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Mebrahtom G, Hailay A, Mariye T, Haile TG, Girmay G, Zereabruk K, Aberhe W, Tadesse DB. Chronic obstructive pulmonary disease in East Africa: a systematic review and meta-analysis. Int Health 2024:ihae011. [PMID: 38324403 DOI: 10.1093/inthealth/ihae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 10/22/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common lung disease that causes restricted airflow and breathing problems. Globally, COPD is the third leading cause of death and low- and middle-income countries account for the majority of these deaths. There is limited information on COPD's prevalence in East Africa. Thus the purpose of this systematic review and meta-analysis is to estimate the pooled prevalence of COPD in East Africa.A computerized systematic search using multiple databases was performed in search of relevant English articles from the inception of the databases to August 2023. All the authors independently extracted the data. R and RStudio software were used for statistical analysis. Forest plots and tables were used to represent the data. The statistical heterogeneity was evaluated using I2 statistics. There was heterogeneity between the included articles. Therefore, a meta-analysis of random effects models was used to estimate the overall pooled prevalence of COPD in East Africa. A funnel plot test was used to examine possible publication bias.The database search produced 512 papers. After checking for inclusion and exclusion criteria, 43 full-text observational studies with 68 553 total participants were found suitable for the review. The overall pooled prevalence of COPD in East Africa was 13.322%. The subgroup analysis found the COPD pooled prevalence in the different countries was 18.994%, 7%, 15.745%, 9.032%, 15.026% and 11.266% in Ethiopia, Uganda, Tanzania, Malawi, Sudan, and Kenya, respectively. Additionally, the subgroup analysis of COPD by study setting among community-based studies was 12.132% and 13.575% for hospital-based studies.According to the study's findings, approximately one of every seven individuals in East Africa has COPD, indicating a notably high prevalence of the disease. Thus governments and other stakeholders working on non-communicable disease control should place an emphasis on preventive measures to minimize the burden of COPD.
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Affiliation(s)
- Guesh Mebrahtom
- Department of Adult Health Nursing, College of Health Science, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Abrha Hailay
- Department of Adult Health Nursing, College of Health Science, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Teklewoini Mariye
- Department of Adult Health Nursing, College of Health Science, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Teklehaimanot Gereziher Haile
- Department of Maternity and Neonatal Nursing, College of Health Science, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Goitom Girmay
- Department of Clinical Midwifery, College of Health Science, Aksum University, Aksum, Ethiopia
| | - Kidane Zereabruk
- Department of Adult Health Nursing, College of Health Science, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Woldu Aberhe
- Department of Adult Health Nursing, College of Health Science, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Degena Bahrey Tadesse
- Department of Adult Health Nursing, College of Health Science, School of Nursing, Aksum University, Aksum, Ethiopia
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Rodriguez C, Salas NM, Bruno M, Brett M, Byrd TF, Ruan L, Jakeman B. Treatment management of M. simiae infection complicated by severe immune reconstitution syndrome in two patients living with HIV. Int J STD AIDS 2023; 34:355-360. [PMID: 36629094 DOI: 10.1177/09564624221151090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Nontuberculosis mycobacterium are increasingly being identified as sources of disseminated infections in immunocompromised patients. These infections can be challenging to identify and treat due complexities of diagnosis and inherent resistance to many medications. We present two cases of patients with human immunodeficiency virus who had Mycobacterium simiae infections, complicated by immune reconstruction inflammatory syndrome (IRIS). We also present a review of the English literature surrounding the disease, including reported resistance patterns to antimicrobial therapy, which can be highly variable.
