Tuberculosis and Nontuberculous Mycobacterial Infections in Older Adults

Schluger, Neil W.

doi:10.1016/j.ccm.2007.07.004

Cited by 34 publications

(20 citation statements)

References 51 publications

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Section: Methodsmentioning

confidence: 99%

“…This is usually a disease of younger people [69, 70]. Older patients with Lady Windermere syndrome commonly present with the characteristic nodular-bronchiectatic changes and tree-in-bud appearance in high resolution computed tomography [69]. The nodular-bronchiectatic pattern has commonly been accompanied with MAC, although other species, including M. abscessus in the US and M. xenopi and M. malmoense in Europe, are also commonly related to this form of disease [71].…”

Section: Methodsmentioning

confidence: 99%

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Management of nontuberculous mycobacterial infection in the elderly

Mirsaeidi

Farshidpour

Ebrahimi

et al. 2014

European Journal of Internal Medicine

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The incidence of nontuberculous mycobacteria (NTM) has increased over the last decades. Elderly people are more susceptible to NTM and experience increased morbidities. NTM incidence is expected to rise due to an increasing elderly population at least up to 2050. Given the importance of NTM infection in the elderly, an increasing interest exists in studying NTM characteristics in aged population. In this review, we summarize the characteristics of NTM infection among elderly patients. We focus on epidemiology, clinical presentation, and treatment options of NTM in this age group. We highlight the differences in the diagnosis and treatment between rapid and slow growing mycobacterial infections. The current recommendation for treatment of NTM is discussed. We debate if in vitro susceptibility testing has a role in treatment of NTM. Drug-drug interaction between antibiotics used to treat NTM and other medications, particularly warfarin, is another important issue that we discuss. Finally, we review the prognosis of NTM disease in elderly patients.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Management of nontuberculous mycobacterial infection in the elderly

Mirsaeidi

Farshidpour

Ebrahimi

et al. 2014

European Journal of Internal Medicine

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“…In low‐prevalence situations, tuberculosis is a problem predominantly of the aged population and includes many more cases of clinical development in immunologically compromised subjects. This is why there are many tuberculosis cases with ‘atypical’ clinical presentation(s) in older persons 110,111 . Elderly patients are more likely to have extrapulmonary tuberculosis, including miliary disease 111 .…”

Section: Clinical Manifestation Of Tuberculosis (Pulmonary and Extrapmentioning

confidence: 99%

Advances in the diagnosis of tuberculosis

2010

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Tuberculosis ranges among the leading causes of morbidity and mortality worldwide. A diagnostic approach to a patient with possible tuberculosis includes a detailed medical history and clinical examination as well as radiological, microbiological, immunological, molecular-biological and histological investigations, where available. Recently, important advances have been achieved in these fields that have led to substantial improvements in the accuracy and the timing of the diagnosis of tuberculosis. Novel methods allow for a better identification of latently infected individuals who are at risk of developing active tuberculosis, they also offer the possibility for a rapid diagnosis of active tuberculosis in patients with negative sputum smears for acid-fast bacilli and enable prompt identification of drug-resistant strains of Mycobacterium tuberculosis directly from respiratory specimen with a high accuracy. In addition, promising methods that will further optimize the diagnosis of tuberculosis are under development. In the future, therapeutic interventions based on the results of novel diagnostic procedures can be made earlier leading to improvements in patient care.

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“…As a consequence of diminished immune function, humans older than 65 y are more susceptible to infections (e.g., influenza, tuberculosis) (2,3), have higher reactivation rates of persistent viruses (e.g., varicellazoster virus) (4), and respond less effectively to vaccination (5)(6)(7)(8)(9). The inability of elderly populations to rapidly control or eliminate infections not only increases their risk for serious sequalae of the primary infections, but also can contribute to a decline in health on multiple levels caused by events including increased risk of secondary infections and/or cardiovascular complications (10).…”

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confidence: 99%

Cell-Intrinsic Defects in the Proliferative Response of Antiviral Memory CD8 T Cells in Aged Mice upon Secondary Infection

Decman

Laidlaw

DiMenna

et al. 2010

The Journal of Immunology

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Although previous studies have demonstrated delayed viral clearance and blunted effector T cell responses in aged mice during infection, memory CD8 T cells and especially secondary responses have received less attention. In this study, we show that modest differences in the number of memory CD8 T cells formed in aged versus young animals were associated with altered memory CD8 T cell differentiation. Aged immune mice had increased morbidity and mortality upon secondary viral challenge, suggesting changes in T cell immunity. Indeed, virus-specific memory CD8 T cells from aged mice showed substantially reduced proliferative expansion upon secondary infection using multiple challenge models. In addition, this defect in recall capacity of aged memory CD8 T cells was cell-intrinsic and persisted upon adoptive transfer into young mice. Thus, the poor proliferative potential of memory T cells and altered memory CD8 T cell differentiation could underlie age-related defects in antiviral immunity.

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Tuberculosis and Nontuberculous Mycobacterial Infections in Older Adults

Cited by 34 publications

References 51 publications

Management of nontuberculous mycobacterial infection in the elderly

Management of nontuberculous mycobacterial infection in the elderly

Advances in the diagnosis of tuberculosis

Cell-Intrinsic Defects in the Proliferative Response of Antiviral Memory CD8 T Cells in Aged Mice upon Secondary Infection

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