendees independent of sputum-Xpert Ultra status","abstract":"Potential Mycobacterium tuberculosis ( Mtb ) transmission during different pulmonary tuberculosis (TB) disease states is poorly understood. We quantified viable aerosolized Mtb from TB clinic attendees following diagnosis and through six months’ follow-up thereafter. Presumptive TB patients (n=102) were classified by laboratory, radiological, and clinical features into Group A: Sputum-Xpert Ultra-positive TB (n=52), Group B: Sputum-Xpert Ultra-negative TB (n=20), or Group C: TB undiagnosed (n=30). All groups were assessed for Mtb bioaerosol release at baseline, and subsequently at 2 wk, 2 mo, and 6 mo. Groups A and B were notified to the national TB program and received standard anti-TB chemotherapy; Mtb was isolated from 92% and 90% at presentation, 87% and 74% at 2 wk, 54% and 44% at 2 mo and 32% and 20% at 6 mo, respectively. Surprisingly, similar numbers were detected in Group C not initiating TB treatment: 93%, 70%, 48% and 22% at the same timepoints. A temporal association was observed between Mtb bioaerosol release and TB symptoms in all three groups. Persistence of Mtb bioaerosol positivity was observed in ~30% of participants irrespective of TB chemotherapy. Captured Mtb bacilli were predominantly acid-fast stain-negative and poorly culturable; however, three bioaerosol samples yielded sufficient biomass following culture for whole-genome sequencing, revealing two different Mtb lineages. Detection of viable aerosolized Mtb in clinic attendees, independent of TB diagnosis, suggests that unidentified Mtb transmitters might contribute a significant attributable proportion of community exposure. Additional longitudinal studies with sputum culture-positive and -negative control participants are required to investigate this possibility.","journal":"Proceedings of the National Academy of Sciences","year":2024,"id":421061,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":31,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9423,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":403916,"name":"Ryan Dinkele","orcid":"0000-0001-6456-7530","position":1,"is_corresponding":false},{"id":403915,"name":"Sophia Gessner","orcid":"0000-0003-0824-0079","position":2,"is_corresponding":false},{"id":403914,"name":"Anastasia Koch","orcid":"0000-0002-5897-4196","position":3,"is_corresponding":false},{"id":956755,"name":"Zeenat Hoosen","orcid":"0009-0004-6770-304X","position":4,"is_corresponding":false},{"id":1213916,"name":"Vanessa January","orcid":null,"position":5,"is_corresponding":false},{"id":490215,"name":"Bryan Leonard","orcid":"0000-0002-5770-8662","position":6,"is_corresponding":false},{"id":490214,"name":"Andrea McKerry","orcid":"0000-0003-4778-022X","position":7,"is_corresponding":false},{"id":490216,"name":"Ronnett Seldon","orcid":"0000-0002-0357-7222","position":8,"is_corresponding":false},{"id":1213917,"name":"Andiswa Vazi","orcid":null,"position":9,"is_corresponding":false},{"id":460914,"name":"Sabine Hermans","orcid":"0000-0001-5146-2932","position":10,"is_corresponding":false},{"id":403919,"name":"Frank Cobelens","orcid":"0000-0002-4367-1133","position":11,"is_corresponding":false},{"id":403921,"name":"Digby F. Warner","orcid":"0000-0002-4146-0930","position":12,"is_corresponding":false},{"id":252299,"name":"Robin Wood","orcid":"0000-0002-4276-7117","position":13,"is_corresponding":false},{"id":289103,"name":"Benjamin Patterson","orcid":"0000-0002-2445-6390","position":0,"is_corresponding":true}],"reference_count":64,"raw_metadata":null,"created_at":"2026-07-19T01:57:36.298171Z","pmid":"38470917","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}