Geographical distribution and clinical relevance of non-tuberculous mycobacteria in Croatia

Janković, Mateja; Samaržija, Miroslav; Sabol, Ivan; Jakopović, Marko; Jankovic, Vera Katalinic; Žmak, Ljiljana; Tićac, Brigita; Marušić, Ante; Obrovac, Mihaela; Ingen, Jakko van

doi:10.5588/ijtld.12.0843

Cited by 59 publications

(50 citation statements)

References 14 publications

(19 reference statements)

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“…We used the ATS/IDSA microbiologic criteria (Table 1) 1 and stricter microbiologic criteria (more than two positive sputum samples or one positive BAL/ brush and one or more positive sputum samples) 13 to establish a laboratory-based diagnosis of NTM-PD. Furthermore, clinical and radiological data were gathered in order to evaluate whether patients had symptoms and radiological findings compatible with the diagnosis of NTM-PD according to the full ATS/IDSA criteria.…”

Section: Identification Of Ntm and Ntm Pulmonary Disease Case Definitionmentioning

confidence: 99%

“…13 Use of ATS/IDSA microbiologic criteria (0.61/100 000) overestimated disease incidence. This overestimation results from a relatively high proportion of clinically insignificant NTM species (such as M. gordonae, M. terrae and M. fortuitum) meeting the ATS/IDSA microbiologic criteria.…”

Section: Incidence and Prevalence Of Ntm-pd In Croatiamentioning

confidence: 99%

“…11,12 Our previous study, using only ATS/IDSA microbiologic criteria or stricter microbiologic criteria estimated the incidence of NTM-PD in Croatia to 0.61 and 0.23 per 100 000 population, respectively. 13 The disease proved most prevalent in older populations with three-fold increase in NTM-PD incidence in persons older than 50 years. 13 In the current study, we sought to correlate microbiologic criteria to full ATS/IDSA diagnostic criteria and validate the use of microbiologic criteria in the estimation of NTM-PD incidence/prevalence.…”

Section: Introductionmentioning

confidence: 99%

“…13 The disease proved most prevalent in older populations with three-fold increase in NTM-PD incidence in persons older than 50 years. 13 In the current study, we sought to correlate microbiologic criteria to full ATS/IDSA diagnostic criteria and validate the use of microbiologic criteria in the estimation of NTM-PD incidence/prevalence.…”

Section: Introductionmentioning

confidence: 99%

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Microbiological criteria in non-tuberculous mycobacteria pulmonary disease: a tool for diagnosis and epidemiology

Janković¹,

Sabol²,

Žmak³

et al. 2016

int j tuberc lung dis

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Section: Identification Of Ntm and Ntm Pulmonary Disease Case Definitionmentioning

confidence: 99%

Section: Incidence and Prevalence Of Ntm-pd In Croatiamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Microbiological criteria in non-tuberculous mycobacteria pulmonary disease: a tool for diagnosis and epidemiology

Janković¹,

Sabol²,

Žmak³

et al. 2016

int j tuberc lung dis

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“…ycobacterium avium complex lung disease (MAC-LD) is the most common form of lung disease caused by nontuberculous mycobacteria (NTM), and the prevalence of MAC-LD is increasing worldwide (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). MAC-LD can present as the upper lobe fibrocavitary form, which occurs primarily in men with underlying lung disease such as previous pulmonary tuberculosis, or as the nodular bronchiectatic (NB) form, which occurs primarily in women without other underlying lung disease (13)(14)(15).…”

mentioning

confidence: 99%

Response to Switch from Intermittent Therapy to Daily Therapy for Refractory Nodular Bronchiectatic Mycobacterium avium Complex Lung Disease

