Nontuberculous Mycobacterial Infections in Ban Pong Hospital

Abstract

The incidence of and reports on nontubercolous mycobacterial infections in Thailand have been increasing both in HIV-infected and HIV-noninfected patients and they varied in clinical manifestations. However almost all of the studies derived from medical university hospital set up. A retrospective study was performed in 33 cases of nontuberculous mycobacterial infections from October 1998 to September 2008 with an objective of presenting the epidemiology and interesting clinical manifestations of nontuberculous mycobacterial infections in Ban Pong Hospital. The prevalence of NTM positive culture specimen was 7.3 percent. There were 23 male and 10 female patients with median aged 44.6 years (range 7-82 years), fifteen of them (15, 45.4%) were HIV- infected. The other associated disease were diabetes (6, 15.8%) and anemia (4,10.6%). Most patients presented with fever (51.5%), chronic cough and hemoptysis (36.4%). Localized lung infections (22, 66.7%) were the most clinical form of NTM infections in this study while disseminated infections were common in HIV-infected patients. Alveolar infiltration (18, 54.5%) was the most common chest radiography abnormality. There were not definite identifications of bacterial species (24, 72.8%) in most cases of NTM infections in this study. Only nine cases had been identified with bacterial species and Mycobacterium avium complex (MAC) was the predominant species (7, 21.2%), followed by Mycobacterium marinum and Mycobacterium chelonae. Of these patients, 3 cases had relapsed and 14 cases died (42.5%). NTM infection is an important medical problems in general hospital due to difficulty in diagnosis, lack of facilities in identification of bacterial species and prolonged treatment with proper antibiotics. Patients should be monitored clinically and followed up periodically for relapse.