Mycobacterium chimaera in heater-cooler devices: an experience in a tertiary hospital in Spain.

The aim of the study was to describe the Mycobacterium chimaera contamination in heater-cooler devices after the application of a protocol of cleaning and disinfection in a tertiary hospital. It was an observational study at the La Paz-Cantoblanco-Carlos III University Hospital, Madrid, Spain. Seven heater-cooler devices are used in our hospital: five 3T Sorin (LivaNova) and two Maquet. We followed the manufacturers' instructions for cleaning and disinfection of the different heater-cooler devices. Environmental testing was developed monthly from January 2017 to July 2019. Samples were obtained from both cardioplegia and patient circuits and before and after the disinfection process and were cultured in appropriate media for non-tuberculous mycobacteria and heterotrophic bacteria (coliforms and Pseudomonas aeruginosa). A total of 320 samples were taken. Mycobacterium chimaera grew in four water samples (1.25%) from three different heater-cooler devices, with two positive results occurring after disinfection. The heterotrophic bacteria Delftia acidovorans and Stenotrophomonas maltophilia were also found. There has not been a case of M. chimaera infection in patients after cardiac surgery in our hospital. In March 2019, we decided to move the heater-cooler device outside the operating room. Mycobacterium chimaera contamination is not always eradicated by disinfection processes. We believe that placing 3T heater-cooler devices outside the operating room is the best option in preventing M. chimaera infection during cardiac surgery.

Magnetoconductivity in quasiperiodic graphene superlattices.

The magnetoconductivity in Fibonacci graphene superlattices is investigated in a perpendicular magnetic field B. It was shown that the B-dependence of the diffusive conductivity exhibits a complicated oscillatory behavior whose characteristics cannot be associated with Weiss oscillations, but rather with Shubnikov-de Haas ones. The absense of Weiss oscillations is attributed to the existence of two incommensurate periods in Fibonacci superlattices. It was also found that the quasiperiodicity of the structure leads to a renormalization of the Fermi velocity [Formula: see text] of graphene. Our calculations revealed that, for weak B, the dc Hall conductivity [Formula: see text] exhibits well defined and robust plateaux, where it takes the unexpected values [Formula: see text], indicating that the half-integer quantum Hall effect does not occur in the considered structure. It was finally shown that [Formula: see text] displays self-similarity for magnetic fields related by [Formula: see text] and [Formula: see text], where [Formula: see text] is the golden mean.

Leptospirosis in an asplenic patient -case report.

BACKGROUND: The presentation of clinical leptospirosis has been historically associated with animal workers, slaughterhouse workers and medical veterinarians. This association has shifted to be related to flooding events and outdoor activities; few cases are related to high-risk factors found in immunosuppressed patients. Scarcely a handful of cases have serological evidence of immune response against Leptospira serovar Bratislava representing serogroup Australis, a serovar associated with poor reproductive performance in swine and horses, and recently with cats. CASE PRESENTATION: Herein, we describe a rare clinical presentation of disseminated Leptospira infection in an immunosuppressed 65-year-old woman. She was admitted to the emergency room with fever, bacteraemia, bilateral uveitis and pulmonary involvement. The patient denied outdoor activities; she only had wide exposure to faeces and urine from cats living in her home. Her medical history included idiopathic thrombocytopenic purpura (ITP) diagnosed at the age of 18. She did not respond to medical treatment, and a splenectomy was performed. At age 60, she was diagnosed with Chronic Myeloid Leukemia (CML), and was treated with a tyrosine kinase inhibitor (TKI) -Imatinib. The patient voluntarily discontinued the treatment for the last 6 months. After extensive workup, no microorganisms were identified by the commonly used stains in microbiology. The diagnosis was performed through dark-field microscopy, microagglutination test (MAT), Leptospira genus-specific PCR, the IS1500 PCR for identification of pathogenic species, and 16S based sequencing for the genus identification. CONCLUSION: Immunosuppressed patients may acquire uncommon infections from ubiquitous microorganisms. In this case, serology evidence of exposure to Leptospira serovar Bratislava by MAT and the presence of the Leptospira genus were identified. It should be on mind for the diagnosis in otherwise healthy patients, and thoroughly search on splenectomised patients exposed to animals. Additionally, this report highlights the usefulness of PCR for diagnosis of this potentially life-threatening illness.

