"Multidrug-resistant tuberculosis" may be nontuberculous mycobacteria

Abdolrazagh Hashemi Shahraki, Parvin Heidarieh, Saeed Zaker Bostanabad, Azar Dokht Khosravi, Mohammad Hashemzadeh, Solmaz Khandan, Maryam Biranvand, Dean E. Schraufnagel, Mehdi Mirsaeidi

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Introduction: Multidrug resistant tuberculosis (MDR-TB) presents a great challenge to public health, especially for developing countries. Some nontuberculous mycobacteria (NTM) cause the similar clinical and radiological characteristics with tuberculosis. We aimed to identify the frequency of NTM infections among subjects who were suspected to have MDR-TB due to lack of response to anti-TB treatment. Methods: This retrospective study evaluated patients with suspected MDR-TB due to lack of sputum conversion after 2-3 month therapy with first line anti-TB treatment from 2009 through 2014. Cultures for mycobacteria were performed and identification was done to species level by phenotypic and molecular tests. The outcome of the patients with NTM disease and related risk factors for poor outcome were evaluated. Results: Out of 117 consecutive strains isolated from suspected MDR-TB subjects, 35 (30%) strains were identified as NTM by using conventional and molecular approaches. Of these patients with positive NTM cultures, 32 (27%) patients met ATS/IDSA diagnostic criteria. Out of 32, 29 (90%) individuals with confirmed NTM diseases had underlying disorders including 8 subjects with malignancy, 5 with organ transplantations, and 4 with the human immunodeficiency virus. No known underlying disorder was found in 3 (9%) subjects. Treatment outcomes were available for 27 subjects, 17 (63%) of whom were cured and 10 (37%) had poor outcome including 6 (60%) who failed and 4 (40%) who died during treatment. Conclusion: The high costs to the patient and society should lead health care providers to consider NTM in all patients suspected of having TB.

Original languageEnglish (US)
Pages (from-to)279-284
Number of pages6
JournalEuropean Journal of Internal Medicine
Volume26
Issue number4
DOIs
StatePublished - May 1 2015
Externally publishedYes

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Nontuberculous Mycobacteria
Multidrug-Resistant Tuberculosis
Nontuberculous Mycobacterium Infections
Organ Transplantation
Therapeutics
Mycobacterium
Sputum
Health Personnel
Developing Countries
Tuberculosis
Retrospective Studies
Public Health
HIV
Costs and Cost Analysis
Neoplasms

Keywords

  • MDR-TB
  • Nontuberculous mycobacteria
  • NTM
  • Tuberculosis

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Shahraki, A. H., Heidarieh, P., Bostanabad, S. Z., Khosravi, A. D., Hashemzadeh, M., Khandan, S., ... Mirsaeidi, M. (2015). "Multidrug-resistant tuberculosis" may be nontuberculous mycobacteria. European Journal of Internal Medicine, 26(4), 279-284. https://doi.org/10.1016/j.ejim.2015.03.001

"Multidrug-resistant tuberculosis" may be nontuberculous mycobacteria. / Shahraki, Abdolrazagh Hashemi; Heidarieh, Parvin; Bostanabad, Saeed Zaker; Khosravi, Azar Dokht; Hashemzadeh, Mohammad; Khandan, Solmaz; Biranvand, Maryam; Schraufnagel, Dean E.; Mirsaeidi, Mehdi.

In: European Journal of Internal Medicine, Vol. 26, No. 4, 01.05.2015, p. 279-284.

Research output: Contribution to journalArticle

Shahraki, AH, Heidarieh, P, Bostanabad, SZ, Khosravi, AD, Hashemzadeh, M, Khandan, S, Biranvand, M, Schraufnagel, DE & Mirsaeidi, M 2015, '"Multidrug-resistant tuberculosis" may be nontuberculous mycobacteria', European Journal of Internal Medicine, vol. 26, no. 4, pp. 279-284. https://doi.org/10.1016/j.ejim.2015.03.001
Shahraki AH, Heidarieh P, Bostanabad SZ, Khosravi AD, Hashemzadeh M, Khandan S et al. "Multidrug-resistant tuberculosis" may be nontuberculous mycobacteria. European Journal of Internal Medicine. 2015 May 1;26(4):279-284. https://doi.org/10.1016/j.ejim.2015.03.001
Shahraki, Abdolrazagh Hashemi ; Heidarieh, Parvin ; Bostanabad, Saeed Zaker ; Khosravi, Azar Dokht ; Hashemzadeh, Mohammad ; Khandan, Solmaz ; Biranvand, Maryam ; Schraufnagel, Dean E. ; Mirsaeidi, Mehdi. / "Multidrug-resistant tuberculosis" may be nontuberculous mycobacteria. In: European Journal of Internal Medicine. 2015 ; Vol. 26, No. 4. pp. 279-284.
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AU - Khosravi, Azar Dokht

AU - Hashemzadeh, Mohammad

AU - Khandan, Solmaz

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AU - Schraufnagel, Dean E.

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N2 - Introduction: Multidrug resistant tuberculosis (MDR-TB) presents a great challenge to public health, especially for developing countries. Some nontuberculous mycobacteria (NTM) cause the similar clinical and radiological characteristics with tuberculosis. We aimed to identify the frequency of NTM infections among subjects who were suspected to have MDR-TB due to lack of response to anti-TB treatment. Methods: This retrospective study evaluated patients with suspected MDR-TB due to lack of sputum conversion after 2-3 month therapy with first line anti-TB treatment from 2009 through 2014. Cultures for mycobacteria were performed and identification was done to species level by phenotypic and molecular tests. The outcome of the patients with NTM disease and related risk factors for poor outcome were evaluated. Results: Out of 117 consecutive strains isolated from suspected MDR-TB subjects, 35 (30%) strains were identified as NTM by using conventional and molecular approaches. Of these patients with positive NTM cultures, 32 (27%) patients met ATS/IDSA diagnostic criteria. Out of 32, 29 (90%) individuals with confirmed NTM diseases had underlying disorders including 8 subjects with malignancy, 5 with organ transplantations, and 4 with the human immunodeficiency virus. No known underlying disorder was found in 3 (9%) subjects. Treatment outcomes were available for 27 subjects, 17 (63%) of whom were cured and 10 (37%) had poor outcome including 6 (60%) who failed and 4 (40%) who died during treatment. Conclusion: The high costs to the patient and society should lead health care providers to consider NTM in all patients suspected of having TB.

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