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PloS One 2015The infections due to Non-Tuberculosis Mycobacteria (NTM) are becoming an important health problem in many countries in the world. Globally, an increase in NTM... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The infections due to Non-Tuberculosis Mycobacteria (NTM) are becoming an important health problem in many countries in the world. Globally, an increase in NTM infections has been reported from many countries around the world. However, limited information is available about the prevalence of NTM infections in Iran.
MATERIAL AND METHODS
The data of the prevalence of NTM infections were collected from databases such as PubMed, Web of science, Cochrane Library, Embase, Scopus, Iranmedex, and Scientific Information Database. Comprehensive Meta-Analysis (V2.0, Biostat) software was used to analyze the data.
RESULTS
The meta-analyses showed that the prevalence of NTM infections was 10.2% (95% confidence interval [95% CI] 6.3-15.9) among culture-positive cases of tuberculosis (TB) in Iran. The further stratified analyses indicated that the prevalence of NTM was higher in studies that were done after year 2000. Additionally, M. simiae (43.3% [95% CI 36.8-50.0]), M. intracellucar (27.3% [95% CI 0.7-95.5]) and M. fortuitum (22.7% [95% CI 16.1-30.9]) were the most prevalent NTM species, respectively.
DISCUSSION
The relatively high prevalence of NTM infections (10.2%) among culture positive cases for TB underlines the need for greater enforcement of infection control strategies. Establishment of appropriate diagnostic criteria and management guidelines for NTM diseases and expanding the number and quality of regional reference laboratories may facilitate more accurate action for prevention and control of NTM infections in Iran.
Topics: Humans; Iran; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Prevalence; Tuberculosis
PubMed: 26052701
DOI: 10.1371/journal.pone.0129073 -
Seminars in Arthritis and Rheumatism Apr 2013To report 2 cases of skin nontuberculous mycobacteria (NTM) occurring in lupus patients and to systematically review the medical literature addressing skin NTM in lupus. (Review)
Review
OBJECTIVES
To report 2 cases of skin nontuberculous mycobacteria (NTM) occurring in lupus patients and to systematically review the medical literature addressing skin NTM in lupus.
METHODS
We reported 2 cases of skin NTM in lupus patients followed at the Toronto Lupus Clinic. We conducted a systematic review of the literature on NTM in lupus patients. Ovid Medline (1946 to March 12, 2012) and Embase (1980 to March 12, 2012) were searched for relevant publications.
RESULTS
Of the 1356 retrieved abstracts, 19 publications were identified and 25 cases of skin NTM were extracted. Skin presentations in this review ranged from papules, plaques, and nodules to ulcerative lesions and abscesses. Skin lesions occurred in the setting of active and inactive lupus and while patients were maintained on steroids and sometimes immunosuppressants. The pathogen species included Mycobacterium chelonae, Mycobacterium haemophilum, Mycobacterium kansasii, Mycobacterium avium, Mycobacterium scrofulaceum, Mycobacterium fortuitum, Mycobacterium marinatum, and Mycobacterium szulgai. The duration of antimycobacterial drugs ranged from 3 to 12 months. Skin excision, drainage, and debridement might be required in some cases. Empirical monotherapy was used initially, and the final choice of antibiotics was based on the susceptibility determined in culture. Overall, the outcomes of the skin lesions resulted in either complete recovery or improvement.
CONCLUSIONS
A high index of suspicion in lupus patients is required to diagnose NTM, as the initial presentation of NTM can mimic lupus skin manifestations.
Topics: Diagnosis, Differential; Humans; Lupus Erythematosus, Systemic; Lupus Vasculitis, Central Nervous System; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Skin Diseases, Infectious
PubMed: 23332736
DOI: 10.1016/j.semarthrit.2012.08.002 -
BMC Nephrology Jun 2012Peritoneal dialysis-associated peritonitis (PD-peritonitis) due to Mycobacterium spp is uncommon. Non-tuberculous Mycobacterium (NTB) PD-peritonitis can present in a... (Review)
Review
BACKGROUND
Peritoneal dialysis-associated peritonitis (PD-peritonitis) due to Mycobacterium spp is uncommon. Non-tuberculous Mycobacterium (NTB) PD-peritonitis can present in a similar fashion to more common causes of bacterial PD-peritonitis. We describe the first reported case of multiresistant Mycobacterium fortuitum PD-peritonitis in an Australian patient.
CASE PRESENTATION
A 38 year-old woman developed mild PD-peritonitis during an overseas holiday. Treatment was complicated by delayed diagnosis, requirement for special investigations, treatment with multiple antibiotics, and conversion to haemodialysis following removal of her Tenckhoff catheter.
CONCLUSION
This case demonstrates the diagnostic yield of pursuing further investigations in cases of initially culture-negative, problematic PD-peritonitis. A systematic review of the literature identified only 17 reports of M. fortuitum PD-peritonitis. Similar to our case, a delay in microbiological diagnosis was frequently noted and the Tenckhoff catheter was commonly removed at the time of diagnosis. The type and duration of antibiotic therapy also varied widely so the optimum treatment appears to be poorly defined.
Topics: Adult; Female; Humans; Mycobacterium Infections, Nontuberculous; Mycobacterium fortuitum; Peritoneal Dialysis; Peritonitis
PubMed: 22682357
DOI: 10.1186/1471-2369-13-35 -
Nephrology, Dialysis, Transplantation :... Apr 2012Peritonitis caused by nontuberculous mycobacterium (NTM) is an important complication in peritoneal dialysis (PD) patients. (Review)
Review
BACKGROUND
Peritonitis caused by nontuberculous mycobacterium (NTM) is an important complication in peritoneal dialysis (PD) patients.
METHODS
Cases of PD complicated by NTM peritonitis reported in the English language literature were identified in the PubMed database. The characteristics of these cases were reviewed.
RESULTS
In 41 articles, we identified 57 cases of PD-associated NTM peritonitis in patients ranging from 5 to 82 years. The prevalent clinical findings of these cases were fever, abdominal pain, cloudy fluid and an elevated leukocyte count in peritoneal fluid. These findings were non-specific and could not be differentiated from symptoms caused by Mycobacterium tuberculosis or other bacteria. The majority of these cases received empirical antibacterial therapy before diagnosis of NTM peritonitis. Isolates in more than half of the peritonitis cases were the rapidly growing Mycobacterium, Mycobacterium fortuitum (38.6%) and Mycobacterium chelonae (14.0%). In most cases, PD catheters were removed and experience with non-removal was limited.
CONCLUSION
Diagnosis of NTM infection should be considered in PD patients with peritonitis that are culture negative or refractory to empirical antibiotic therapy.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Peritoneal Dialysis; Peritonitis; Prognosis; Young Adult
PubMed: 21891775
DOI: 10.1093/ndt/gfr504