Isolation of Non-Tuberculous Mycobacteria in Children Investigated for Pulmonary Tuberculosis

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dc.contributor.authorHatherill, Marken_ZA
dc.contributor.authorHawkridge, Tonyen_ZA
dc.contributor.authorWhitelaw, Andrewen_ZA
dc.contributor.authorTameris, Micheleen_ZA
dc.contributor.authorMahomed, Hassanen_ZA
dc.contributor.authorMoyo, Sizuluen_ZA
dc.contributor.authorHanekom, Willemen_ZA
dc.contributor.authorHussey, Gregoryen_ZA
dc.date.accessioned2015-11-09T13:17:39Z
dc.date.available2015-11-09T13:17:39Z
dc.date.issued2006en_ZA
dc.description.abstractObjective To evaluate the frequency and clinical significance of non-tuberculous mycobacteria (NTM) isolates among children investigated for pulmonary tuberculosis in a rural South African community. METHODS: Children were investigated for pulmonary tuberculosis as part of a tuberculosis vaccine surveillance program (2001-2005). The clinical features of children in whom NTM were isolated, from induced sputum or gastric lavage, were compared to those with culture-proven M. tuberculosis . RESULTS: Mycobacterial culture demonstrated 114 NTM isolates from 109 of the 1,732 children investigated, a crude yield of 6% (95% CI 5-7). The comparative yield of positive NTM cultures from gastric lavage was 40% (95% CI 31-50), compared to 67% (95% CI 58-76) from induced sputum. 95% of children with NTM isolates were symptomatic. Two children were HIV-infected. By contrast, M. tuberculosis was isolated in 187 children, a crude yield of 11% (95% CI 9-12). Compared to those with culture-proven M. tuberculosis , children with NTM isolates were less likely to demonstrate acid-fast bacilli on direct smear microscopy (OR 0.19; 95% 0.0-0.76). Children with NTM were older (p<0.0001), and more likely to demonstrate constitutional symptoms (p = 0.001), including fever (p = 0.003) and loss of weight or failure to gain weight (p = 0.04), but less likely to demonstrate a strongly positive tuberculin skin test (p<0.0001) or radiological features consistent with pulmonary tuberculosis (p = 0.04). DISCUSSION: NTM were isolated in 6% of all children investigated for pulmonary tuberculosis and in more than one third of those with a positive mycobacterial culture. NTM may complicate the diagnosis of PTB in regions that lack capacity for mycobacterial species identification. The association of NTM isolates with constitutional symptoms suggestive of host recognition requires further investigation.en_ZA
dc.identifier.apacitationHatherill, M., Hawkridge, T., Whitelaw, A., Tameris, M., Mahomed, H., Moyo, S., ... Hussey, G. (2006). Isolation of Non-Tuberculous Mycobacteria in Children Investigated for Pulmonary Tuberculosis. <i>PLoS One</i>, http://hdl.handle.net/11427/14784en_ZA
dc.identifier.chicagocitationHatherill, Mark, Tony Hawkridge, Andrew Whitelaw, Michele Tameris, Hassan Mahomed, Sizulu Moyo, Willem Hanekom, and Gregory Hussey "Isolation of Non-Tuberculous Mycobacteria in Children Investigated for Pulmonary Tuberculosis." <i>PLoS One</i> (2006) http://hdl.handle.net/11427/14784en_ZA
dc.identifier.citationHatherill, M., Hawkridge, T., Whitelaw, A., Tameris, M., Mahomed, H., Moyo, S., ... & Hussey, G. (2006). Isolation of non-tuberculous mycobacteria in children investigated for pulmonary tuberculosis. PLoS One, 1(1), e21. doi:10.1371/journal.pone.0000021en_ZA
dc.identifier.ris TY - Journal Article AU - Hatherill, Mark AU - Hawkridge, Tony AU - Whitelaw, Andrew AU - Tameris, Michele AU - Mahomed, Hassan AU - Moyo, Sizulu AU - Hanekom, Willem AU - Hussey, Gregory AB - Objective To evaluate the frequency and clinical significance of non-tuberculous mycobacteria (NTM) isolates among children investigated for pulmonary tuberculosis in a rural South African community. METHODS: Children were investigated for pulmonary tuberculosis as part of a tuberculosis vaccine surveillance program (2001-2005). The clinical features of children in whom NTM were isolated, from induced sputum or gastric lavage, were compared to those with culture-proven M. tuberculosis . RESULTS: Mycobacterial culture demonstrated 114 NTM isolates from 109 of the 1,732 children investigated, a crude yield of 6% (95% CI 5-7). The comparative yield of positive NTM cultures from gastric lavage was 40% (95% CI 31-50), compared to 67% (95% CI 58-76) from induced sputum. 95% of children with NTM isolates were symptomatic. Two children were HIV-infected. By contrast, M. tuberculosis was isolated in 187 children, a crude yield of 11% (95% CI 9-12). Compared to those with culture-proven M. tuberculosis , children with NTM isolates were less likely to demonstrate acid-fast bacilli on direct smear microscopy (OR 0.19; 95% 0.0-0.76). Children with NTM were older (p<0.0001), and more likely to demonstrate constitutional symptoms (p = 0.001), including fever (p = 0.003) and loss of weight or failure to gain weight (p = 0.04), but less likely to demonstrate a strongly positive tuberculin skin test (p<0.0001) or radiological features consistent with pulmonary tuberculosis (p = 0.04). DISCUSSION: NTM were isolated in 6% of all children investigated for pulmonary tuberculosis and in more than one third of those with a positive mycobacterial culture. NTM may complicate the diagnosis of PTB in regions that lack capacity for mycobacterial species identification. The association of NTM isolates with constitutional symptoms suggestive of host recognition requires further investigation. DA - 2006 DB - OpenUCT DO - 10.1371/journal.pone.0000021 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2006 T1 - Isolation of Non-Tuberculous Mycobacteria in Children Investigated for Pulmonary Tuberculosis TI - Isolation of Non-Tuberculous Mycobacteria in Children Investigated for Pulmonary Tuberculosis UR - http://hdl.handle.net/11427/14784 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14784
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0000021
dc.identifier.vancouvercitationHatherill M, Hawkridge T, Whitelaw A, Tameris M, Mahomed H, Moyo S, et al. Isolation of Non-Tuberculous Mycobacteria in Children Investigated for Pulmonary Tuberculosis. PLoS One. 2006; http://hdl.handle.net/11427/14784.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2006 Hatherill et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherChildrenen_ZA
dc.subject.otherMycobacterium tuberculosisen_ZA
dc.subject.otherTuberculosis diagnosis and managementen_ZA
dc.subject.otherSputumen_ZA
dc.subject.otherSkin testsen_ZA
dc.subject.otherTuberculinen_ZA
dc.subject.otherVaccinesen_ZA
dc.subject.otherRespiratory physiologyen_ZA
dc.titleIsolation of Non-Tuberculous Mycobacteria in Children Investigated for Pulmonary Tuberculosisen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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