Unveiling optical in-plane anisotropy of 2D materials from oblique incidence of light.

In this work, we present a theoretical study of the dispersion of linearly polarized light between two dielectric media separated by an anisotropic two-dimensional (2D) material under oblique incidence. Assuming that the 2D material is a conducting sheet of negligible thickness, generalized Fresnel coefficients are derived as a function of usual quantities (e.g. refraction indexes and scattering angles) and the anisotropic in-plane optical conductivity of the interstitial 2D material. In particular, we analyzed the modifications due to the 2D material of two classical optical phenomena: the Brewster effect and the total internal reflection. As a application, our general findings are particularized for uniaxially strained graphene. Effects of a uniaxial strain on the Brewster angle and the reflectance (under total internal reflection) are evaluated as a function of the magnitude and direction of strain.

Relationship of American Indian blood quantum with osteoporosis risk: a cross-sectional study of American Indian women in Oklahoma.

Information regarding the prevalence and risk of osteoporosis among American Indian (AI) women is limited. This study showed that with increasing AI blood quantum, the prevalence of osteoporosis at the hip based on BMD T-scores decreased and this appeared to be independent of other risk factors. INTRODUCTION: This study was designed to investigate the effects of AI blood quantum (BQ) on osteoporosis prevalence and risk in a cohort of AI women in Oklahoma. METHODS: Women (n = 301), aged 50 years and older, were recruited to participate in the Oklahoma American Indian Women's Osteoporosis Study. Baseline bone density, fracture history, bone biochemical markers, and potential risk factors were assessed. Participants were stratified by AI BQ into BQ1 ≤ 25%, BQ2 = 25-49%, BQ3 = 50-74%, and BQ4 = 75-100%. The effects of BQ on the prevalence and risk of osteoporosis were evaluated. RESULTS: Based on T-scores, one in approximately eight women in the study was osteoporotic at one or more sites. The prevalence of osteoporosis decreased (p < 0.05) with increasing BQ, especially at the hip, trochanteric, and intertrochanter regions. No differences in bone-specific alkaline phosphatase and C-telopeptide were observed across BQ that could account for the differences in bone density. 25-OH vitamin D decreased with increasing BQ, but mean for each BQ1-4 was > 40 ng/mL. Fracture history did not differ across BQ, and though 52% of the population consumed less than the RDA for calcium, no effect of BQ was observed. CONCLUSIONS: In this cohort of women who identified as AI, greater Indian BQ was associated with a decrease in the prevalence of osteoporosis.

Fingerprints of a position-dependent Fermi velocity on scanning tunnelling spectra of strained graphene.

Nonuniform strain in graphene induces a position dependence of the Fermi velocity, as recently demonstrated by scanning tunnelling spectroscopy experiments. In this work, we study the effects of a position-dependent Fermi velocity on the local density of states (LDOS) of strained graphene, with and without the presence of a uniform magnetic field. The variation of LDOS obtained from tight-binding calculations is successfully explained by analytical expressions derived within the Dirac approach. These expressions also rectify a rough Fermi velocity substitution used in the literature that neglects the strain-induced anisotropy. The reported analytical results could be useful for understanding the nonuniform strain effects on scanning tunnelling spectra of graphene, as well as when it is exposed to an external magnetic field.

Sound waves induce Volkov-like states, band structure and collimation effect in graphene.

We find exact states of graphene quasiparticles under a time-dependent deformation (sound wave), whose propagation velocity is smaller than the Fermi velocity. To solve the corresponding effective Dirac equation, we adapt the Volkov-like solutions for relativistic fermions in a medium under a plane electromagnetic wave. The corresponding electron-deformation quasiparticle spectrum is determined by the solutions of a Mathieu equation resulting in band tongues warped in the surface of the Dirac cones. This leads to a collimation effect of electron conduction due to strain waves.

Pathogenic Compound Heterozygous Mutations in a Mexican Mestizo Patient with Niemann-Pick Disease Type B.

