Prevalence and Clinical Manifestations of Disseminated<i>Mycobacterium avium</i>Complex Infection in South Africans with Acquired Immunodeficiency Syndrome

Pettipher, Clive Allan; Karstaedt, Alan; Hopley, Mark

doi:10.1086/323979

Cited by 30 publications

(13 citation statements)

References 13 publications

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“…It has been recognised as an important opportunistic infection in countries in sub-Saharan Africa in studies employing mycobacterial blood cultures. [5][6] It is associated with a high mortality in the ART era with only 30% of such patients alive beyond 2 years. 7 Treatment failure is common, reasons including drug toxicity, inadequate serum levels and development of drug resistance.…”

Section: Discussionmentioning

confidence: 99%

“…In 37 patients dying beyond one year on ART, virological failure was present in 11 (30%), and non-HIV-related causes of death occurred in 10. The main causes were acute sepsis (6), tuberculosis (7) and chronic medical conditions (5). Initiating ART at higher CD4 counts should reduce early mortality.…”

Section: Profile Of Cause Of Death Assigned To Adults On Antiretrovirmentioning

confidence: 99%

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Profile of cause of death assigned to adults on antiretroviral therapy in Soweto

Karstaedt

2012

S Afr Med J

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Section: Discussionmentioning

confidence: 99%

Section: Profile Of Cause Of Death Assigned To Adults On Antiretrovirmentioning

confidence: 99%

Profile of cause of death assigned to adults on antiretroviral therapy in Soweto

Karstaedt

2012

S Afr Med J

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“…However, pulmonary disease may also be due to non-tuberculous mycobacteria (NTM), particularly in HIV-infected patients. Several recent studies from sub-Saharan Africa suggest the prevalence of NTM disease may be higher than previously recognized [1]–[4]. One study has also reported isolating NTM species from water and soil in Uganda [5].…”

Section: Introductionmentioning

confidence: 98%

The Role of Speciation in Positive Lowenstein-Jensen Culture Isolates from a High Tuberculosis Burden Country

Worodria¹,

Anderson²,

Cattamanchi³

et al. 2011

PLoS ONE

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ObjectiveTo determine the need for routine speciation of positive Lowenstein-Jensen mycobacterial cultures in HIV-infected patients suspected of having pulmonary tuberculosis at Mulago Hospital in Kampala, Uganda.MethodsSputum and bronchoalveolar lavage Lowenstein-Jensen mycobacterial culture isolates from consecutive, HIV-infected patients admitted to Mulago Hospital with 2 weeks or more of cough were subjected to IS6110 PCR and rpoB genetic analysis to determine the presence of Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM).ResultsEighty (100%) mycobacterial cultures from 65 patients were confirmed to be members of MTBC. Subsequent analysis of the cultures from 54 patients by PCR and sequence analyses to identify co-infection with NTM confirmed the presence of MTBC as well as the presence of Micrococcus luteus (n = 4), Janibacter spp. (n = 1) and six cultures had organisms that could not be identified.ConclusionsPresumptive diagnosis of tuberculosis on the basis of a positive Lowenstein-Jensen culture is sufficient in HIV-infected Ugandans suspected of having tuberculosis. Routine molecular confirmation of positive Lowenstein-Jensen cultures is unnecessary in this low resource setting.

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“…More recently, research has been initiated in African and East Asian countries (1)(2)(3)(4)(5). There have been no recent reports on isolation and clinical relevance of NTM on the Arabian Peninsula.…”

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confidence: 99%

Clinical Relevance of Nontuberculous Mycobacteria, Oman

Al-Mahruqi¹,

Ingen²,

Al-Busaidy³

et al. 2009

Emerg. Infect. Dis.

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Little is known about the clinical relevance of nontuberculous mycobacteria (NTM) in the Arabian Peninsula. We assessed the prevalence and studied a random sample of isolates at a reference laboratory in Muscat, Oman. NTM cause disease in this region, and their prevalence has increased.N ontuberculous mycobacteria (NTM) are common inhabitants of the environment and have been cultured from water, soil, and animal sources worldwide. NTM are opportunistic pathogens, mostly affecting patients with preexisting pulmonary disease such as chronic obstructive pulmonary disease or tuberculosis (TB), or those with systemic impairment of immunity. The latter group includes those with HIV infection, those using immunosuppressive drugs, and those with leukemia (1).Because NTM are common in the environment and resistant to commonly used disinfectants, they can be present in nonsterile patient material such as sputum and contaminated medical equipment (bronchoscope washers or samples in the laboratory) and consequently cause pseudoinfection (1,2). To distinguish pseudoinfections from NTM disease and establish the clinical relevance of isolated NTM, the American Thoracic Society (ATS) has published diagnostic criteria (1).Studies on the clinical relevance of NTM have traditionally been restricted to western countries, where the incidence of TB is relatively low. More recently, research has been initiated in African and East Asian countries (1-5). There have been no recent reports on isolation and clinical relevance of NTM on the Arabian Peninsula. We analyzed a random sample of NTM isolated from clinical samples in Oman by using molecular techniques. Their clinical relevance was retrospectively analyzed by applying the updated ATS diagnostic criteria for NTM disease (1). The StudyPrevalence of NTM at the Central Public Health Laboratory (CPHL), the national TB reference laboratory of the Ministry of Health in Muscat, Oman, was assessed by using a laboratory database. The CPHL Institutional Review Board reviewed and approved this study. The CPHL received 5,488 samples submitted for Mycobacterium spp. culture during 2006-2007. Samples were subcultured in Lowenstein-Jensen medium and automated Mycobacterial Growth Indicator Tubes (MGIT960; Becton Dickinson, Franklin Lakes, NJ, USA) and incubated at 36°C. A total of 491 (9%) samples yielded positive cultures. M. tuberculosis complex bacteria were isolated from 445 (91%) samples, and NTM were isolated from 46 samples (9%). Most NTM were cultured from respiratory samples (sputum, n = 36, 78%; bronchial lavage, n = 2, 4%); the remainder were from lymph nodes (n = 3, 6%), urine (n = 2, 4%), or other sources (n = 3, 6%). The percentage of NTM increased from 7.6% (18/235) in 2006 to 10.9% (28/256) in 2007.Thirteen samples were randomly selected from all NTM isolated at CPHL during January 2006-September 2007. Selected NTM were subjected to molecular identification at the Dutch National Mycobacteria Reference Laboratory (National Institute for Public Health and the Environment, Bilthoven, ...

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Prevalence and Clinical Manifestations of DisseminatedMycobacterium aviumComplex Infection in South Africans with Acquired Immunodeficiency Syndrome

Cited by 30 publications

References 13 publications

Profile of cause of death assigned to adults on antiretroviral therapy in Soweto

Profile of cause of death assigned to adults on antiretroviral therapy in Soweto

The Role of Speciation in Positive Lowenstein-Jensen Culture Isolates from a High Tuberculosis Burden Country

Clinical Relevance of Nontuberculous Mycobacteria, Oman

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