TY - JOUR
T1 - "Multidrug-resistant tuberculosis" may be nontuberculous mycobacteria
AU - Shahraki, Abdolrazagh Hashemi
AU - Heidarieh, Parvin
AU - Bostanabad, Saeed Zaker
AU - Khosravi, Azar Dokht
AU - Hashemzadeh, Mohammad
AU - Khandan, Solmaz
AU - Biranvand, Maryam
AU - Schraufnagel, Dean E.
AU - Mirsaeidi, Mehdi
N1 - Publisher Copyright:
© 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2015/5/1
Y1 - 2015/5/1
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.
AB - 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.
KW - MDR-TB
KW - NTM
KW - Nontuberculous mycobacteria
KW - Tuberculosis
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U2 - 10.1016/j.ejim.2015.03.001
DO - 10.1016/j.ejim.2015.03.001
M3 - Article
C2 - 25784643
AN - SCOPUS:84928829266
VL - 26
SP - 279
EP - 284
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
SN - 0953-6205
IS - 4
ER -