Niemann-Pick disease (NPD) type B is a lysosomal storage disorder caused by a deficiency of acid sphingomyelinase (ASM). We report the clinical follow-up of a 16-year-old Mexican mestizo woman with a NPD type B phenotype who presented hepatosplenomegaly, persitstenly low high-density lipoprotein (HDL) cholesterol and thrombocytopenia, without central nervous system involvement. After of a dengue fever episode with severe anemia and pancytopenia, leading to a bone marrow study n which foamy histiocytes were noticed and diagnosis of NiemannPick disease was suspected; and confirmed by biochemical and molecular tests. The missense c.1343 A>G (p.Tyr448Cys, formerly Y446C) and c. 1426C>T (p.Arg476Trp, formerly R474W) mutations in the SMPD1 gene were identified. These mutations have never been reported in the Mexican population. Since the c.1343 A>G (Y446C) mutation has been previously reported in a Japanese patient with NPD type A, we suggest an attenuator effect of c.1426C>T (R474W) allele (previously associated with the NPD type B phenotype). In conclusion, this is the first description of the concomitant occurrence of Y446C and R476W mutations in a Mexican patient with NPD type B, showing the importance of increased awareness and availability of specialized diagnostic tests in the diagnosis of rare inherited metabolic diseases.

Challenges of modelling real nanoparticles: Ni@Pt electrocatalysts for the oxygen reduction reaction.

Theoretical/computational methods have been extensively applied to screen possible nano-structures attempting to maximize catalytic and stability properties for applications in electrochemical devices. This work shows that the method used to model core@shell structures is of fundamental importance in order to truly represent the physicochemical changes arising from the formation of a core-shell structure. We demonstrate that using a slab approach for modelling nanoparticles the oxygen adsorption energies are qualitatively well represented. Although this is a good descriptor for the catalytic activity, huge differences are found for the calculated surface stability between the results of a nano-cluster and those of a slab approach. Moreover, for the slab method depending on the geometric properties of the core and their similarity to the elements of the core or shell, contradictory effects are obtained. In order to determine the changes occurring as the number of layers and nano particle size are increased, clusters of Ni@Pt from 13 to 260 atoms were constructed and analyzed in terms of geometric parameters, oxygen adsorption, and dissolution potential shift. It is shown that the results of modelling the Ni@Pt nanoparticles with a cluster approach are in good agreement with experimental geometrical parameters, catalytic activity, and stability of a carefully prepared series of Ni@Pt nanostructures where the shell thickness is systematically changed. The maximum catalytic activity and stability are found for a monolayer of Pt whereas adding a second and third layer the behavior is almost the same than that in pure Pt nanoparticles.

Electromagnetic energy transport in finite photonic structures.

We have derived, for oblique propagation, an equation relating the averaged energy flux density to energy fluxes arising in the process of scattering by a lossless finite photonic structure. The latter fluxes include those associated with the dispersion relation of the structure, reflection, and interference between the incident and reflected waves. We have also derived an explicit relation between the energy flux density and the group velocity, which provides a simple and systematical procedure for studying theoretically and experimentally the properties of the energy transport through a wide variety of finite photonic structures. Such a relation may be regarded as a generalization of the corresponding one for infinite periodic systems to finite photonic structures. A finite, N-period, photonic crystal was used to illustrate the usefulness of our results.

Anisotropic AC conductivity of strained graphene.

The density of states and the AC conductivity of graphene under uniform strain are calculated using a new Dirac Hamiltonian that takes into account the main three ingredients that change the electronic properties of strained graphene: the real displacement of the Fermi energy, the reciprocal lattice strain and the changes in the overlap of atomic orbitals. Our simple analytical expressions for the density of states and the AC conductivity generalize previous expressions for uniaxial strain. The results suggest a way to measure the Grüneisen parameter ß that appears in any calculation of strained graphene, as well as the emergence of a sort of Hall effect due to shear strain.

Functional analysis of endo-1,4-ß-glucanases in response to Botrytis cinerea and Pseudomonas syringae reveals their involvement in plant-pathogen interactions.

