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HIV-negative pulmonary disease caused by nontuberculous mycobacteria in Southern Brazil: clinical and microbiological characterization

HIV-negative pulmonary disease caused by nontuberculous mycobacteria in Southern Brazil: clinical and microbiological characterization
  • HIV-negative pulmonary disease caused by nontuberculous

Fonte

AME Publishing Company

Europe PubMed Central

PubMed Central

Autoria

Fernanda Guioti PugaRenata Helena Candido PocenteErica ChimaraValdes Roberto Bollela

Resumo

Background: Nontuberculous mycobacteria (NTM) have been identified with increasing frequency in
the clinical practice. The aim of this study was to characterize NTM isolates in respiratory specimens from
patients with pulmonary disease and to correlate this with clinical/radiological findings, decision to start
treatment and outcomes.
Methods: A cross-sectional descriptive study was performed and included all patients who had at least one
NTM isolated in respiratory specimens between 2011 and 2014. NTM culture was performed in liquid
medium followed by immunochromatographic identification (anti-MPT64). Species identification was based
on nucleic acid amplification followed by restriction analysis of a 441 bp fragment of the hsp65 gene (hsp65
PRA) and patients’ records were reviewed.
Results: From 14,394 cultures in 4 years, 590 (4.10%) grew NTM and 305 (51.7%) isolates were
characterized till species level, representing 290 patients including those with and without human
immunodeficiency virus (HIV) infection. Two hundred and eleven non-HIV patients had NTM isolated
from respiratory specimens, 49 (23.2%) had criteria for active disease based on the American Thoracic
Society (ATS) 2007. The majority was men above 51 years old and M. intracellulare was detected in 59.2%
(29/49), followed by M. avium 14.3% (7/49), and M. abscessus 12.2% (6/49).
Conclusions: Old age, nodular and nodular/bronchiectasis radiographic pattern, previous tuberculosis
(TB) treatment and M. intracellulare were more frequent among NTM-disease patients compared to those
only colonized. Positive culture and maintenance of clinical symptoms (poor outcome) was a rule when M.
abscessus caused NTM-disease. Positive acid-fast smear in respiratory specimen is a strong predictor of
disease.

 

HIV-negative pulmonary disease caused by nontuberculous

 

 

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