Clinical and Therapeutic Features of Pulmonary Nontuberculous Mycobacterial Disease, Rio de Janeiro, Brazil

• Main Authors: Karla Gripp Couto de Mello, Fernanda C.Q. Mello, Liamar Borga, Valeria Rolla, Rafael S. Duarte, Elizabeth P. Sampaio, Steven M. Holland, D. Rebecca Prevots, Margareth P. Dalcolmo
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2013-03-01
• Series: Emerging Infectious Diseases
• Subjects: mycobacteria; atypical; nontuberculous mycobacteria; bacteria; Brazil; mycobacteria, atypical
• Online Access: https://wwwnc.cdc.gov/eid/article/19/3/12-0735_article
• ISSN: 1080-6040; 1080-6059

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.