Clinical features of infection caused by non-tuberculous mycobacteria: 7 years’ experience

Adžić-Vukičević, Tatjana; Barać, Aleksandra; Blanka-Protić, Ana; Laban-Lazovic, Marija; Luković, Bojana; Škodrić-Trifunović, Vesna; Rubino, Salvatore

doi:10.1007/s15010-018-1128-2

Cited by 19 publications

(10 citation statements)

References 27 publications

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“…Analysis of microbiologic data revealed that M. gordonae was not pathogenic, as it was identified only in the colonization group. Lack of pathogenic effect of M. gordonae was also documented by Adzic et al, who analyzed the clinical significance of positive respiratory NTM isolates in Serbia [19].…”

Section: Discussionsupporting

confidence: 52%

“…Increased susceptibility to NTM-LD in patients with past tuberculosis was documented in our previous report, but it concerned patients with all types of chronic lung disease [18]. Susceptibility to NTM colonization of post-tuberculous lesions may concern primarily M. kansasii [19,20], which was not a frequent NTM type in the present study group.…”

Section: Discussionsupporting

confidence: 40%

See 1 more Smart Citation

Non-Tuberculous Mycobacteria in Respiratory Specimens of Patients with Obstructive Lung Diseases—Colonization or Disease?

Szturmowicz¹,

Oniszh²,

Wyrostkiewicz³

et al. 2020

Antibiotics

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Non-tuberculous mycobacteria (NTM) are increasingly a cause of human respiratory tract colonization and mycobacterial lung disease (NTM-LD), especially in patients with chronic lung diseases. The aim of the present study was to find the factors predictive of NTM-LD in patients with obstructive lung diseases and NTM respiratory isolates. A total of 839 isolates of NTM, obtained from 161 patients between 2010 and 2020 in a single pulmonary unit, have been retrospectively reviewed. Of these isolates, 73 concerned 36 patients with obstructive lung diseases (COPD-26, asthma-3, COPD/asthma overlap syndrome-7). NTM-LD was recognized according to the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) criteria in 17 patients, colonization in 19. Lower BMI, elevated body temperature on admission, infiltrative/cavitary lesions on chest CT, and NTM species other than Mycobacterium gordonae were the significant predictors of NTM-LD recognition. Based on the above-mentioned predictive factors, an original scoring system was implemented. The diagnostic utility of the scoring system was higher than that of single parameters. We conclude that NTM-LD prediction in patients with obstructive lung diseases and positive respiratory isolates is difficult. A scoring system based on clinical, radiological and microbiological characteristics was capable of facilitating the differential diagnosis, but it needs further validation in a larger study group.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionsupporting

confidence: 40%

Non-Tuberculous Mycobacteria in Respiratory Specimens of Patients with Obstructive Lung Diseases—Colonization or Disease?

Szturmowicz¹,

Oniszh²,

Wyrostkiewicz³

et al. 2020

Antibiotics

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“…The gold standard for diagnosing TB remains based on culturing and 43.5% and 28.3% of the culture-confirmed lymph node cases also had a PCR and microscopy positive sample, respectively, establishing the importance of collecting material for culture. Furthermore, routine mycobacterial examination enables physicians to rule-out drug resistance and non-TB mycobacteria (Adzic-Vukicevic et al, 2018). Yet, a considerable number of patients did not have lymph node material sent for mycobacterial culture or histological examination, and it is assumed that the diagnosis of TB is often not considered before late into the course of disease.…”

Section: Discussionmentioning

confidence: 99%

Clinical features of tuberculous lymphadenitis in a low-incidence country

Mathiasen

Andersen

Johansen

et al. 2020

International Journal of Infectious Diseases

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Background: Tuberculous lymphadenitis (TBLA) is the most common extrapulmonary manifestation of tuberculosis (TB) in Denmark. However, the clinical features of patients with TBLA have never been systematically studied in this setting. Methods: Patients treated for TBLA in Central Region Denmark from 2007 to 2016 were identified using the national TB surveillance register and The Danish Hospital Patient Registry. Data of clinical characteristics and treatment were extracted from hospital records. Results: Eighty-three TBLA patients were identified. The median age was 32 years (IQR 23-42); 71 (85.5%) were migrants; 58 (69.9%) presented with cervical lymphadenopathy; and 45 (54.2%) had one or more systemic TB symptom such as fever, chills, night sweats, fatigue, and weight loss. Sixty-five patients had no comorbidities (78.3%). HIV co-infection was seen in five (7.2%) of the 69 who were tested for HIV. Abscesses and/or draining sinuses were noted in 13 (15.7%) patients and 15 (18.1%) had concurrent pulmonary infection. The median time from first hospital contact to treatment initiation was 42 days (IQR 16-82) and admitted patients were hospitalised for a median of 7 days (IQR 3-13.5). For 24 patients (28.9%), lymph node material was not sent for mycobacterial culture and 52 (62.7%) had microbiologically confirmed TB. Treatment outcome was successful for 70 patients (84.3%). Conclusion: In Denmark, TBLA is mainly seen among young and previously healthy migrants presenting with cervical lymphadenopathy and sparse systemic symptoms. The diagnosis is often considerably delayed and not microbiologically verified, implying diagnostic difficulties. Treatment outcome needs to be improved.

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“…4 In Serbia, this pathogen is rarely mentioned, with very few papers published regarding its identification. 6,7 This is the first case report from this country.…”

Section: Introductionmentioning

confidence: 83%

Isoniazid-resistant Mycobacterium kansasii in an HIV-positive patient, and possible development of immune reconstitution inflammatory syndrome after initiation of highly active antiretroviral therapy: case report

Despotović¹,

Savić

Salemović³

et al. 2016

International Journal of Infectious Diseases

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Non-tuberculous mycobacteria are rare but important causes of infection in HIV-positive individuals. A 28-year-old HIV-positive male presented with a high fever, non-productive cough, right subcostal pain, splenomegaly, a very low CD4 count, elevated C-reactive protein and erythrocyte sedimentation rate, and a normal white blood cell count. The suspicion of tuberculosis (TB) was very high, and sputum samples were positive for acid-fast bacilli. Standard quadruple anti-TB therapy was initiated, but once culture of the sample revealed Mycobacterium kansasii, pyrazinamide was withdrawn. Highly active antiretroviral therapy (HAART) was initiated soon after, consisting of abacavir/lamivudine and efavirenz. The patient's general condition deteriorated 2 weeks after HAART initiation, which could have been due to the development of immune reconstitution inflammatory syndrome (IRIS). The patient recovered and was discharged in good condition. However, the results of resistance testing of the isolated organism arrived after discharge, and showed isoniazid and streptomycin resistance. This is the first case report of M. kansasii infection from Serbia and shows the difficulties encountered during the course of treatment.

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Clinical features of infection caused by non-tuberculous mycobacteria: 7 years’ experience

Cited by 19 publications

References 27 publications

Non-Tuberculous Mycobacteria in Respiratory Specimens of Patients with Obstructive Lung Diseases—Colonization or Disease?

Non-Tuberculous Mycobacteria in Respiratory Specimens of Patients with Obstructive Lung Diseases—Colonization or Disease?

Clinical features of tuberculous lymphadenitis in a low-incidence country

Isoniazid-resistant Mycobacterium kansasii in an HIV-positive patient, and possible development of immune reconstitution inflammatory syndrome after initiation of highly active antiretroviral therapy: case report

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