Clinical significance of Mycobacterium asiaticum isolates in Queensland, Australia.
Mycobacterium asiaticum was first reported as a cause of human disease in 1982, with only a few cases in the literature to date. This study aims to review the clinical significance of M. asiaticum isolates in Queensland, Australia. A retrospective review (1989 to 2008) of patients with M. asiaticum isolates was conducted. Data were collected through the Queensland TB Control Centre database. Disease was defined in accordance with the American Thoracic Society criteria. Twenty-four patients (13 female) had a positive culture of M. asiaticum, many residing around the Tropic of Capricorn. M. asiaticum was responsible for pulmonary disease (n = 2), childhood lymphadenitis (n = 1), olecranon bursitis (n = 1), 6 cases of possible pulmonary disease, and 2 possible wound infections. Chronic lung disease was a risk factor for pulmonary infection, and wounds/lacerations were a risk factor for extrapulmonary disease. Extrapulmonary disease responded to local measures. Pulmonary disease responded to ethambutol-isoniazid-rifampin plus pyrazinamide for the first 2 months in one patient, and amikacin-azithromycin-minocycline in another patient. While M. asiaticum is rare in Queensland, there appears to be an environmental niche. Although often a colonizer, it can be a cause of pulmonary and extrapulmonary disease. Treatment of pulmonary disease remains challenging. Extrapulmonary disease does not mandate specific nontuberculous mycobacterium (NTM) treatment.
Department of Thoracic Medicine, The Prince Charles Hospital Brisbane, Brisbane, Australia. r
Miriam
M
Grech
Robyn
R
Carter
Rachel
R
Thomson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D002062:Bursitis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009161:Mycobacterium / Q000145:classification* / Q000302:isolation & purification*; D009164:Mycobacterium Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014388:Tuberculosis, Lymph Node / Q000188:drug therapy / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000382:microbiology; D014946:Wound Infection / Q000188:drug therapy / Q000382:microbiology
D000891:Anti-Infective Agents, Local; D000995:Antitubercular Agents