We examined sputum bacterial loads in adults with newly diagnosed tuberculosis using quantitative culture and time-until-positive (DTP) culture in BACTEC 460. Patients with cavitary disease had higher CFU levels than those without cavities and shorter DTPs. Within radiographic strata of moderately and far advanced tuberculosis, higher CFU counts were associated with cavitary disease.

Active tuberculosis (TB) is associated with prolonged suppression of Mycobacterium tuberculosis (MTB)‐specific immune responses, but mechanisms involved are understood incompletely. We investigated a potential role for CD4⁺CD25⁺ regulatory T cells in depressed anti‐MTB immunity by evaluating serially CD4 cell phenotype and interferon (IFN)‐γ production by mononuclear cells from patients with TB. At diagnosis, frequencies of CD4⁺CD25⁺ T cells were increased in blood from TB patients compared to healthy purified protein derivative (PPD)‐positive controls (with a history of prior TB exposure), and remained elevated at completion of therapy (6 months). By contrast, expression of another activation marker, CD69, by CD4 T cells was increased at diagnosis, but declined rapidly to control levels with treatment. Among CD4⁺CD25⁺ T cells from TB patients at diagnosis those expressing high levels of CD25, probably representing regulatory T cells, were increased 2·9‐fold when compared to control subjects, while MTB‐stimulated IFN‐γ levels in whole blood supernatants were depressed. A role for CD4⁺CD25⁺ T cells in depressed IFN‐γ production during TB was substantiated in depletion experiments, where CD25⁺‐depleted CD4 T cells produced increased amounts of IFN‐γ upon MTB stimulation compared to unseparated T cells. At follow‐up, IFN‐γ production improved most significantly in blood from TB patients with high baseline frequencies of CD4⁺CD25⁺ T cells (more than threefold higher than controls for both total and CD25^hi+ CD4 T cells), who also had a significant drop in frequencies of both total and ‘regulatory’ CD4⁺CD25⁺ T cells in response to treatment. Expansion of CD4⁺CD25⁺ regulatory T cells during active TB may play a role in depressed T cell IFN‐γ production.

Embora as evidências a respeito dos impactos do isolamento sobre a violência doméstica e familiar sejam incipientes, notícias divulgadas na mídia e relatórios de organizações internacionais apontam para o aumento desse tipo de violência³. Na China, os registros policiais de violência doméstica triplicaram durante a epidemia⁴. Na Itália⁵, na França⁶ e na Espanha⁷ também foi observado aumento na ocorrência de violência doméstica após a implementação da quarentena domiciliar obrigatória.

Rationale: Linezolid, the first oxazolidinone approved for clinical use, has effective in vitro and promising in vivo activity against Mycobacterium tuberculosis. Objectives: To evaluate the early and extended early bactericidal activity of linezolid in patients with pulmonary tuberculosis. Methods: Randomized open label trial. Thirty patients with newly diagnosed smear-positive pulmonary tuberculosis (10 per arm) were assigned to receive isoniazid (300 mg daily) and linezolid (600 mg twice daily or 600 mg once daily) for 7 days. Sputum for quantitative culture was collected for 2 days before and then daily during 7 days of study drug administration. Bactericidal activity was estimated by measuring the decline in bacilli during the first 2 days (early bactericidal activity) and the last 5 days of study drug administration (extended early bactericidal activity). Measurements and Main Results: The mean early bactericidal activity of isoniazid (0.67 log10 cfu/ml/d) was greater than that of linezolid twice and once daily (0.26 and 0.18 log10 cfu/ml/d, respectively). The extended early bactericidal activity of linezolid between Days 2 and 7 was minimal. Conclusions: Linezolid has modest early bactericidal activity against rapidly dividing tubercle bacilli in patients with cavitary pulmonary tuberculosis during the first 2 days of administration, but little extended early bactericidal activity. Clinical trial registered with www.clinicaltrials.gov (NCT00396084).