Mycobacterium simiae infection in a patient with Acquired Immunodeficiency Syndrome

Sampaio, Jorge Luiz Mello; Artiles, N; Pereira, R.M.G.; Souza, Jorge Rodrigues de; Leite, José Paulo Gagliardi

doi:10.1590/s1413-86702001000600010

Cited by 25 publications

(22 citation statements)

References 5 publications

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“…This finding is in agreement with those of previous studies (7,24,25). The clinical presentation, radiographic findings, and utility of sputum-based diagnostic modalities may differ between HIV-positive and -negative cases and may differ in HIV-infected individuals as immune suppression progresses (1,26). These factors increase the complexity of management of patients with HIV/M.…”

Section: Discussionsupporting

confidence: 90%

<i>Mycobacterium simiae</i>: a Possible Emerging Pathogen in Iran

et al. 2013

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SUMMARY: Mycobacterium simiae has been reported worldwide, particularly from the Middle East. This organism has been recognized as a causative agent of pulmonary and disseminated infections. In this study, we used molecular methods to detect this organism from patients who were suspected of having tuberculosis. A total of 117 isolates of mycobacteria were evaluated from different regions of Iran. Isolates were identified using phenotypic methods and gene sequencing of 16S rRNA, rpoB, hsp65, and ITS. Of the 117 isolates, 12 M. simiae isolates (10.2z) were identified from different clinical samples, including bronchoalveolar lavage and sputum (n ＝ 8), blood (n ＝ 3), and lymph node biopsy (n ＝ 1). Three isolates (3/12, 25z) were recovered from blood samples of HIV cases when the CD4 ＋ count was less than 50/ml. There was no significant relationship between infection and age or gender. Infection with nontuberculous mycobacteria (NTM), including M. simiae, is the major problem among immunocompromised patients. The results of this study illustrated the importance of molecular methods for accurate and rapid detection of NTM infections in the treatment of nonresponding patients with suspected tuberculosis.

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Section: Discussionsupporting

confidence: 90%

<i>Mycobacterium simiae</i>: a Possible Emerging Pathogen in Iran

et al. 2013

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“…(13) Transmission is thought to be airborne and fecal-oral since it has been detected in healthy human feces. (16) The isolate found in this study was resistant to all common antituberculous drugs, as were M. simiae described in other case reports.…”

Section: Discussionsupporting

confidence: 67%

“…There have been few reports of M. simiae infection in HIV-infected patients. (13)(14)(15) Although its association with human disease is not frequent, pulmonary infection with M. simiae has been reported in monkey trainers and in other individuals having close contact to these animals, (16) as well as in patients with pre-existing pulmonary resistance to any of the other drugs tested and, at 14.9%, was considerably higher than 5.9% worldwide rate reported by the World Health Organization. (6) According to that report, a higher than 10% rate of resistance to isoniazid and rifampicin can predict the development of MDR-TB.…”

Section: Discussionmentioning

confidence: 94%

Doença pulmonar por Mycobacterium tuberculosis e micobactérias não-tuberculosas entre pacientes recém-diagnosticados como HIV positivos em Moçambique, África

