Epidemiology and risk factors associated with NTM pulmonary and extrapulmonary infections in a high tuberculosis endemic Region

Autor: Reena Raveendran, Chand Wattal, Sanam Rasool Wani
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Lung Diseases
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Tuberculosis
Endemic Diseases
pulmonary
030106 microbiology
lcsh:QR1-502
India
Mycobacterium Infections
Nontuberculous
Microbial Sensitivity Tests
Mycobacterium abscessus
lcsh:Microbiology
Mycobacterium tuberculosis
03 medical and health sciences
non-tuberculous mycobacteria
0302 clinical medicine
Risk Factors
Clarithromycin
Internal medicine
medicine
Humans
Prospective Studies
030212 general & internal medicine
Risk factor
Lung
e-test
biology
business.industry
mycobacterium cm assay
Nontuberculous Mycobacteria
biology.organism_classification
medicine.disease
bacterial infections and mycoses
Anti-Bacterial Agents
extrapulmonary
Mycobacterium tuberculosis complex
Amikacin
Spectrometry
Mass
Matrix-Assisted Laser Desorption-Ionization
business
matrix-assisted laser desorption/ionisation time of flight mass spectrometry
medicine.drug
Mycobacterium
Zdroj: Indian Journal of Medical Microbiology, Vol 38, Iss 2, Pp 169-175 (2020)
ISSN: 1998-3646
0255-0857
Popis: Introduction: Non-tuberculous mycobacteria, although identified as pathogenic to humans long time ago, are emerging as the new threat in the past two decades. Even in tuberculosis endemic country such as India, they are being isolated from the clinical specimens more often than previously. This change in trend is of concern, because they are often misdiagnosed as Mycobacterium tuberculosis or even as drug-resistant tuberculosis. Objectives: A prospective, observational study was planned to identify the frequency and risk factors associated with pulmonary and extrapulmonary non-tuberculous mycobacterial (NTM) infections. Agreement between two commercially available molecular systems, namely GenoType Mycobacteria CM assay and matrix-assisted laser desorption/ionisation time of flight mass spectrometry (MALDI TOF MS) used in the identification of mycobacterial species is also analysed. Materials and Methods: NTM isolated from pulmonary and extrapulmonary clinical specimens over a period of 1½ year was included in the study. Patient demographics were collected, and the risk factors associated with NTM infections were analyzed. NTM grown on culture was speciated using GenoType Mycobacteria CM assay (HAIN Life Sciences, Germany) and MALDI TOF MS (bioMerieux, France). Drug-susceptibility tests were done for rapid-growing NTM using E-test (bioMerieux, France). Results: Eight hundred and fifty-four mycobacteria were isolated from 5009 specimens processed during the study period. Out of the mycobacteria grown, 74 (8.7%) were NTM and 780 (91.3%) were Mycobacterium tuberculosis complex. The NTM isolated from pulmonary specimens were 46 (62.16%) and from extrapulmonary sources were 28 (37.84%). The most common species isolated from pulmonary specimens was Mycobacterium intracellulare and from extrapulmonary specimens was Mycobacterium abscessus. Concordance between the two commercial assays used for the identification was 96.49%. The most common risk factor associated with pulmonary NTM was previous lung pathology, while with extrapulmonary NTM infection was previous surgical intervention. Drug-susceptibility tests for rapid growers showed amikacin and clarithromycin as the most active drugs in vitro. Conclusions: NTM plays a significant role in causing pulmonary and extrapulmonary infections even in our part of the country with high endemicity of tuberculosis. NTM has emerged as important pathogens even in the immunocompetent patients. There is a need for rapid diagnosis and susceptibility testing of NTM to aid physicians administer timely and appropriate treatment to the patients.
Databáze: OpenAIRE
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