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Atypical mycobacteria in a tuberculosis hospital
Canadian Medical Association Journal
|April 3, 1976
Summary
Atypical mycobacteria caused disease in 47 tuberculosis patients, with most strains resistant to drugs. This infection led to poor treatment response and high mortality, highlighting the need for updated classification.
Area of Science:
- Microbiology
- Infectious Diseases
- Pulmonology
Background:
- Tuberculosis (TB) hospitals manage patients with Mycobacterium tuberculosis.
- Atypical mycobacteria, also known as non-tuberculous mycobacteria (NTM), can cause pulmonary disease.
- Accurate identification and classification of mycobacteria are crucial for effective treatment.
Observation:
- Cultures from 1667 consecutive tuberculosis hospital admissions revealed atypical mycobacteria in 80 patients (4.8%).
- Using strict criteria, 47 of these cases were confirmed as caused by atypical mycobacteria.
- These isolated organisms predominantly exhibited resistance to multiple antitubercular drugs.
Findings:
- A significant proportion of atypical mycobacteria infections in this cohort were drug-resistant.
- 14 patients (30%) died, with 8 deaths attributed to uncontrollable pulmonary infection by atypical mycobacteria.
- Ten patients showed a poor response to prescribed treatments.
Implications:
- Atypical mycobacteria pose a significant clinical challenge, particularly in immunocompromised individuals or those with underlying lung disease.
- The drug resistance observed underscores the need for susceptibility testing and tailored therapeutic strategies for NTM infections.
- Adoption of simplified mycobacterial classification systems, such as Runyon's, is recommended for improved diagnostics and management.