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