Plant cell wall modification is a critical component in stress responses. Endo-1,4-ß-glucanases (EGs) take part in cell wall editing processes, e.g. elongation, ripening and abscission. Here we studied the infection response of Solanum lycopersicum and Arabidopsis thaliana with impaired EGs. Transgenic TomCel1 and TomCel2 tomato antisense plants challenged with Pseudomonas syringae showed higher susceptibility, callose priming and increased jasmonic acid pathway marker gene expression. These two EGs could be resistance factors and may act as negative regulators of callose deposition, probably by interfering with the defence-signalling network. A study of a set of Arabidopsis EG T-DNA insertion mutants challenged with P. syringae and Botrytis cinerea revealed that the lack of other EGs interferes with infection phenotype, callose deposition, expression of signalling pathway marker genes and hormonal balance. We conclude that a lack of EGs could alter plant response to pathogens by modifying the properties of the cell wall and/or interfering with signalling pathways, contributing to generate the appropriate signalling outcomes. Analysis of microarray data demonstrates that EGs are differentially expressed upon many different plant-pathogen challenges, hormone treatments and many abiotic stresses. We found some Arabidopsis EG mutants with increased tolerance to osmotic and salt stress. Our results show that impairing EGs can alter plant-pathogen interactions and may contribute to appropriate signalling outcomes in many different biotic and abiotic plant stress responses.

Plasmid DNA immunization with Trypanosoma cruzi genes induces cardiac and clinical protection against Chagas disease in the canine model.

The only existing preventive measure against American trypanosomosis, or Chagas disease, is the control of the transmitting insect, which has only been effective in a few South American regions. Currently, there is no vaccine available to prevent this disease. Here, we present the clinical and cardiac levels of protection induced by expression to Trypanosoma cruzi genes encoding the TcSP and TcSSP4 proteins in the canine model. Physical examination, diagnostic chagasic serology, and serial electrocardiograms were performed before and after immunization, as well as after experimental infection. We found that immunization with recombinant plasmids prevented hyperthermia in the acute phase of experimental infection and produced lymphadenomegaly as an immunological response against the parasite and additionally prevented heart rate elevation (tachycardia) in the acute and/or chronic stages of infection. Immunization with T. cruzi genes encoding the TcSP and TcSSP4 antigens diminished the quality and quantity of the electrocardiographic abnormalities, thereby avoiding progression to more severe developments such as right bundle branch block or ventricular premature complexes in a greater number of dogs.

Glutamate supply positively affects serum release of triiodothyronine and insulin across time without increases of glucose during the onset of puberty in female goats.

The current study evaluated the effect of glutamate supply on the onset of puberty and possible links to changes in serum concentrations of insulin [INS], glucose [GLU] and triiodothyronine [T(3)]. The study was conducted from June to November in prepuberal female goats (n=18; 3 mo. old, 7/8 Saanen-Alpine, 1/8 Criollo, 26° north) randomly assigned to two experimental groups: (i) excitatory amino acids group (group AA, n=10; 16.52±1.04 kg LW, 3.4±0.12 body condition score [BCS], receiving an intravenous infusion of 7 mg kg(-1) live weight [LW] of l-glutamate, twice a week, and (ii) control group (group CC, n=8; 16.1±1.04 kg LW, 3.1±0.12 BCS) receiving saline. Blood samples were obtained twice a week, for assessing progesterone [P(4)], as well as in a monthly basis to evaluate INS and T(3) by RIA. Mean final LW and BCS were 23.2±0.72 kg, 3.53±0.10 units, without differences between groups. The AA group depicted an earlier onset of puberty (6.9±0.3 compared to 7.5±0.4 mo.; P<0.05) and an increased ovarian activity (70±0.28% compared to 25±0.26%; P<0.05). Neither serum INS concentrations nor serum glucose concentrations differed between treatments (1.2±0.06 ng mL(-1) and 89.6±1.8 mg 100 mL(-1); P>0.05, respectively). Serum T(3) concentrations, however, were greater in AA goats (1.55±0.03 compared to 1.39±0.04 ng mL(-1)). In addition, a treatment x time interaction occurred (P<0.05) across the experimental period for both T(3) and INS, with increases by the last third of the experimental period, time at which the onset of puberty occurred in both experimental groups. No differences (P>0.05) for glucose concentrations across time occurred between treatments. Results indicate that, in prepuberal goats, glutamate acts as a cue for sexual maturation in a glucose-independent pathway, while both T(3) and INS seem to act as metabolic modulators for the establishment of puberty in goats. Actions of INS and T(3) are mediated directly on hypothalamic centers regulating the pulsatile release of GnRH or indirectly by peripheral cues reflecting INS-T(3) actions on somatic development remains to be determined.

A method for isolating RNA from metabolically active bacterial flora associated with octopus.

