Situation and trends of pathogenic mycobacteria detection from hemoculture samples in the upper central region of Thailand
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Abstract
Mycobacterium tuberculosis complex (MTBC), the causative agent of tuberculosis, and some species of non-tuberculous mycobacteria (NTM) are human pathogenic mycobacteria. They are also the important opportunistic pathogens in HIV-infected patients. Mycobacterial bloodstream infection is risk factor associated with death in patients. This retrospective study reviewed the records of mycobacterial hemoculture samples that were sent from hospital for diagnostics to the mycobacterial laboratory of the Office of Disease Prevention and Control Region 3 Nakhon Sawan. The aim of this study was situation and trends analysis of mycobateria that were causes of bacteremia in patients. During the period from fiscal year 2010 to 2016, there were 90 hemoculture samples that were more male samples than female samples and ratio was 2.1:1. Almost all patients were a group of 20- to 60-year-old and median age of all patients was 38 year-old. 55.6% of all patients were infected with HIV. Frequently isolated mycobacterial pathogens were NTM (51.1%) that greater than MTBC (48.9%). Most MTBC isolates were pan-susceptible to first-line drugs that detected in 77.3%. Multidrug-resistant TB (MDR-TB) isolates were detected in 4.5% of MTBC isolates and one of MDR-TB isolates was resistant to ofloxacin and cycloserine that were second-line drugs. The majority of NTM isolates were M. avium (56%), and the other NTM were M. intracellulare (7%), M. abscessus (2%) M. kansasii (2%) and NTM that unidentified species by line-probe assay (LPA) were detected in up to 13%. Trends of infection with MTBC decreased from 60.0% in 2010 to 41.2 in 2016. In contrast, the proportion of NTM increased from 40% in 2010 to 58.8% in 2016. From this study, mycobacteremia was associated with HIV infection, so control programmes of mycobacterial and HIV infection must work together on target groups, especially working age group. By the way, increasing NTM isolation from hemoculture samples can be a public health problem in the future. Therefore, we should enhance awareness and surveillance of NTM infection.
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