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Affiliation(s)
- Chelsea Rodriguez
- Department of Pharmacy, 21764University of New Mexico Hospitals, Albuquerque, NM, USA
| | - Natalie Mariam Salas
- Department of Internal Medicine, Division of Infectious Diseases, 1104University of New Mexico Hospitals, Albuquerque, NM, USA
| | - Matthew Bruno
- Department of Pharmacy Practice and Administrative Sciences, 15520University of New Mexico College of Pharmacy, Albuquerque, NM, USA
| | - Meghan Brett
- Department of Internal Medicine, Division of Infectious Diseases, 1104University of New Mexico Hospitals, Albuquerque, NM, USA
| | - Tom F Byrd
- Department of Internal Medicine, Division of Infectious Diseases, 1104University of New Mexico Hospitals, Albuquerque, NM, USA
| | - Lucy Ruan
- Department of Internal Medicine, Division of Infectious Diseases, 1104University of New Mexico Hospitals, Albuquerque, NM, USA
| | - Bernadette Jakeman
- Department of Pharmacy Practice and Administrative Sciences, 15520University of New Mexico College of Pharmacy, Albuquerque, NM, USA
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Dashtbin S, Mirkalantari S, Dadashi M, Darban_Sarokhalil D. Investigation of drug regimens and treatment outcome in patients with Mycobacterium Simiae: a systematic review. Expert Rev Anti Infect Ther 2022; 20:1015-1023. [DOI: 10.1080/14787210.2022.2056019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Shirin Dashtbin
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shiva Mirkalantari
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Dadashi
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Davood Darban_Sarokhalil
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
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Characterization of Clinical Isolates of Mycobacterium simiae Using Drug Susceptibility Tests and Molecular Analyses. Curr Microbiol 2021; 78:2324-2331. [PMID: 33847796 DOI: 10.1007/s00284-021-02486-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Abstract
Mycobacterium simiae is an emerging nontuberculous mycobacterium (NTM) and an opportunistic pathogen which is described mainly in Asia and presents in the environment that can cause pulmonary infection. The objective of this study is to characterize M. simiae clinical isolates using mycobacterial interspersed repetitive unit variable-number tandem repeats (MIRU-VNTR) typing for the differentiation of the strains. A total of 169 clinical isolates of NTM were recovered from patients suspected of having tuberculosis (TB)-like and related infections. After isolation and identification of mycobacterial strains by conventional biochemical and PCR-based tests, M. simiae strains were confirmed using restriction fragment length polymorphism (RFLP)-based identification assay. Furthermore, drug susceptibility and MIRU-VNTR typing was performed using on the clinical isolates of M. simiae. Out of 169 NTM strains, 92 (54.4%) isolates were identified as M. simiae. Antibiotic susceptibility experiments indicated that all 92 M. simiae isolates were resistant to first line antimycobacterial agents. Moreover, 8 (8.6%) M. simiae isolates were resistant to ciprofloxacin; and 6 (6.5%) were resistant to both amikacin and kanamycin, while the remaining were susceptible to second line antimycobacterial agents. MIRU-VNTR analysis showed that the M. simiae isolates were classified in four distinct M. simiae clusters and two single types. The minimum spanning analysis revealed that the isolates were grouped in three complexes. The data suggested that MIRI-VNTR typing is useful for typing of M. simiae isolates, however, MIRU-16 locus was absolutely absent in M. simiae.
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Lotfi H, Sankian M, Meshkat Z, Khalifeh Soltani A, Aryan E. Mycobacterium simiae pulmonary infection: a case series and literature review. Respirol Case Rep 2021; 9:e00719. [PMID: 33628451 PMCID: PMC7898274 DOI: 10.1002/rcr2.719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/15/2020] [Accepted: 01/16/2021] [Indexed: 11/24/2022] Open
Abstract
Incidence of Mycobacterium simiae pulmonary infection is increasing and diagnosis and treatment are challenging. We surveyed the clinical features, risk factors, diagnosis, and management in 20 patients from northeastern Iran diagnosed by line probe assay and confirmed by sequencing the ITS (16S-23S) rRNA region and carried out a literature review using the keywords "pulmonary infection" and "Mycobacterium simiae." The mean age of patients was 55.1 years, with 80% female and 90% diagnosed by sputum. Clinical symptoms included severe cough (90%), sputum production (70%), haemoptysis (50%), and chest pain (35%). Comorbidities included a history of tuberculosis (60%), smoking (40%), or chronic obstructive pulmonary disease (20%). Patients were treated with levofloxacin, clarithromycin, and co-trimoxazole. Except for two patients, the clinical symptoms improved. Mycobacterium simiae pulmonary infection is increasing in people with underlying diseases. Although choosing the most appropriate treatment remains a challenge, combining successful treatments could be useful in treating these patients.
