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Clinical relevance of nontuberculous mycobacteria isolated from sputum in a gold mining workforce in South Africa: an observational, clinical study

van Halsema, Clare L., Chihota, Violet N., van Pittius, Nicolaas C. Gey, Fielding, Katherine L., Lewis, James J., van Helden, Paul D., Churchyard, Gavin J. and Grant, Alison D. 2015. Clinical relevance of nontuberculous mycobacteria isolated from sputum in a gold mining workforce in South Africa: an observational, clinical study. BioMed Research International 2015 , 959107. 10.1155/2015/959107

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Abstract

Background. The clinical relevance of nontuberculous mycobacteria (NTM), detected by liquid more than solid culture in sputum specimens from a South African mining workforce, is uncertain. We aimed to describe the current spectrum and relevance of NTM in this population. Methods. An observational study including individuals with sputum NTM isolates, recruited at workforce tuberculosis screening and routine clinics. Symptom questionnaires were administered at the time of sputum collection and clinical records and chest radiographs reviewed retrospectively. Results. Of 232 individuals included (228 (98%) male, median age 44 years), M. gordonae (60 individuals), M. kansasii (50), and M. avium complex (MAC: 38) were the commonest species. Of 38 MAC isolates, only 2 (5.3%) were from smear-positive sputum specimens and 30/38 grew in liquid but not solid culture. MAC was especially prevalent among symptomatic, HIV-positive individuals. HIV prevalence was high: 57/74 (77%) among those tested. No differences were found in probability of death or medical separation by NTM species. Conclusions. M. gordonae, M. kansasii, and MAC were the commonest NTM among miners with suspected tuberculosis, with most MAC from smear-negative specimens in liquid culture only. HIV testing and identification of key pathogenic NTM in this setting are essential to ensure optimal treatment.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Social Sciences (Includes Criminology and Education)
Publisher: Hindawi Publishing Corporation
ISSN: 2314-6133
Date of First Compliant Deposit: 15 August 2019
Date of Acceptance: 21 December 2014
Last Modified: 15 Aug 2019 13:40
URI: http://orca.cf.ac.uk/id/eprint/123894

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