AIM: Development of a method for the isolation and purification of metagenomic RNA (mgRNA) from the ectopic bacterial flora of octopus. METHODS AND RESULTS: Modifications were made to the methods of Valenzuela-Avendaño et al. (Plant Mol Biol Rep, 2005, 23, 199a) and Chomczynski and Sacchi (Anal Biochem, 1987, 162, 156) to develop a protocol based on chemical lysis with Trizol. This proposed protocol effectively isolated mgRNA. The resulting bacterial RNA transcripts were amplified with universal primers directed to the hypervariable regions of the 16S rRNA gene by complementary DNA synthesis. Protocol efficacy in the study of metabolically active bacterial flora was proven using DGGE, which produced a banding pattern that recovered sequences mainly related to the Vibrionaceae family. CONCLUSION: The analysed samples were clearly complex, and the proposed protocol was proven to effectively isolate mgRNA from the metabolically active bacterial flora associated with octopus. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first protocol proposed for the isolation of bacterial mgRNA that allows identification and study of metabolically active bacterial flora associated with octopus. This is an important step forward in understanding and controlling the microbial community of this economically important fishery resource, aimed at detecting its potentially pathogenic bacteria.

Zero-width band gap associated with the n[over] = 0 condition in photonic crystals containing left-handed materials.

We demonstrate that the band structure of a photonic crystal consisting of alternating layers of right-handed material (RHM) and left-handed material (LHM) can exhibit two types of zero- n[over ] gaps of zero width. It is shown that each type has an associated null-gap condition which determines the scaling properties of the frequency nu(0) at which the corresponding null gap occurs. Specifically, while scaling in the layer thicknesses does not modify the value of the frequency nu(0) determined by one of these conditions, the frequency nu(0) associated with the other one does not exhibit such a scaling behavior. We have also shown that near the touching point nu(0) (for both types of null gaps) and around the center of the Brillouin zone, the dispersion curves exhibit a linear dependence on the Bloch wave vector k . As a consequence, the corresponding density of states and group velocity are practically flat as functions of k in the neighborhood of k=0 . Another interesting property of the considered structure is that an electromagnetic wave with frequency nu(0) can be transmitted through a finite RHM-LHM photonic crystal without any change in amplitude and phase.

Anti-PDGFR-alpha antibodies measured by non-bioactivity assays are not specific for systemic sclerosis.

OBJECTIVE: To evaluate the presence of anti-PDGFR-alpha antibodies by immunological methods in patients with systemic sclerosis (SSc). METHODS: Fifty-eight women diagnosed with SSc and 36 healthy women controls were included. IgG anti-PDGFR-alpha were measured by ELISA and immunoblot. Associations with clinical and immunological findings were also studied. RESULTS: Non-significant differences were detected between patients with SSc and controls: median value 0.287 (range 0-2.06) versus median value 0.226 (range 0-2.94), respectively (p = 0.583). No correlation between the presence of anti-PDGFR-alpha antibodies and clinical and serological features was found. Serum samples from patients with SSc and healthy people who had high titres of anti-PDGFR-alpha antibodies by ELISA recognised the same band corresponding to PDGFR-alpha by immunoblot. CONCLUSION: Although anti-PDGFR-alpha antibodies seem to be disease-specific when determined by bioactivity assays, these antibodies are also detected in normal subjects when immunological methods are used. Thus, anti-PDGFR-alpha antibodies may arise from natural autoantibodies. Possibly, SSc autoantibodies recognise a different epitope on the PDGFR-alpha molecule which triggers its stimulatory effect when analysed by functional assays. Alternatively, naturally occurring autoantibodies may even become pathogenic after affinity maturation and class switching in genetically susceptible subjects.

Photonic band structure and symmetry properties of electromagnetic modes in photonic crystals.

Within the Maxwell framework and using a transfer-matrix technique we have determined a general equation which governs the photonic band structure and the density of states of one-dimensional superlattices composed of two alternate layers characterized by different refractive indexes, which may take on positive as well as negative values. Besides the usual well-known results, we have found null-gap points for commensurate values of the optical path lengths of each layer. Furthermore, we have been able to characterize non-Bragg gaps that show up in frequency regions in which the average refractive index is null.