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Affiliation(s)
- Hadi Lotfi
- Antimicrobial Resistance Research CenterMashhad University of Medical SciencesMashhadIran
- Laboratory of Microbiology, Department of Medical MicrobiologyGhaem University Hospital, Mashhad University of Medical SciencesMashhadIran
| | - Mojtaba Sankian
- Immunobiochemistry LaboratoryImmunology Research Center, Mashhad University of Medical SciencesMashhadIran
| | - Zahra Meshkat
- Antimicrobial Resistance Research CenterMashhad University of Medical SciencesMashhadIran
- Laboratory of Microbiology, Department of Medical MicrobiologyGhaem University Hospital, Mashhad University of Medical SciencesMashhadIran
| | - Ahmad Khalifeh Soltani
- Department of Infectious Diseases and Tropical Medicine, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Ehsan Aryan
- Antimicrobial Resistance Research CenterMashhad University of Medical SciencesMashhadIran
- Laboratory of Microbiology, Department of Medical MicrobiologyGhaem University Hospital, Mashhad University of Medical SciencesMashhadIran
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Chin KL, Sarmiento ME, Alvarez-Cabrera N, Norazmi MN, Acosta A. Pulmonary non-tuberculous mycobacterial infections: current state and future management. Eur J Clin Microbiol Infect Dis 2020; 39:799-826. [PMID: 31853742 PMCID: PMC7222044 DOI: 10.1007/s10096-019-03771-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 11/18/2019] [Indexed: 12/11/2022]
Abstract
Currently, there is a trend of increasing incidence in pulmonary non-tuberculous mycobacterial infections (PNTM) together with a decrease in tuberculosis (TB) incidence, particularly in developed countries. The prevalence of PNTM in underdeveloped and developing countries remains unclear as there is still a lack of detection methods that could clearly diagnose PNTM applicable in these low-resource settings. Since non-tuberculous mycobacteria (NTM) are environmental pathogens, the vicinity favouring host-pathogen interactions is known as important predisposing factor for PNTM. The ongoing changes in world population, as well as socio-political and economic factors, are linked to the rise in the incidence of PNTM. Development is an important factor for the improvement of population well-being, but it has also been linked, in general, to detrimental environmental consequences, including the rise of emergent (usually neglected) infectious diseases, such as PNTM. The rise of neglected PNTM infections requires the expansion of the current efforts on the development of diagnostics, therapies and vaccines for mycobacterial diseases, which at present, are mainly focused on TB. This review discuss the current situation of PNTM and its predisposing factors, as well as the efforts and challenges for their control.
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Affiliation(s)
- Kai Ling Chin
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah (UMS), Kota Kinabalu, Sabah, Malaysia.
| | - Maria E Sarmiento
- School of Health Sciences, Universiti Sains Malaysia (USM), Kubang Kerian, Kelantan, Malaysia
| | - Nadine Alvarez-Cabrera
- Center for Discovery and Innovation (CDI), Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, USA
| | - Mohd Nor Norazmi
- School of Health Sciences, Universiti Sains Malaysia (USM), Kubang Kerian, Kelantan, Malaysia
| | - Armando Acosta
- School of Health Sciences, Universiti Sains Malaysia (USM), Kubang Kerian, Kelantan, Malaysia.
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Affiliation(s)
- Jean-Francois Jabbour
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Amal Hamieh
- Division of Infectious Diseases, Department of Internal Medicine, Al Rassoul Al Azam Hospital, Beirut, Lebanon
| | - Sima L. Sharara
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Souha S. Kanj
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
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Keragala BSDP, Gunasekera CN, Yesudian PD, Guruge C, Dissanayaka BS, Liyanagama DP, Jinadasa GIM, Constantine SR, Herath HMMTB. Disseminated Mycobacterium simiae infection in a patient with adult-onset immunodeficiency due to anti-interferon-gamma antibodies - a case report. BMC Infect Dis 2020; 20:258. [PMID: 32234012 PMCID: PMC7110743 DOI: 10.1186/s12879-020-04984-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 03/20/2020] [Indexed: 11/17/2022] Open
Abstract
Background Mycobacterial species other than Mycobacterium tuberculosis and Mycobacterium leprae are generally free-living organisms and Mycobacterium simiae is one of the slowest growing Non-tuberculous mycobacteria. This is the first case report of Mycobacterium simiae infection in Sri Lanka and only very few cases with extrapulmonary manifestation reported in the literature. Case presentation A 24-year-old, previously healthy Sri Lankan male presented with generalized lymphadenopathy with discharging sinuses, evening pyrexia, weight loss, poor appetite and splenomegaly. Lymph node biopsies showed sheets of macrophages packed with organisms in the absence of granulomata. Ziehl Neelsen, Wade Fite and Giemsa stains revealed numerous red coloured acid-fast bacilli within foamy histiocytes. Slit skin smear for leprosy was negative and tuberculosis, fungal and bacterial cultures of the lymph node and bone marrow did not reveal any growth. Later he developed watery diarrhea and colonoscopy revealed multiple small polyps and ulcers throughout the colon extending up to the ileum, Which was confirmed to be due to cytomegalovirus confirmed by PCR and successfully treated with ganciclovir. Positron emission tomography scan guided biopsies of the gut and lymph nodes confirmed presence of mycobacterial spindle cell pseudo-tumours and PCR assays revealed positive HSP65. The culture grew Mycobacterium Simiae. Flow cytometry analysis on patient’s blood showed extremely low T and B cell counts and immunofixation revealed low immunoglobulin levels. His condition was later diagnosed as adult onset immunodeficiency due to anti- interferon – gamma autoantibodies. He was initially commenced on empirical anti-TB treatment with atypical mycobacterial coverage. He is currently on a combination of daily clarithromycin, ciprofloxacin, linezolid with monthly 2 g/kg/intravenous immunoglobulin to which, he had a remarkable clinical response with complete resolution of lymphadenopathy and healing of sinuses. Conclusions This infection is considered to be restricted to certain geographic areas such as mainly Iran, Cuba, Israel and Arizona and this is the first case report from Sri lanka. Even though the infection is mostly seen in the elderly patients, our patient was only 24 years old. In the literature pulmonary involvement was common presentation, but in this case the patient had generalized lymphadenopathy and colonic involvement without pulmonary involvement.
