Title:
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High Rates of Non-Tuberculous Mycobacteria Isolation in
Mozambican Children with Presumptive Tuberculosis
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Author:
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López Varela, Elisa; García-Basteiro, Alberto L.; Augusto, Orvalho; Fraile, Oscar; Bulo, Helder; Ira, Tasmiya; Gondo, Kizito; Ingen, Jakko van; Naniche, Denise; Sacarlal, Jahit; Alonso, Pedro
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Abstract:
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INTRODUCTION: Non-tuberculous mycobacteria (NTM) can cause
disease which can be clinically and radiologically
undistinguishable from tuberculosis (TB), posing a diagnostic
and therapeutic challenge in high TB settings. We aim to
describe the prevalence of NTM isolation and its clinical
characteristics in children from rural Mozambique. METHODS: This
study was part of a community TB incidence study in children
<3 years of age. Gastric aspirate and induced sputum sampling
were performed in all presumptive TB cases and processed for
smear testing using fluorochrome staining and LED Microscopy,
liquid and solid culture, and molecular identification by
GenoType(R) Mycobacterium CM/AS assays. RESULTS: NTM were
isolated in 26.3% (204/775) of children. The most prevalent NTM
species was M. intracellulare (N = 128), followed by M.
scrofulaceum (N = 35) and M. fortuitum (N = 9). Children with
NTM were significantly less symptomatic and less likely to
present with an abnormal chest radiograph than those with M.
tuberculosis. NTM were present in 21.6% of follow-up samples and
25 children had the same species isolated from >/=2 separate
samples. All were considered clinically insignificant and none
received specific treatment. Children with NTM isolates had
equal all cause mortality and likelihood of TB treatment as
those with negative culture although they were less likely to
have TB ruled out. CONCLUSIONS: NTM isolation is frequent in
presumptive TB cases but was not clinically significant in this
patient cohort. However, it can contribute to TB misdiagnosis.
Further studies are needed to understand the epidemiology and
the clinical significance of NTM in children. |
Subject(s):
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-Tuberculosi -Infants -Moçambic -Tuberculosis -Children -Mozambique |
Rights:
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cc by (c) López Varela et al., 2017
http://creativecommons.org/licenses/by/3.0/es/ |
Document type:
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Article Article - Published version |
Published by:
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Public Library of Science (PLoS)
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