title: Clinical and therapeutic features of pulmonary nontuberculous mycobacterial disease, Brazil, 1993-2011.
abstract: To identify clinical and therapeutic features of pulmonary nontuberculous mycobacterial (PNTM) disease, we conducted a retrospective analysis of patients referred to the Brazilian reference center, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, who received a diagnosis of PNTM during 1993–2011 with at least 1 respiratory culture positive for NTM. Associated conditions included bronchiectasis (21.8%), chronic obstructive pulmonary disease (20.7%), cardiovascular disease (15.5%), AIDS (9.8%), diabetes (9.8%), and hepatitis C (4.6%).Two patients had Hansen disease; 1 had Marfan syndrome. Four mycobacterial species comprised 85.6% of NTM infections: Mycobacterium kansasii, 59 cases (33.9%); M. avium complex, 53 (30.4%); M. abscessus, 23 (13.2%); and M. fortuitum, 14 (8.0%). A total of 42 (24.1%) cases were associated with rapidly growing mycobacteria. In countries with a high prevalence of tuberculosis, PNTM is likely misdiagnosed as tuberculosis, thus showing the need for improved capacity to diagnose mycobacterial disease as well as greater awareness of PNTM disease prevalence.
authors.affiliation: National School of Public Heath, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
authors.forename: Karla Gripp Couto
authors.initials: KG
authors.lastname: de Mello
authors.forename: Fernanda C Queiroz
authors.initials: FC
authors.lastname: Mello
authors.forename: Liamar
authors.initials: L
authors.lastname: Borga
authors.forename: Valeria
authors.initials: V
authors.lastname: Rolla
authors.forename: Rafael S
authors.initials: RS
authors.lastname: Duarte
authors.forename: Elizabeth P
authors.initials: EP
authors.lastname: Sampaio
authors.forename: Steven M
authors.initials: SM
authors.lastname: Holland
authors.forename: D Rebecca
authors.initials: DR
authors.lastname: Prevots
authors.forename: Margareth P
authors.initials: MP
authors.lastname: Dalcolmo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001938:Brazil; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000382:microbiology*; D015269:Mycobacterium avium Complex / Q000187:drug effects / Q000302:isolation & purification*; D019909:Mycobacterium kansasii / Q000187:drug effects / Q000302:isolation & purification*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents