Failure to Recognize Nontuberculous Mycobacteria Leads to Misdiagnosis of Chronic Pulmonary Tuberculosis

Abstract

BackgroundNontuberculous mycobacterial (NTM) infections cause morbidity worldwide. They are difficult to diagnose in resource-limited regions, and most patients receive empiric treatment for tuberculosis (TB). Our objective here is to evaluate the potential impact of NTM diseases among patients treated presumptively for tuberculosis in Mali.MethodsWe re-evaluated sputum specimens among patients newly diagnosed with TB (naïve) and those previously treated for TB disease (chronic cases). Sputum microscopy, culture and Mycobacterium tuberculosis drug susceptibility testing were performed. Identification of strains was performed using molecular probes or sequencing of secA1 and/or 16S rRNA genes.ResultsOf 142 patients enrolled, 61 (43%) were clinically classified as chronic cases and 17 (12%) were infected with NTM. Eleven of the 142 (8%) patients had NTM disease alone (8 M. avium, 2 M. simiae and 1 M. palustre). All these 11 were from the chronic TB group, comprising 11/61 (18%) of that group and all were identified as candidates for second line treatment. The remaining 6/17 (35.30%) NTM infected patients had coinfection with M. tuberculosis and all 6 were from the TB treatment naïve group. These 6 were candidates for the standard first line treatment regimen of TB. M. avium was identified in 11 of the 142 (8%) patients, only 3/11 (27.27%) of whom were HIV positive.ConclusionsNTM infections should be considered a cause of morbidity in TB endemic environments especially when managing chronic TB cases to limit morbidity and provide appropriate treatment.

Efflux Inhibition with Verapamil Potentiates Bedaquiline in Mycobacterium tuberculosis

“…Eight clinical isolates of M. tuberculosis with various first-and second-line drug susceptibility patterns (Table 2) were obtained from Project SEREFO-NIAID/University of Bamako Research Collaboration on HIV/TB, in Bamako, Mali, for evaluation in this study (15,16).…”

High prevalence of non-tuberculous mycobacterial disease among non-HIV infected individuals in a TB endemic country – experience from a tertiary center in Delhi, India

“…Moreover, NTM co-infections with MTB disease are not infrequent, though rarely diagnosed. 10 As NTM strains exhibits high drugresistance to first-line anti-tubercular drugs, many of NTM infections would be considered TB treatment failures, and subsequently treated for multidrugresistant TB (MDR-TB) disease. The same was highlighted in a recent report from China, where NTM accounted for 30% of suspected MDR-TB cases and 4% of retreatment TB cases.…”

Serodiagnosis of Mycobacterium avium Complex and Mycobacterium abscessus Complex Pulmonary Disease by Use of IgA Antibodies to Glycopeptidolipid Core Antigen

“…In clinical practice, it is difficult to distinguish NTM-PD from PTB, because the symptoms and radiographic findings are often similar. This leads to an incorrect diagnosis or unnecessary treatment in many patients with NTM-PD (13). Therefore, serodiagnosis of NTM-PD could be useful for rapid differentiation of NTM-PD from PTB.…”