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. 2025 Apr 19:53:101303.
doi: 10.1016/j.lanepe.2025.101303. eCollection 2025 Jun.

Clinical presentation, diagnostics, and outcomes of infants with congenital and postnatal tuberculosis: a multicentre cohort study of the Paediatric Tuberculosis Network European Trials Group (ptbnet)

Florian Götzinger  1   2   3 , Alejandra Alonso Caprile  4 , Antoni Noguera-Julian  5   6   7 , Andrea Lo Vecchio  8 , Fernando Baquero-Artigao  9 , Teresa Del Rosal  9 , Folke Brinkmann  10 , Françoise Mouchet  11 , Svetlana Velizarova  12 , Karsten Kötz  13 , Nicole Ritz  14   15   16 , Danilo Buonsenso  17 , Rinn Song  18 , Robindra Basu Roy  19   20 , Tea Nieminen  21 , Cornelius Rau  22 , Vira Chechenieva  1   23 , Steven Welch  24 , Petra Kaiser-Labusch  25 , Marieke Emonts  26   27 , Charlotte Buxbaum  28 , Daniel Blázquez-Gamero  29 , Alasdair Bamford  30   31   32 , Marc Tebruegge  1   3   16   32 , Nuria Martinez-Alier  4 ; Paediatric Tuberculosis Network European Trials Group (ptbnet)
Affiliations

Clinical presentation, diagnostics, and outcomes of infants with congenital and postnatal tuberculosis: a multicentre cohort study of the Paediatric Tuberculosis Network European Trials Group (ptbnet)

Florian Götzinger et al. Lancet Reg Health Eur. .

Abstract

Background: According to estimates, globally more than 200,000 pregnant women develop tuberculosis (TB) annually. Despite this, data on perinatal TB remain scarce. This study aimed to describe perinatal TB, comprising congenital (cTB) and postnatal (pTB) TB, in a European setting.

Methods: Retrospective cohort study via the Paediatric Tuberculosis Network European Trials Group (ptbnet) capturing and comparing cases of cTB and pTB diagnosed at 104 participating European healthcare institutions between 1995 and 2019.

Findings: Forty-six cases reported by 20 centres were included in the final analysis (cTB, n = 27; pTB, n = 19). Median age at symptom onset was one week in cTB (IQR: 0-1 weeks), and 12 weeks in pTB patients (IQR: 5-18 weeks). Prematurity was more common in cTB than pTB patients [57.9% (11/19); 95% CI: 36.3-76.9% vs. 21.1% (4/19); 95% CI: 8.5-43.3%; p = 0.049], and the average birth weight was significantly lower [1680 g; IQR: 932-2805 g vs. 2890 g; IQR: 2461-3400 g; p = 0.0043]. Microbiological confirmation was achieved in most patients [85.2% (23/27); 95% CI: 67.5-94.1% vs. 78.9% (15/19); 95% CI: 56.7-91.5%; p = 0.70]. The sensitivity of interferon-gamma release assays was poor in both groups [25.0% (3/12) 95% CI: 8.9-53.2% vs. 35.7% (5/14) 95% CI: 16.3-61.2%; p = 0.68]; in contrast, the sensitivity of the tuberculin skin tests (at 5 mm cut-off) was significantly higher in pTB patients [16.7% (2/12) 95% CI: 4.7-44.8% vs. 66.7% (10/15); 95% CI: 41.7-84.8%; p = 0.0185]. Approximately half of the patients required intensive care support [51.9% (14/27) 95% CI: 34.0-69.3% vs. 47.4% (9/19); 95% CI: 27.3-68.3%; p > 0.99]. Four (4/46; 8.7%) patients died, and four (4/46; 8.7%) had severe long-term sequelae.

Interpretation: There was substantial mortality and morbidity in this patient cohort, despite the high-resource setting. cTB was associated with premature birth and low birth weight. In contrast to microbiological tests, immunological tests perform poorly in perinatal TB, and should therefore not be used as rule-out tests.

Funding: No study-specific funding.

Keywords: Congenital; Diagnostics; Europe; Interferon-gamma release assay; Perinatal; TB.

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Conflict of interest statement

FG has received speaker fees and remuneration for advisory work from bioMérieux, and has received support for conference attendance from Pfizer. MT has received laboratory materials from Cellestis/Qiagen at reduced pricing and free of charge for other TB-related studies, and has received support from Cepheid for an unrelated TB diagnostics study. NMA has received support for conference attendance from AstraZeneca. ALV received grant support from Merck Sharp &Dohme, and consulting fees from Angelini Pharma. The manufacturers had no influence on the conduct of this study, or the decision to submit for publication. ANJ was supported by a research grant from the Carlos III Institute of Health, Ministry of Economy and Competitiveness (Spain), reference PI22/00766, and by the Spanish Society of Pneumology and Thoracic Surgery, grant number 169-2022. RS has received grant support by the United States National Institutes of Health (NIH). ME has received grant support by the European Union's Horizon 2020 research and innovation programme, grant number 848196. AB received fixed term consultancy fees by WHO relating to antimicrobial resistance in children and antibiotic prioritisation, is member of the scientific steering committee of the Paediatric European Network for Treatment of AIDS—Infectious Diseases (PENTA-ID) and chair of the European Paediatric HIV treatment guidelines working group (PENTA/European AIDS Clinical Society). SW holds a part-time contract with PENTA, is a committee member for the British Association for Paediatric Tuberculosis (BAPT), steering committee member of ptbnet, guideline committee member for the Children's HIV Association (Chiva) and Clinical Specialist Advisor to the British Thoracic Society MDR TB Clinical Advice Service. BKL is member of a patient advocacy group for Cystic Fibrosis.

Figures

Fig. 1
Fig. 1
Dot plot diagram showing the age at symptom onset (A) and the age at presentation (B) in infants with congenital and postnatal tuberculosis. Each dot represents one patient; the horizontal lines indicate the medians.
See this image and copyright information in PMC

References

    1. Global tuberculosis report 2023. World Health Organization; Geneva: 2023. Licence: CC BY-NC-SA 3.0 IGO.
    1. Sugarman J., Colvin C., Moran A.C., Oxlade O. Tuberculosis in pregnancy: an estimate of the global burden of disease. Lancet Glob Health. 2014;2(12):e710–e716. - PubMed
    1. Zenner D., Kruijshaar M.E., Andrews N., Abubakar I. Risk of tuberculosis in pregnancy: a national, primary care-based cohort and self-controlled case series study. Am J Respir Crit Care Med. 2012;185(7):779–784. - PubMed
    1. Schaaf H.S., Collins A., Bekker A., Davies P.D. Tuberculosis at extremes of age. Respirology. 2010;15(5):747–763. - PubMed
    1. Abughali N., Van der Kuyp F., Annable W., Kumar M.L. Congenital tuberculosis. Pediatr Infect Dis J. 1994;13(8):738–741. - PubMed

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