Isolation of non-tuberculous mycobacteria among patients with pulmonary tuberculosis in Ontario, Canada

• Published in: The international journal of tuberculosis and lung disease Vol. 17; no. 5; pp. 676 - 681
• Main Authors: Damaraju, D., Jamieson, F., Chedore, P., Marras, T. K.
• Format: Journal Article
• Language: English
• Published: Paris, France International Union Against Tuberculosis and Lung Disease 01.05.2013; International Union against Tuberculosis and Lung Disease
• Subjects: Adult; Age; Aged; Antitubercular Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the respiratory system; Bacteriological Techniques; Biological and medical sciences; Clinical Significance; Female; Human bacterial diseases; Humans; Incidence; Infectious diseases; Logistic Models; M. Tuberculosis Complex; Male; Medical sciences; Middle Aged; Multivariate Analysis; Mycobacterium avium; Mycobacterium Avium Complex; Mycobacterium avium Complex - isolation & purification; Mycobacterium avium-intracellulare Infection - epidemiology; Mycobacterium avium-intracellulare Infection - microbiology; Mycobacterium Infections, Nontuberculous - diagnosis; Mycobacterium Infections, Nontuberculous - drug therapy; Mycobacterium Infections, Nontuberculous - epidemiology; Mycobacterium Infections, Nontuberculous - microbiology; Mycobacterium xenopi - isolation & purification; Nontuberculous Mycobacteria - drug effects; Nontuberculous Mycobacteria - isolation & purification; Odds Ratio; Ontario - epidemiology; Pneumology; Prognosis; Retrospective Studies; Sputum - microbiology; Time Factors; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Pulmonary - diagnosis; Tuberculosis, Pulmonary - drug therapy; Tuberculosis, Pulmonary - epidemiology; Tuberculosis, Pulmonary - microbiology; Young Adult; Canada; North America; Ontario; America; Human; Lung disease; Prognosis; Respiratory disease; Pulmonary tuberculosis; Mycobacterium avium; Patient; Mycobacterial infection; M. tuberculosis complex; clinical significance; Complexes; Complexity; Infection; Mycobacterium avium complex; Mycobacteriales; Bacteriosis; Mycobacteriaceae; Bacteria; Isolation; Actinomycetes
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.12.0684

SETTING AND OBJECTIVE: There are limited data regarding the frequency and significance of co-isolating pulmonary non-tuberculous mycobacteria (NTM) in patients with pulmonary tuberculosis (PTB).DESIGN: We identified all patients with culture-proven PTB in Ontario, Canada, in 2004, identified those with NTM 'co-isolation' (≤6 months following initial TB isolate) and determined subsequent NTM isolation over 5 years.RESULTS: In 2004, 369 people in Ontario had culture-proven PTB (average age 46 years, SD 21, 41% female). NTM co-isolation occurred in 11% (40/369), including Mycobacterium avium complex 22/40 (55%), M. xenopi 7/40 (18%), M. gordonae 6/40 (15%) and others 5/40 (13%). Patients with NTM co-isolation were older (55 vs. 45 years, P = 0.004), but had similar sex ratios (females 43% vs. 40%, P = 0.87). Among patients with co-isolation, 23% (9/40) went on to have ≥2 NTM cultures (excluding initial culture), compared with 3% (10/329) in the PTB group (including initial culture, P = 0.0001). In the co-isolation group, the median (quartiles) number of samples collected for mycobacterial study was 6 (4-8) compared to 2 (1-4) in the PTB group (P < 0.0001).CONCLUSIONS: The high frequency of subsequent NTM isolation among patients with NTM co-isolation during PTB may warrant follow-up for potential NTM disease.