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Nontuberculous Mycobacteria; Experience in a University Hospital in Buenos Aires, Argentina.
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A1978 - Nontuberculous Mycobacteria; Experience in a University Hospital in Buenos Aires, Argentina.
Author Block: M. M. Perin1, N. Rolan1, L. Canteros2, D. Burgos1, R. A. Gomez Tejada1, L. Limongi1, C. M. Luna1, A. M. Putruele1; 1Pulmonary Division, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina, 2Microbiology Departament, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
Rationale: In recent years there has been an increase in the frequency of mycobacteriosis in immunocompetent and immunocompromised patients. Species and their pathogenic capacity vary between countries and latitudes. Although Argentina is a country with a high prevalence of tuberculosis, there is little data on the frequency of nontuberculous mycobacteria. The objective of this study was to identify the frequency of non-tuberculous mycobacteria in a university hospital, the demographic, clinical characteristics of the patients and the different species according to the rescue in the cultures. Evaluate the established treatment, its adherence and evolution. Methods: A review of the clinical records of the patients treated in the pulmonary division of Hospital de Clínicas José de San Martín and of the cultures processed in the area of mycobacteria between the years 2009 to 2017 was carried out. Demographic data, risk factors, comorbidities, rescue in the cultures and clinical evolution were analyzed. Results: Between the years 2009 to 2017, from 599 cases of mycobacteria isolated, 38 were non-tuberculous mycobacteria. There was a slight predominance of males, 53%; the age range presented two peaks of incidence, third and seventh decade. 3 cases presented positive serology for HIV.Respiratory comorbidities were the most frequent, 31% presented non-CF bronchiectasis; 23% smokers and 7% COPD. The avium-intracellulare complex was the most frequently isolated, 50%. Clarithromycin was part of 79% of the schemes performed, being the most frequent the association of clarithromycin-rifampicin-ethambutol 46%. 42% of the patients completed treatment with medical discharge; 29%continue to follow up and the remaining 29%, 3 died and 8 dropped out. Conclusion: The results obtained are similar to those observed in other series. The treatment that included clarithromycin presented satisfactory success rates. The dropout rate was high, possibly due to the prolonged duration of treatment and multiple drug requirement. These data suggest the need for guidelines adapted to the situation of Latin American countries.
Author Block: M. M. Perin1, N. Rolan1, L. Canteros2, D. Burgos1, R. A. Gomez Tejada1, L. Limongi1, C. M. Luna1, A. M. Putruele1; 1Pulmonary Division, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina, 2Microbiology Departament, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
Rationale: In recent years there has been an increase in the frequency of mycobacteriosis in immunocompetent and immunocompromised patients. Species and their pathogenic capacity vary between countries and latitudes. Although Argentina is a country with a high prevalence of tuberculosis, there is little data on the frequency of nontuberculous mycobacteria. The objective of this study was to identify the frequency of non-tuberculous mycobacteria in a university hospital, the demographic, clinical characteristics of the patients and the different species according to the rescue in the cultures. Evaluate the established treatment, its adherence and evolution. Methods: A review of the clinical records of the patients treated in the pulmonary division of Hospital de Clínicas José de San Martín and of the cultures processed in the area of mycobacteria between the years 2009 to 2017 was carried out. Demographic data, risk factors, comorbidities, rescue in the cultures and clinical evolution were analyzed. Results: Between the years 2009 to 2017, from 599 cases of mycobacteria isolated, 38 were non-tuberculous mycobacteria. There was a slight predominance of males, 53%; the age range presented two peaks of incidence, third and seventh decade. 3 cases presented positive serology for HIV.Respiratory comorbidities were the most frequent, 31% presented non-CF bronchiectasis; 23% smokers and 7% COPD. The avium-intracellulare complex was the most frequently isolated, 50%. Clarithromycin was part of 79% of the schemes performed, being the most frequent the association of clarithromycin-rifampicin-ethambutol 46%. 42% of the patients completed treatment with medical discharge; 29%continue to follow up and the remaining 29%, 3 died and 8 dropped out. Conclusion: The results obtained are similar to those observed in other series. The treatment that included clarithromycin presented satisfactory success rates. The dropout rate was high, possibly due to the prolonged duration of treatment and multiple drug requirement. These data suggest the need for guidelines adapted to the situation of Latin American countries.
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