Resistencia insulínica en niños y adolescentes obesos

Objetivos. Valorar la resistencia insulínica en niños y adolescentes obesos, analizar las variables relacionadas con ella y comprobar si la acantosis nigricans es un buen marcador de la misma. Pacientes y métodos. Estudio prospectivo de los niños de 7 a 15 años que consultaron por sobrepeso y presentaban un índice de masa corporal (IMC) mayor del percentil 97 para su edad y sexo. Se excluyeron los que presentaban alguna alteración del metabolismo hidrocarbonado. Se utilizó como control un grupo de 50 niños sanos con IMC normal. Se recogieron variables clínicas (antecedentes familiares de diabetes tipo 2, edad, sexo, situación puberal, IMC, presencia de acantosis nigricans (AN), presión arterial e índice cintura-cadera). Se determinaron en ayunas glucemia, insulinemia, triglicéridos, colesterol (total, HDL y LDL) y ácido úrico. Se calculó el índice "HOMA" y se definió Resistencia Insulínica cuando su valor era superior a 3,8. Los resultados se expresan como media (desviación estándar). Resultados. Se incluyeron en el estudio 67 sujetos (32 varones) de 6,8 a 15,0 años de edad (media 11,6), 29 púberes y 38 prepúberes. Al comparar con el grupo control, los obesos presentaron niveles signicativamente más altos de glucemia (94,5 (7,7) frente a 73,8 (3,1) mg/dl), insulinemia (26,7 (15,7) frente a 12,0 (1,7) mU/l), HOMA (6,1 (3,7) frente a 2,5 (1,6)) y triglicéridos (107,9 (47,4) frente a 65,2 (27,4) mg/dl) y más bajos de HDL-colesterol (47,0 (10,0) frente a 65,1 (15,9) mg/dl). 44/67 niños (65,7 por ciento) presentaban Resistencia Insulínica, siendo más frecuente en individuos púberes (26/29 insulin resistentes, frente a 18/38 en los prepúberes) (p= 0,01). Los individuos insulin resistentes presentaban un colesterol HDL más bajo que los insulín sensibles (44 (12) frente a 53 (13) mg/dl) (p= 0,03). De los 34 pacientes que presentaban AN, 9 eran insulín sensibles y 19 que no la presentaban eran insulín resistentes. Conclusiones. En los niños y adolescentes obesos la Resistencia Insulínica es muy frecuente, incluso antes del inicio de la pubertad. Su frecuencia aumenta en individuos púberes y en aquellos con niveles bajos de colesterol HDL. La acantosis nigricans no es un buen marcador de Resistencia Insulínica (AU)

Pulmonary tuberculosis in children in a developing country.

OBJECTIVE: We evaluated the clinical and epidemiologic characteristics of Peruvian children presenting with pulmonary tuberculosis (PTB) to determine whether features predictive of confirmed PTB could be identified. STUDY DESIGN: This was a cross-sectional study of 135 children (mean age: 6.8 years) presenting to the Hospital del Niño in Lima, Peru, with presumptive diagnosis of PTB. Clinical, epidemiologic, and laboratory findings were compared between 3 groups of pediatric patients with a presumptive diagnosis of PTB: those with positive Mycobacterium tuberculosis (MTB) cultures, those likely to have PTB based on clinical criteria but with negative cultures, and those who did not meet clinical diagnostic criteria or have positive cultures. RESULTS: A total of 50 (37%) patients were diagnosed with definitive PTB based on positive sputum culture. Another 55 (47%) patients were classified as having probable PTB based on meeting at least 2 of the following criteria: cough lasting for at least 2 weeks, typical chest radiograph changes, purified protein derivative (PPD) >/=10 mm, or history of tuberculosis family contact. Patients with definitive or probable PTB were significantly older than patients without clinical PTB, and those with symptomatic disease were significantly older than those with asymptomatic disease. Patients with PTB diagnosed by culture were significantly more likely than those diagnosed using clinical criteria to have cough lasting >/=2 weeks, fever, and a PPD >/=10 mm. CONCLUSIONS: The typical presentation of PTB in Peruvian children includes symptoms of active pulmonary disease similar to those seen in adults. This presentation differs significantly from that reported in developed countries, where many children have minimal or no symptoms at the time of presentation. The diagnostic criteria for pediatric PTB must be modified in hyperendemic developing country environments where features may differ from those described in the United States. The triad of cough lasting >/=2 weeks, fever, and a PPD >/=10 mm was highly predictive for culture-positive PTB among children in this low-income Peruvian population.