Clinical relevance of Mycobacterium malmoense isolation in The Netherlands

Uncertainty exists about the clinical relevance of Mycobacterium malmoense isolation, especially in pulmonary samples. We therefore determined clinical relevance, treatment and outcome of M. malmoense isolation in The Netherlands. A retrospective medical file study was conducted for all patients in...

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Published in:The European respiratory journal Vol. 34; no. 4; p. 926
Main Authors: Hoefsloot, W, van Ingen, J, de Lange, W C M, Dekhuijzen, P N R, Boeree, M J, van Soolingen, D
Format: Journal Article
Language:English
Published: England 01.10.2009
Subjects:
Adult
Aged
Aged, 80 and over
Antitubercular Agents - therapeutic use
Drug Resistance, Bacterial
Female
Humans
Male
Middle Aged
Morbidity
Mycobacterium Infections, Nontuberculous - drug therapy
Mycobacterium Infections, Nontuberculous - epidemiology
Mycobacterium Infections, Nontuberculous - microbiology
Netherlands - epidemiology
Nontuberculous Mycobacteria - isolation & purification
Retrospective Studies
Tuberculosis, Lymph Node - drug therapy
Tuberculosis, Lymph Node - epidemiology
Tuberculosis, Lymph Node - microbiology
Tuberculosis, Pulmonary - drug therapy
Tuberculosis, Pulmonary - epidemiology
Tuberculosis, Pulmonary - microbiology
Netherlands
ISSN:1399-3003, 1399-3003
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Summary:Uncertainty exists about the clinical relevance of Mycobacterium malmoense isolation, especially in pulmonary samples. We therefore determined clinical relevance, treatment and outcome of M. malmoense isolation in The Netherlands. A retrospective medical file study was conducted for all patients in The Netherlands from whom Mycobacterium malmoense had been isolated between January 2002 and January 2006. Diagnostic criteria for nontuberculous mycobacterial (NTM) disease published by the American Thoracic Society (ATS) were used to determine clinical relevance. Treatment was compared with guidelines published by the British Thoracic Society. In total, 51 patients were found from whom M. malmoense was isolated. Of these, 40 (78%) patients had pulmonary isolates and 32 (80%) of them met the ATS diagnostic criteria. Cavitary disease was most common (n = 28; 88%). Patients with pulmonary disease were mostly males, with an average age of 56 yrs and pre-existing chronic obstructive pulmonary disease. Cervical lymphadenitis was the most common extrapulmonary disease type. Adherence to treatment guidelines was poor. A good clinical response to treatment was observed in 70% and 73% of patients treated for pulmonary and extrapulmonary disease, respectively. In conclusion, M. malmoense is a clinically highly relevant NTM in The Netherlands causing serious pulmonary morbidity. Adherence to treatment guidelines is not satisfactory.
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ISSN:1399-3003
1399-3003
DOI:10.1183/09031936.00039009