Diagnosis Of Nontuberculous Mycobacteria Research Articles

Aplicación de RPC-PLFR en el diagnóstico de micobacterias no tuberculosas

The amplification of a fragment from hsp65 gene by polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP) analysis with BstEll and Haelll restriction enzymes has demonstrated to be very useful for identification of Non-Tuberculous Mycobacteria (NTM). The biochemical tests as well as the PCR-RFLP were carried out in 13 reference strains and 46 strains received in the laboratory. The results by biochemical tests were available in 4-6 weeks whereas the PCR-RFLP only required 48 hours. In both methods, Mycobacterium intracellulare, M. kansasii and M. fortuitum were the most frequently detected species. The PCR-RFLP method is fast, cheap and simple. Its application in Reference Laboratories could be very useful for diagnosis of NTM.

Usefulness of Bronchoscopy for the Diagnosis of Nontuberculous Mycobacterial Pulmonary Disease

Background : Because of the low sensitivity of sputum smear and culture, diagnosis of nontuberculous mycobac󰠀 terium (NTM) pulmonary disease, especially in patients with bronchiectasis, is often difficult. We investigated the usefulness of bronchoscopy for the diagnosis of NTM pulmonary disease including M. avium complex (MAC) and M. abscessus in patients with bronchiectasis and multiple pulmonary nodules on chest computed tomography (CT). Methods : We reviewed 48 cases of patients who were performed bronchoscopic bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) under suspect of NTM pulmonary disease based on CT findings of bronchiectasis and multiple nodules from April 2002 to June 2003. Results : Twenty five of the 48 patients (54%; 12 MAC, 14 M. abscessus) were diagnosed as NTM pulmonary disease on the basis of the American Thoracic Society diagnostic criteria for NTM pulmonary disease. Sixteen of the 21 patients (76%; 5 MAC, 11 M. abscessus) with 3 or more positive sputum cultures of NTM were confirmed tissue invasion by TBLB. Five of the 24 patients (21%; 4 MAC, 1 M. abscessus) who could not be diagnosed with sputum cultures were diagnosed by bronchoscopic BAL and TBLB. Conclusion : Bronchoscopy is helpful for the diagnosis of NTM pulmonary disease and confirmation of tissue invasion by NTM, not only MAC but also M. abscessus, in patients with bronchiectasis and multiple nodules on chest CT scan. (Tuberc Respir Dis 2004; 57:242-249)

Early chemotherapy for non‐tuberculous mycobacterial infections in patients with cystic fibrosis

Aim: To evaluate the response rate to antimycobacterial drug therapy in patients with cystic fibrosis (CF) suffering from infection by non‐tuberculous mycobacteria (NTM). Methods: Ten patients, aged 10–34 y, out of 180 CF patients, were diagnosed with NTM disease. They had been regularly checked and examined for pulmonary symptoms, and had had chest X‐rays and sputum cultures (including for mycobacteria) performed. One additional 36‐y‐old female received her CF diagnosis soon after the NTM diagnosis. Results: Mycobacterium avium‐intracellulare complex (MAC) was found in 10 out of 11 patients and M. kansasii in 1 patient. Treatment with antimycobacterial drugs resulted in clinical improvement (weight gain or stabilization of weight and/or improved or stabilized lung function in 8 out of 11 patients) and mycobacterial culture turned negative in 10 out of 11. Conclusion: Promising results may be associated with early intervention with antimycobacterial therapy in CF patients.

A UK centre's experience of mycobacterial infections in HIV-infected patients.

A descriptive retrospective review of 26 patients with mycobacterial infection; 7 Mycobacterium tuberculosis (MTB), 17 Mycobacterium avium complex (MAC), one M. xenopei and one M. kansasii. Diagnosis of non-tuberculous mycobacteria (NTM) was made mainly from blood in 68%, with biopsy material initially useful in 68%. All MTB were fully sensitive. No patients received MAC chemoprophylaxis, yet resistance to rifabutin, ciprofloxacin and ethambutol was noted. It is important to examine the UK experience of mycobacterial infection; individual centres may find it useful to review infecting organisms and resistance patterns.

Cervicofacial mycobacterial adenitis in children: Endemic to san diego?

Nontuberculous mycobacteria (NTM) are an important cause of cervicofacial lymphadenitis in children. A dramatic increase has been seen in confirmed cases of NTM lymphadenitis in San Diego in the past few years. This report encompasses a span of 2 years 9 months, during which 22 children had confirmed NTM infection and another 14 had necrotizing granulomatous lymphadenitis in whom the specific diagnosis of NTM could not be made. This apparent increase in the prevalence of NTM as compared to previous reports in the literature suggests a possible endemic risk for NTM in the San Diego area. These cases are reviewed and our diagnostic and surgical approach to possible NTM infection is described. We also discuss possible explanations for the increasing occurrence of NTM in the San Diego area.