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Solid organ transplant recipients have an increased risk of tuberculosis (TB). Due to the use of immunosuppressants, the incidence of TB among solid organ transplant recipients has been consistently reported to be higher than that among the general population. TB frequently develops within the first year after transplantation when a high level of immunosuppression is maintained. Extrapulmonary TB and disseminated TB account for a substantial proportion of TB among solid organ transplant recipients. Treatment of TB among recipients is complicated by the drug–drug interactions between anti-TB drugs and immunosuppressants. TB is associated with an increased risk of graft rejection, graft failure and mortality. Detection and management of latent TB infection among solid organ transplant candidates and recipients have been recommended. However, strategy to mitigate the risk of TB among solid organ transplant recipients has not yet been established in Taiwan. To address the challenges of TB among solid organ transplant recipients, a working group of the Transplantation Society of Taiwan was established. The working group searched literatures on TB among solid organ transplant recipients as well as guidelines and recommendations, and proposed interventions to strengthen TB prevention and care among solid organ transplant recipients. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus (DM) is a known risk factor for tuberculosis (TB), leading to an approximate three-fold higher risk of developing active TB. However, epidemiological studies on the prevalence of latent TB infection (LTBI) in DM patients are lacking. In this study, we investigated the presence of LTBI and determined risk factors for LTBI in DM patients. Methodology: We conducted a cross-sectional study at Taipei Medical University-Shuang Ho Hospital in northern Taiwan. The study population comprised DM patients (aged 20-70 years) attending a metabolism outpatient clinic between February 2011 and February 2013, excluding patients who were suspected or confirmed to have active TB. Venous blood samples were drawn from patients to detect LTBI using the QuantiFERON-TB Gold In-Tube (QFT-GIT) method. Results: We enrolled 1120 patients with DM. The QFT-GIT showed positive results for 241 people (21.5%) and negative results for 879 people (78.5%). The mean age at QFT-GIT positivity was 58.2 years, which was significantly dissimilar to the mean age at QFT-GIT negativity, which was 55.0 years (p < 0.001). Multivariate logistic regression indicated that the trend of QFT-GIT positivity increased after the age of 50 years. Effective glycemic control did not differ significantly between QFT-GIT-positive and -negative patients. Moreover, men were predominant were predominant in both QFT-GIT-positive and -negative patients. Conclusions: More than one-fifth of DM patients have LTBI. Among the DM patients, those older than 50 years may have a higher risk of LTBI. Moreover, effective glycemic control did not differ significantly in patients with LTBI [ABSTRACT FROM AUTHOR]

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Citrus tatter leaf virus (CTLV) causes chlorotic leaves with bud union incompatibility in citrus scion and its current incidence in Taiwan is 65%. However, the burden of infection has long been underestimated due to its common latency, and the serious threat of tatter leaf disease should be investigated and addressed without delay. Here, the biological characteristics and genome sequences of Taiwanese isolates are evaluated. Full‐length sequencing and phylogenetic analysis of three local isolates revealed similarities with isolates from neighbouring countries, indicating their possible origins. Two mild isolates obtained from Liuchen sweet orange (LCd‐NA‐1) and kumquat (Kq‐6‐2‐46) were inoculated on indicator plants and exhibited differences in foliar symptom expression and temperature tolerance compared with foreign isolates causing severe disease. Improved quantitative PCR‐based detection methods using redesigned primer pairs indicated high sensitivity and specificity for both local and foreign isolates. Similar but delayed systemic symptoms were observed when wildtype virus in vitro transcripts generated from a full‐length infectious clone of the Ponkan mandarin isolate (pCTLV‐Pk‐8) were inoculated on Chenopodium quinoa. These symptoms were unevenly distributed and highly concentrated on the inoculated sides of leaves and top leaves. A single codon mutation (U5642C) in the coat protein transcription start site in the pCTLV‐Pk‐8 sequence resulted in defective systemic infection, indicating a role for the coat protein in viral movement. The combination of biological assays, improved detection and infectious clone construction provides comprehensive information and a foundation for citrus virus management and further research. [ABSTRACT FROM AUTHOR]

Lisianthus ( Eustoma grandiflorum) grown in screenhouses in Taiwan showed ringspots and concentric line patterns on leaves. A virus having isometric particles approximately 30-32 nm in diameter was isolated from affected lisianthus. Combined results of biological, cytological, serological, molecular and phylogenetic analyses show that the virus can be identified as Pothos latent virus (Po LV), genus Aureusvirus, family Tombusviridae. Inoculating the virus on non-infected lisianthus plants reproduced the symptoms previously observed in the field. So, this is the first report of Po LV causing disease in lisianthus and the first report of the virus in Taiwan. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between diabetes and latent tuberculosis infections (LTBI) in high TB incidence areas., Design: Community-based comparison study., Setting: Outpatient diabetes clinics at 4 hospitals and 13 health centres in urban and rural townships. A community-based screening programme was used to recruit non-diabetic participants., Participants: A total of 2948 patients with diabetes aged older than 40 years were recruited, and 453 non-diabetic participants from the community were enrolled., Primary and Secondary Outcome Measures: The interferon-gamma release assay (IGRA) and the tuberculin skin test were used to detect LTBI. The IGRA result was used as a surrogate of LTBI in logistic regression analysis., Results: Diabetes was significantly associated with LTBI (adjusted OR (aOR)=1.59; 95% CI 1.11 to 2.28) and age correlated positively with LTBI. Many subjects with diabetes also had additional risk factors (current smokers (aOR=1.28; 95% CI 0.95 to 1.71), comorbid chronic kidney disease (aOR=1.26; 95% CI 1.03 to 1.55) and history of TB (aOR=2.08; 95% CI 1.19 to 3.63)). The presence of BCG scar was protective (aOR=0.66; 95% CI 0.51 to 0.85). Duration of diabetes and poor glycaemic control were unrelated to the risk of LTBI., Conclusion: There was a moderately increased risk of LTBI in patients with diabetes from this high TB incidence area. This finding suggests LTBI screening for the diabetics be combined with other risk factors and comorbidities of TB to better identify high-risk groups and improve the efficacy of targeted screening for LTBI., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)