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"Multidrug-resistant tuberculosis" may be nontuberculous mycobacteria
#MMPMID25784643
Shahraki AH
; Heidarieh P
; Bostanabad SZ
; Khosravi AD
; Hashemzadeh M
; Khandan S
; Biranvand M
; Schraufnagel DE
; Mirsaeidi M
Eur J Intern Med
2015[May]; 26
(4
): 279-84
PMID25784643
show ga
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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