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Mortazavi Z, Bahrmand A, Sakhaee F, Doust RH, Vaziri F, Siadat SD, Fateh A. Evaluating the clinical significance of nontuberculous mycobacteria isolated from respiratory samples in Iran: an often overlooked disease. Infect Drug Resist 2019; 12:1917-1927. [PMID: 31308711 PMCID: PMC6613451 DOI: 10.2147/idr.s214181] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 06/08/2019] [Indexed: 01/09/2023] Open
Abstract
Purpose Nontuberculous mycobacteria (NTM) infection is an increasing problem worldwide whose clinical significance is still largely unknown. The aim of this study was to investigate the epidemiology of NTM infection from respiratory samples and to determine their clinical significance. Patients and methods This cross-sectional study was performed on 7,825 clinical samples from December 2015 to December 2017. Detection was conducted using phenotypic and genotypic (hsp65 PCR-RFLP, rpoB, and 16S rRNA genes sequencing) methods. All clinical information including symptoms and radiological findings was extracted from patients’ records. Results A total of 478 were confirmed to have respiratory samples which were culture positive for mycobacteria, with the prevalence of NTM infection obtained as 53 (11.1%). Overall, Mycobacterium (M.) fortuitum was the most frequent NTM isolate, followed by M. simiae, M. kansasii, M. gordonae, and M. conceptionense. There was a relationship between NTM isolates and gender (P=0.039), symptoms (P=0.048), and radiographic findings (P=0.013). Bronchiectasis, infiltration, and cavitary lesion were the most frequent radiological findings in M. fortuitum, M. simiae, and M. kansasii, respectively, with cough being the most frequent symptom. Conclusion We reported five different NTM isolates in respiratory samples with a high frequency of M. fortuitum. NTM infections may play an important role in causing pulmonary disease and in tuberculosis management in endemic settings. Nevertheless, more studies are required to further examine the clinical significance of NTM isolates.
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Affiliation(s)
- Zahra Mortazavi
- Department of Microbiology, Faculty of Advance Science, Tehran Medical Science, Islamic Azad University, Tehran, Iran
| | - Ahmadreza Bahrmand
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | - Fatemeh Sakhaee
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | - Reza Hosseini Doust
- Department of Microbiology, Faculty of Advance Science, Tehran Medical Science, Islamic Azad University, Tehran, Iran
| | - Farzam Vaziri
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.,Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Seyed Davar Siadat
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.,Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Abolfazl Fateh
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.,Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
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Nasiri M, Heidary M, Azimi T, Goudarzi H, Tabarsi P, Darban-Sarokhalil D, Feizabadi M. Mycobacterium simiae pulmonary disease in Iran: systematic review and meta-analysis. New Microbes New Infect 2018; 26:118-123. [PMID: 30370055 PMCID: PMC6199180 DOI: 10.1016/j.nmni.2018.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/11/2018] [Accepted: 09/13/2018] [Indexed: 02/05/2023] Open
Abstract
Mycobacterium simiae is one of the most common nontuberculous mycobacteria (NTM) microorganisms causing lung disease in many countries in the world. A reliable estimate of the extent of M. simiae pulmonary disease has not been well investigated in Iran. We systematically searched multiple databases to identify relative studies. Studies were excluded if they did not use the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) diagnostic criteria for NTM diseases. Data were extracted independently and in duplicate. We assessed pooled estimate by using a random model effect, and sources of heterogeneity were assessed by using Cochran's Q and the I 2 statistic. The potential for publication bias was explored by using Begg's and Egger's tests. All analyses were conducted with Stata 14.0 (StataCorp, College Station, TX, USA). Of 172 articles identified, seven met the inclusion criteria. Of 355 patients who were culture positive for NTM, 82 had M. simiae pulmonary disease according to the ATS/IDSA diagnostic criteria. The pooled frequency of M. simiae pulmonary disease among patients with NTM was 25.0% (95% confidence interval, 16.8-33.2). No evidence of publication bias was observed among the included studies (p >0.05 for Begg's and Egger's tests). Clinical isolates of M. simiae are increasingly being recognized as a cause of pulmonary disease in Iran and need further attention by health authorities.
