Clinical relevance of nontuberculous mycobacteria isolated from sputum in a gold mining workforce in South Africa : an observational, clinical study

Van Halsema, Clare L. ; Chihota, Violet N. ; Gey van Pittius, Nicolaas C. ; Fielding, Katherine L. ; Lewis, James J. ; Van Helden, Paul D. ; Churchyard, Gavin J. ; Grant, Alison D. (2015)

CITATION: Van Halsema, C. L. et al. 2015. Clinical relevance of nontuberculous mycobacteria isolated from sputum in a gold mining workforce in South Africa : an observational, clinical study. BioMed Research International, 2015, Article ID 959107, doi:10.1155/2015/959107.

The original publication is available at https://www.hindawi.com/journals/bmri

Article

Background.The clinical relevance of nontuberculous mycobacteria (NTM), detected by liquid more than solid culture in sputum specimens from a South African mining workforce, is uncertain. We aimed to describe the current spectrum and relevance of NTMin this population. Methods. An observational study including individuals with sputum NTMisolates, recruited at workforce tuberculosis screening and routine clinics. Symptomquestionnaires were administered at the time of sputumcollection and clinical records and chest radiographs reviewed retrospectively. Results.Of 232 individuals included (228 (98%) male,median age 44 years), M. gordonae (60 individuals), M. kansasii (50), and M. aviumcomplex (MAC: 38) were the commonest species.Of 38MAC isolates, only 2 (5.3%) were from smear-positive sputum specimens and 30/38 grew in liquid but not solid culture. MAC was especially prevalent among symptomatic, HIV-positive individuals. HIV prevalence was high: 57/74 (77%) among those tested.No differences were found in probability of death or medical separation by NTM species. Conclusions. M. gordonae, M. kansasii, andMAC were the commonest NTMamong miners with suspected tuberculosis, withmostMAC fromsmear-negative specimens in liquid culture only. HIV testing and identification of key pathogenic NTM in this setting are essential to ensure optimal treatment.

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