141 A retrospective review of non-tuberculous mycobacteria in paediatric cystic fibrosis patients at a regional centre

Abstract

Non-tuberculous mycobacteria (NTM) are increasingly isolated from CF patients. We carried out a retrospective review of respiratory specimens from paediatric patients at a regional CF centre to assess the possible significance of NTM. Samples from 158 patients were reviewed. 7 patients (4%) were identified as having NTM isolated from at least one clinical specimen (4 male, 3 female, age range when NTM first isolated 7−12 yrs). The sample type of first isolation was a bronchoalveolar lavage (BAL) in 2 cases, sputum in 3 cases and cough swab in 2 cases. The NTM isolated were M avium complex (MAC) (n = 3), M. chelonae (n = 3) and M abscessus (n = 1). Initial NTM positive samples were isolated from 1 patient in 2007, 3 patients in 2008, 2 in 2009 and 1 in 2010. None of the initial positive samples (BALs or sputums) were smear positive, although one patient with an initial smear negative, culture positive sputum was smear positive on a follow-up BAL. All isolates were initially sensitive in vitro to azithromycin and clarithromycin. Only one patient was treated for NTM infection. MAC was isolated from a BAL following deterioration in respiratory symptoms; Burkholderia vietnamiensis was also isolated and he received dual treatment with ciprofloxacin and azithromycin and was showing an improvement in respiratory function at 3 months. All patients had other potential pathogens isolated with NTM, including Aspergillus sp. (n = 4). Three patients received steroids for treatment of ABPA prior to isolation of NTM. Identifying whether NTM represents colonisation or infection is difficult and may be complicated by other organisms; trial of therapy with assessment of response may be indicated.