et al. 2008

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Objective: Mycobacteriosis is frequently diagnosed among HIV-infected patients. In Mozambique, where few patients are under antiretroviral therapy and the prevalence of tuberculosis is high, there is need for better characterization of mycobacteria at the species level, as well as for the identification of patterns of resistance to antituberculous drugs. Methods: We studied a sample of 503 HIV-infected individuals suspected of having pulmonary tuberculosis. Of those 503, 320 tested positive for mycobacteria through sputum smear microscopy or culture of bronchoalveolar lavage fluid. Results: Acid-fast bacilli were observed in the sputum of 73% of the individuals presenting positivecultures. Of 277 isolates tested, only 3 were nontuberculous mycobacteria: 2 were identified as Mycobacterium avium and one was identified as M. simiae. Strains initially characterized as M. tuberculosis complex through polymerase chain reaction restriction analysis (PRA) of the hsp65 gene were later confirmed as such through PRA of the gyrB gene. Among the M. tuberculosis isolates, resistance patterns were as follows: to isoniazid, 14%; to rifampin, 6%; and multidrug resistance, 5%. Previously treated cases showed significantly higher rates of resistance to first-line antituberculous drugs. The most common radiological pattern was interstitial infiltrate (in 67%), followed by mediastinal lymph node enlargement (in 30%), bronchiectasis (in 28%), miliary nodules (in 18%) and cavitation (in 12%). Patients infected with nontuberculous mycobacteria presented clinical profiles indistinguishable from those of other patients. The median CD4 lymphocyte count in this group was 134 cells/mm 3 . Conclusions: There is a strong association between tuberculosis and AIDS in Mozambique, as expected in a country with a high prevalence of tuberculosis. Although drug resistance rates are high, the isoniazid-rifampin regimen continues to be the appropriate choice for initial therapy.Keywords: Tuberculosis; Mycobacteria, atypical; HIV; Acquired immunodeficiency syndrome; Drug Resistance, Multiple; Mozambique. ResumoObjetivo: A micobacteriose é frequentemente diagnosticada entre pacientes infectados pelo HIV. Em Moçambique, onde apenas um pequeno número de pacientes encontra-se sob tratamento anti-retroviral, e a tuberculose tem alta prevalência, existe a necessidade de melhor caracterização destes agentes bacterianos, em nível de espécie, bem como de se caracterizar os padrões de resistência às drogas antituberculosas. Métodos: Em uma coorte de 503 indivíduos HIV positivos suspeitos de tuberculose pulmonar, 320 apresentaram positividade para baciloscopia ou cultura no escarro e no lavado brônquico. Resultados: Bacilos álcool-ácido resistentes foram detectados no escarro em 73% dos casos com cultura positiva. De 277 isolados em cultura, apenas 3 mostraram-se tratar de micobactérias não-tuberculosas:2 Mycobacterium avium e uma M. simiae. Todos os isolados de M. tuberculosis inicialmente caracterizados através de reação em cadeia de polimerase (RCP) do...

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“…The causes of this possibly unusual sex distribution remain unknown. Extrapulmonary infections are seldom reported and are restricted to immunocompromised hosts [5,11]. Cases have occurred in the Netherlands before the present study period [12].…”

Section: Discussionmentioning

confidence: 99%

“…However, in due course, M. simiae isolation has been reported from many places in the world [4][5][6].…”

mentioning

confidence: 99%

Clinical relevance of Mycobacterium simiae in pulmonary samples

Ingen

Boeree²,

Dekhuijzen³

et al. 2008

European Respiratory Journal

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The aim of the present study was to determine the clinical relevance of Mycobacterium simiae isolation from clinical samples.The medical files of patients in the Netherlands from whom M. simiae was isolated between 1999 and 2006 were reviewed in order to assess frequency and clinical relevance. Clinical relevance was defined as fulfilment of the diagnostic criteria of the American Thoracic Society.From the files, 28 patients were identified, of whom six (21%) met the American Thoracic Society diagnostic criteria. A slight (54%) female predominance was observed, which is uncommon for nontuberculous mycobacteria isolation. Fulfilment of the diagnostic criteria and initiation of treatment were not in agreement; treatment results were poor.Only a minority of clinical M. simiae isolates are clinically relevant and, applying the American Thoracic Society diagnostic criteria, the number of true infections is overestimated. Physicians in the Netherlands do not always use these criteria in daily practice, resulting in both over-and underdiagnosis of M. simiae infection. Further studies are required in order to improve diagnostic criteria and treatment regimens.

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Mycobacterium simiae infection in a patient with Acquired Immunodeficiency Syndrome

Cited by 25 publications

References 5 publications

<i>Mycobacterium simiae</i>: a Possible Emerging Pathogen in Iran

<i>Mycobacterium simiae</i>: a Possible Emerging Pathogen in Iran

Doença pulmonar por Mycobacterium tuberculosis e micobactérias não-tuberculosas entre pacientes recém-diagnosticados como HIV positivos em Moçambique, África

Clinical relevance of Mycobacterium simiae in pulmonary samples

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