Koh

Jeong

Jeon

et al. 2015

Antimicrob Agents Chemother

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dIntermittent three-times-weekly antibiotic therapy is recommended for the initial treatment of patients with noncavitary nodular bronchiectatic Mycobacterium avium complex lung disease. Although some experts recommend switching from intermittent to daily therapy for patients whose sputum has persistent positive cultures after intermittent therapy, the clinical efficacy of these modifications is unknown. Of 20 patients whose sputum had persistent positive cultures after 12 months of intermittent antibiotic therapy, specimens from 6 patients (30%) achieved a negative culture after a change to daily therapy. Mycobacterium avium complex lung disease (MAC-LD) is the most common form of lung disease caused by nontuberculous mycobacteria (NTM), and the prevalence of MAC-LD is increasing worldwide (1-12). MAC-LD can present as the upper lobe fibrocavitary form, which occurs primarily in men with underlying lung disease such as previous pulmonary tuberculosis, or as the nodular bronchiectatic (NB) form, which occurs primarily in women without other underlying lung disease (13-15).Intermittent three-times-weekly therapy, which consists of a macrolide (clarithromycin [CLR] or azithromycin [AZM]), rifampin (RIF), and ethambutol (EMB), is recommended for the initial treatment of noncavitary NB MAC-LD (16). After at least 12 months of this intermittent antibiotic therapy, however, sputum culture conversion fails in about 15% to 25% of patients (17,18). Some experts recommended modifications of the first-line therapy, such as switching from intermittent therapy to daily therapy, for these patients (19). However, there are no data in the literature regarding the clinical efficacy of these modifications in patients with refractory NB MAC-LD. The objective of the present study was to evaluate the effects of switching from intermittent therapy to daily therapy in noncavitary NB MAC-LD patients whose sputum failed culture conversion after at least 12 months of initial intermittent antibiotic therapy.We recently reported the treatment outcomes of 118 treatment-naive patients with noncavitary NB MAC-LD who initiated standard intermittent antibiotic therapy (18). The regimen for the intermittent therapy included the following components administered three times weekly: 500 mg of AZM or 1,000 mg of CLR, EMB at 25 mg/kg of body weight, and 600 mg of RIF. Of these patients, 79 patients (67%) achieved successful sputum culture conversion and 39 patients (33%) had unfavorable outcomes, including 13 patients with early discontinuation of antibiotic therapy and 26 patients whose sputum failed to convert to negative cultures despite 12 months of intermittent antibiotic therapy (18).Of these 26 patients, 1 patient was transferred to another hospital, and 25 patients continued antibiotic therapy in our institution; intermittent therapy continued in 4 patients (16%), and intermittent therapy was switched to daily therapy in 21 patients (84%). The modifications of antibiotic therapy in these 21 patients were at the discretion of the attending p...

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Evaluation and clinical impact of MALDI Biotyper Mycobacteria Library v6.0 for identification of nontuberculous mycobacteria by MALDI‐TOF mass spectrometry

et al. 2023

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Major challenges in the identification of non-tuberculous mycobacteria (NTM) by MALDI-TOF MS include protein extraction protocol and updating of the NTM database. The aim of this study was to evaluate MALDI Biotyper Mycobacteria Library v6.0 (Bruker Daltonics GmbH, Bremen, Germany) for identification of clinical NTM isolates and its impact on clinical management. NTM isolates cultivated from clinical samples in 101 patients were identified simultaneously by PCR-reverse hybridization (Hain Lifescience GmbH, Nehren, Germany) as a routinely used reference molecular method and using MALDI Biotyper Microflex LT/SH after protein extraction. Each isolate was applied to eight spots, and mean scores were used in analysis. MALDI-TOF MS obtained correct identification to the species level for 95 (94.06%) NTM isolates. The majority of correctly identified isolates (92/95; 96.84%) were identified with highconfidence score of ≥1.80 and only 3.16% (3/95) with a score of <1.80. Mean value ± SD of RGM NTM isolates (2.127 ± 0.172) was statistically significant higher in comparison to SGM NTM isolates (2.027 ± 0.142) with a p value of 0.007. In comparison to PCR-reverse hybridization, discordant identification results by MALDI-TOF MS were found in six (6/101; 5.94%) NTM isolates for which clinical data were analyzed. We demonstrated a high confidence NTM identifications using Mycobacterium Library v 6.0 on routine clinical isolates. This is the first study that analyzed MALDI-TOF MS identification results of NTM isolates in the context of clinical data, and it showed that MALDI-TOF MS with its updated databases could help clarify the epidemiology, clinical characteristics, and course of infections caused by less frequent NTM species.

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Geographical distribution and clinical relevance of non-tuberculous mycobacteria in Croatia

Cited by 59 publications

References 14 publications

Microbiological criteria in non-tuberculous mycobacteria pulmonary disease: a tool for diagnosis and epidemiology

Microbiological criteria in non-tuberculous mycobacteria pulmonary disease: a tool for diagnosis and epidemiology

Response to Switch from Intermittent Therapy to Daily Therapy for Refractory Nodular Bronchiectatic Mycobacterium avium Complex Lung Disease

Evaluation and clinical impact of MALDI Biotyper Mycobacteria Library v6.0 for identification of nontuberculous mycobacteria by MALDI‐TOF mass spectrometry

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