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Volume 16, Number 3—March 2010

CME ACTIVITY

Extensively Drug-Resistant Mycobacterium tuberculosis from Aspirates, Rural South Africa

Scott K. HeysellComments to Author , Anthony P. Moll, Neel R. Gandhi, François J. Eksteen, Palav Babaria, Yacoob Coovadia, Lynn Roux, Umesh Lalloo, Gerald Friedland, and N. Sarita Shah
Author affiliations: Tugela Ferry Care and Research Collaboration, Tugela Ferry, South Africa (S.K. Heysell, A.P. Moll, N.R. Gandhi, F.J. Eksteen, P. Babaria, U. Lalloo, G. Friedland, N.S. Shah); University of Virginia, Charlottesville, Virginia, USA (S.K. Heysell); Philanjalo Care Center, Tugela Ferry (A.P. Moll, FJ. Eksteen); Yale University, New Haven, Connecticut, USA (P. Babaria, G. Friedland); Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA (N.R. Gandhi, N.S. Shah); National Health Laboratory Services, Durban, South Africa (Y. Coovadia, L. Roux); Enhancing Care Initiative-KZN, Nelson R. Mandela School of Medicine, Durban (U. Lalloo)

Main Article

Table 1

Patient characteristics and results of aspirate cultures for Mycobacterium tuberculosis, South Africa, September 1, 2006–December 31, 2008*

Characteristic Lymph node Pleural fluid
Total no. patients 34 33
Median age, y (IQR) 31 (25–39) 33 (28–39)
Female sex, no. (%)
18 (53)
21 (64)
HIV status, no. (%)
Positive 30 (88) 24 (73)
Negative 1 (3) 1 (3)
Unknown
3 (9)
8 (24)
Median CD4 cells/mm3 (IQR)
128.5† (84–375)
207‡ (118–334)
Receiving ARVs,§ no. (% of HIV-infected)
Yes 14 (47) 13 (54)
No 13 (43) 10 (42)
Unknown 3 (10) 1 (4)
Median duration on ARVs, wk (IQR)
8.4¶ (2.4–21.1)
10.5# (5.8–55.1)
History of prior TB, no. (%) 8 (24) 9 (27)
Receiving TB treatment,§ no. (%) 20 (59) 18 (55)
Median duration of TB treatment, wk (IQR)
12** (4–16)
6†† (3–14)
Positive culture results, no. (%)
M. tuberculosis 12 (35) 9 (27)
Drug-susceptible TB, no. (% of M. tuberculosis) 9 (75) 3 (33)
XDR TB, no. (%) 1 (8) 6 (67)
Missing drug susceptibility results, no. (%) 2 (17) 0
Nontuberculous mycobacteria 1 (3) 0
Cryptococcus sp. 0 1 (3)
Other bacteria 2 (6) 1 (3)

*IQR, interquartile range; ARVs, antiretroviral drugs; TB, tuberculosis; XDR TB, extensively drug-resistant TB.
†Available for 26 HIV-infected patients, excluding CD4% for 1 infant (36%).
‡Available for 18 HIV-infected patients.
§At time of aspirate collection.
¶Available for 10 of 14 patients receiving ARVs.
#Available in 12 of 13 patients receiving ARVs.
**Available for 9 patients.
††Available for 12 patients.

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