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Free Content Microbiological criteria in non-tuberculous mycobacteria pulmonary disease: a tool for diagnosis and epidemiology

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SETTING: The value of microbiological criteria in diagnosing non-tuberculous mycobacteria pulmonary disease (NTM-PD) and monitoring its epidemiology is unknown.

OBJECTIVES: To correlate the rate of NTM-PD based on microbiological criteria (American Thoracic Society/Infectious Diseases Society of America [ATS/IDSA] or stricter microbiological criteria) compared with the full ATS/IDSA criteria, to assess the positive predictive value (PPV) of different microbiological criteria in predicting NTM-PD, and to evaluate the clinical relevance of different NTM species.

DESIGN: Retrospective study of all patients with pulmonary NTM isolates in Croatia during an 8-year period. NTM species were divided into low, intermediate and high clinical relevance groups for additional analyses.

RESULTS: Good correlation between both microbiological and full ATS/IDSA criteria was observed. The PPV of stricter and ATS/IDSA microbiological criteria was respectively 93.3% and 59.8%. The usefulness of microbiological criteria varied between groups. ATS/IDSA microbiological criteria had a PPV of 89.8% in the high relevance group, while in the intermediate relevance group, the PPV of stricter and ATS/IDSA microbiological criteria was respectively 94.3% and 63.4%.

CONCLUSIONS: Microbiological criteria are useful in detecting NTM-PD, allowing laboratory-based monitoring. Stricter criteria should be used for species of low clinical relevance, and less stringent criteria for species of high relevance in the local setting.
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Keywords: atypical mycobacteria; incidence; prevalence; pulmonary mycobacteriosis

Document Type: Research Article

Affiliations: 1: Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb 2: Division of Molecular Medicine, Laboratory of Molecular Virology and Bacteriology, Ruder Boskovic Institute, Zagreb 3: National Mycobacteria Reference Laboratory, Croatian National Institute of Public Health, Zagreb 4: Mycobacteria Laboratory, Institute of Public Health, Rijeka 5: Department for Respiratory Diseases, Clinical Hospital Centre, Rijeka 6: Department of Clinical and Molecular Microbiology, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia 7: Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Publication date: July 1, 2016

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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 lung health world-wide.

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