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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)

Main Article

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. avium–intracellulare–scrofulaceum; 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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