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Volume 16, Number 3—March 2010
CME ACTIVITY - Dispatch

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.

Main Article

Page created: December 14, 2010
Page updated: December 14, 2010
Page reviewed: December 14, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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