Isolation of non-tuberculous mycobacteria among patients with pulmonary tuberculosis in Ontario, Canada
Abstract: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.
Document Type: Research Article
Affiliations: 1: University of Toronto, Department of Medicine, Toronto, Ontario, Canada; University of British Columbia, Division of Respirology, Vancouver, British Columbia, Canada 2: Public Health Ontario Laboratories, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada 3: Public Health Ontario Laboratories, Toronto, Ontario, Canada 4: University of Toronto, Department of Medicine, Toronto, Ontario, Canada; Department of Medicine, Division of Respirology, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada
Publication date: 2013-05-01
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