title: Mycobacterium genavense in the Netherlands: an opportunistic pathogen in HIV and non-HIV immunocompromised patients. An observational study in 14 cases.
abstract: Mycobacterium genavense is an opportunistic non-tuberculous mycobacterium previously mostly associated with HIV-infected patients with CD4 counts below 100/μL. In this retrospective observational study of medical charts we studied all Dutch patients in whom M. genavense was detected between January 2002 and January 2010. Of the 14 patients identified, 13 (93%) showed clinically relevant M. genavense disease. All patients with M. genavense disease were severely immunocompromised, including HIV-infected patients, solid organ transplant recipients, those with chronic steroid use in combination with other immune modulating drugs, recipients of chemotherapy for non-Hodgkin lymphoma, and those with immunodeficiency syndromes. Two patients had non-disseminated pulmonary M. genavense disease. Of the 12 patients treated, eight (75%) showed a favourable outcome. Four patients died in this study, three despite treatment for M. genavense disease. We conclude that M. genavense is a clinically relevant pathogen in severely immunocompromised patients that causes predominantly disseminated disease with serious morbidity and mortality. M. genavense is increasingly seen among non-HIV immunocompromised patients.
authors.affiliation: Department of Pulmonary Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. w.hoefsloot@long.umcn.nl
authors.forename: W
authors.initials: W
authors.lastname: Hoefsloot
authors.forename: J
authors.initials: J
authors.lastname: van Ingen
authors.forename: E J G
authors.initials: EJ
authors.lastname: Peters
authors.forename: C
authors.initials: C
authors.lastname: Magis-Escurra
authors.forename: P N R
authors.initials: PN
authors.lastname: Dekhuijzen
authors.forename: M J
authors.initials: MJ
authors.lastname: Boeree
authors.forename: D
authors.initials: D
authors.lastname: van Soolingen
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009161:Mycobacterium / Q000145:classification / Q000302:isolation & purification*; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D009426:Netherlands / Q000453:epidemiology; D009894:Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents