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Incidence, Clinical Manifestation, Treatment Outcome, and Drug Susceptibility Pattern of Nontuberculous Mycobacteria in Hiv Patients in Tehran, Iran Publisher Pubmed



Feysia SG1 ; Hasannejad M2, 3 ; Amini S4 ; Hamzelou G4 ; Kazemian H1, 5 ; Kardanyamchi J1 ; Karamizarandi M1 ; Feizabadi MM1, 6
Authors
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Authors Affiliations
  1. 1. Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Iran Iranian Research Center for HIV/AIDS, Tehran, Iran
  3. 3. Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Referral Tuberculosis Laboratory, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
  6. 6. Thoracic Research Center, Tehran University of Medical sciences, Tehran, Iran

Source: Ethiopian journal of health sciences Published:2020


Abstract

Background: Nontuberculous mycobacterial (NTM) infections have radically increased worldwide due to the increase in HIV infections. The disease activity increases with progressive immunodeficiency. Methods: A total of 216 HIV seropositive patients suspected of having mycobacterial infection were recruited for this study. Clinical samples were collected from each patient and cultured on Lowenstein-Jensen media. Detection and species identification were simultaneously done using Reverse Blot Hybridization Assay System. Also, the minimum inhibitory concentrations (MIC) for each isolate were determined in 7H9 broth media for 10 antibiotics. Results: In this study, 4 rapid and 4 slow-growing NTM species were isolated and identified. Mycobacterium fortuitum was the most common NTM species, 3/8 (37.5%), followed by Mycobacterium kansasii, 2/8 (25%). The cases were identified as pulmonary disease, 5/8 (62.5 %), disseminated infection, 2/8 (25%), and skin abscess, 1/8 (12.5%). M. chelonae and Mycobacterium avium were isolated from patients diagnosed with disseminated infection with treatment failure. The skin abscess was caused by infection with M. simiae. The results of the MIC testing were as follows: M. kansasii and M. fortuitum were susceptible to amikacin (AMK); M. avium to clarithromycin (CLA); M. fortuitum 2/3 (67%) to ciprofloxacin (CIP); 1/2 (50%) of M. kansasii isolates to CLA, and M. chelonae to rifampin (RIF), linezolid (LIN), AMK, and CIP at medium and high concentrations. Conclusion: AMK showed incredible in vitro activity against M. kansasii and M. fortuitum. Also, M. avium was susceptible to CLA, whereas M. simiae and M. chelonae were resistant to the tested drugs in this study. © 2020 Seifu Gizaw Feysia, et al.