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

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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.
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Keywords: M. tuberculosis complex; Mycobacterium avium complex; clinical significance; prognosis

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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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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