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Mycobacterium kansasii infections in Western Australia (1962-1987)
1Chest Service, Health Department of Western Australia, Perth.
Abstract:
The records of 81 patients with isolations of Mycobacterium kansasii in Western Australia over 26 years have been reviewed. Thirty-nine individuals with 40 episodes of infection were considered to have disease due to M. kansasii: 36 in the lungs (90%), two in the joints (5%), and one each in the skin (2.5%) and the lymph nodes (2.5%). The average incidence rate per 100,000 per year was 0.14 for the state with the highest in the Geraldton Mid-west region (0.57). The male:female ratio was 4:1 and the mean age 50 years (SD 14.5). For pulmonary disease the male:female ratio was 3.5:1, the mean age 53 years (SD 11), 42% being miners or ex-miners and 91% smokers or ex-smokers. Almost 97% of those infected were Caucasian and none were Aboriginal. Drug treatment was highly successful, particularly with the rifampicin/ethambutol combination, where 12 months appeared to be adequate. There are differences in the demography of the patients having pulmonary disease compared to the 42 with insignificant isolations.
Insights
Mycobacterium kansasii infections are rare but treatable, primarily affecting the lungs in middle-aged Caucasian males in Western Australia. Drug regimens, especially rifampicin/ethambutol, show high success rates within 12 months.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Mycobacterium kansasii is an atypical mycobacterium that can cause disease in humans.
- Understanding the epidemiology and clinical presentation of M. kansasii infections is crucial for effective management.
Purpose of the Study:
- To review the records of patients with M. kansasii isolations in Western Australia over 26 years.
- To describe the demography, clinical manifestations, and treatment outcomes of M. kansasii infections.
Main Methods:
- Retrospective review of patient records with M. kansasii isolations.
- Analysis of demographic data, infection sites, and treatment responses.
Main Results:
- 40 episodes of M. kansasii disease were identified in 39 patients, predominantly pulmonary (90%).
- The average incidence was 0.14 per 100,000 person-years, with higher rates in the Geraldton Mid-west region.
- Pulmonary cases primarily affected Caucasian males (mean age 53), often miners and smokers. Treatment with rifampicin/ethambutol was highly successful within 12 months.
Conclusions:
- M. kansasii infections in Western Australia are infrequent, with pulmonary disease being the most common manifestation.
- Risk factors for pulmonary M. kansasii include male gender, Caucasian ethnicity, mining occupation, and smoking.
- Standard drug treatment regimens, particularly rifampicin/ethambutol, are effective for M. kansasii infections.