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Volume 15, Number 2—February 2009

Dispatch

Clinical Relevance of Nontuberculous Mycobacteria, Oman

Sara H. Al-Mahruqi, Jakko van IngenComments to Author , Suleiman Al-Busaidy, Martin J. Boeree, Samiya Al-Zadjali, Arti Patel, P.N. Richard Dekhuijzen, and Dick van Soolingen
Author affiliations: Central Public Health Laboratory, Muscat, Oman (S.H. Al-Mahruqi, S. Al-Busaidy, S. Al-Zadjali, A. Patel); Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands (J. van Ingen, M.J. Boeree, P.N.R. Dekhuijzen); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (J. van Ingen, D. van Soolingen)

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Table

Clinical and microbiologic data for 13 patients with Mycobacterium spp. infections, Oman, 2006–2007*

Patient no./sex/ age, y Species AFB smear Positive cultures Source Condition Symp. Chest radiograph 2007 ATS criteria Therapy Outcome
1/F/64 M. intracellulare† + Multiple Sputum PC, F, WL, CP, M NP Met HRZE Improved
2/M/29 MAIS complex + Single Sputum PC, Hp, WL Cavities Met HRZE Improved
3/F/31 M. chimaera‡ Multiple Sputum None RUL bronch. Not met None Stable
4/M/28 M. chimaera‡ + Multiple Sputum PC, WL RUL multiple scars, left lung destroyed, abscess, PT Met SClaCip Failure
5/M/18 16S: M. colombiense Single BAL HD PC, Hp, CP NP Met HRE Improved
6/M/57 16S: M. flavescens NP Single Urine AP NP Not met NA NA
7/F/57 M. simiae Single Sputum HIV PC Patchy opacities in LUL and lingula Met HRE Improved
8/F/12 M. kansasii III/IV/V Single Sputum None Normal Not met NA NA
9/M/43 M. tuberculosis and M. intracellulare + Multiple Sputum PC, F, WL, M Cavities NA HRZES Failure
10/F/7 M. marinum Single Skin Skin lesion NP Met ECla Improved
11/F/65 M. chimaera‡ + Multiple Sputum PC, BA Destroyed left lung Met ClaCip Improved
12/F/83 M. avium Single Sputum None RUL infiltration Not met NA NA
13/M/63 M. intracellulare† + Single Sputum Prior PNTM disease PC, WL, M Bronch., PI Met RECip Improved

*AFB, acid-fast bacilli; Symp., symptoms; ATS, American Thoracic Society; PC, productive cough; F, fever; WL, weight loss; CP, chest pain; M, malaise/fatigue; NP, not performed; H, isoniazid; R, rifampicin; Z, pyrazinamide; E, ethambutol; MAIS, M. aviumintracellularescrofulaceum; Hp, hemoptysis; RUL, right upper lobe of lung; LUL, left upper lobe of lung; Bronch., bronchiectasis; PT, pleural thickening; S, streptomycin; Cla, clarithromycin; Cip, ciprofloxacin; 16S, identified by 16S rDNA gene sequencing; BAL, bronchoalveolar lavage fluid; HD, heart disease; AP, abdominal pain; NA, not applicable; BA, backache; PI, parenchymal infiltration; PNTM, pulmonary nontuberculous mycobacteria.
†Reaction with the MIN-1 probe; M. intracellulare sequevar Min-A, -B, -C, or -D.
‡Reaction with the MIN-2 probe; M. intracellulare sequevar MAC-A, which was recently elevated to the species level (M. chimaera) (7).

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