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Affiliation(s)
- M.J. Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M. Heidary
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - T. Azimi
- Department of Medical Microbiology, School of Public Health, Tehran, Iran
| | - H. Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - P. Tabarsi
- Clinical TB and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - D. Darban-Sarokhalil
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - M.M. Feizabadi
- Department of Medical Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Hamieh A, Tayyar R, Tabaja H, E. L. Zein S, Bou Khalil P, Kara N, Kanafani ZA, Kanj N, Bou Akl I, Araj G, Berjaoui G, Kanj SS. Emergence of Mycobacterium simiae: A retrospective study from a tertiary care center in Lebanon. PLoS One 2018; 13:e0195390. [PMID: 29617415 PMCID: PMC5884548 DOI: 10.1371/journal.pone.0195390] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 03/21/2018] [Indexed: 11/19/2022] Open
Abstract
Objective The objective of this study is to describe the clinical significance of Mycobacterium simiae at a major tertiary care center in Lebanon. Methods This is a retrospective study of patients with positive cultures for M. simiae isolated between 2004 and 2016 at the American University of Beirut Medical Center. Results This study included 103 M. simiae isolates recovered from 51 patients. Their mean age was 62.7 years. The majority were males and smokers. Specimens were mostly from respiratory sources (97%). Common comorbidities included chronic lung disease (such as chronic obstructive pulmonary disease), solid tumor, systemic disease, and diabetes mellitus. Productive cough and dyspnea were the most common symptoms. Frequent radiographic findings were infiltrates and nodules on chest X-ray and nodules, infiltrates, and bronchiectasis on chest computed tomography scan. Among 18 tested isolates, 5.8% were resistant to clarithromycin, 11.7% to amikacin, and 70–100% to other antimicrobials. Out of 13 patients receiving early treatment, 5 noted improvement, one had recurrence of symptoms, two received alternative diagnosis, and five died. Two of those deaths were related to M. simiae. Common treatment regimens included clarithromycin in different combinations with trimethoprim-sulfamethoxazole, moxifloxacin, and amikacin. Moreover, clofazimine was used in only two patients whose isolates were resistant to all but one agent. Duration of treatment ranged from 6–24 months. Conclusion In Lebanon, M. simiae is increasingly encountered with true infection rates of at least 47%. Furthermore, the prevalence of multidrug resistance among the Lebanese M. simiae isolates is very high limiting the treatment options.
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Affiliation(s)
- Amal Hamieh
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ralph Tayyar
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Houssam Tabaja
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Saeed E. L. Zein
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Pierre Bou Khalil
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nathalie Kara
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Zeina A. Kanafani
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nadim Kanj
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Imad Bou Akl
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - George Araj
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghina Berjaoui
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Souha S. Kanj
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
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Dal Molín-Veglia MA, Sánchez-Martínez F, Fernández-Alarza AF, Domínguez-Álvarez M. Micobacteriosis pulmonar en un paciente en tratamiento crónico con metotrexato. Arch Bronconeumol 2018; 54:225-226. [DOI: 10.1016/j.arbres.2017.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/31/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
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13
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Computed Tomography Findings of Pulmonary Mycobacterium simiae Infection. Can Respir J 2017; 2017:6913564. [PMID: 28127232 PMCID: PMC5239841 DOI: 10.1155/2017/6913564] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 11/28/2016] [Indexed: 01/15/2023] Open
Abstract
Nontuberculous mycobacterial (NTM) pulmonary infections can be quite similar to tuberculosis, both clinically and radiologically. However, the treatment protocol is not similar. Mycobacterium simiae is a rare cause of NTM pulmonary infection. Herein, we aimed to evaluate and compare the computed tomography (CT) scan findings of M. simiae infection in lungs. For this reason, thirty-four patients (n = 34) with M. simiae lung infection were retrospectively evaluated. Diagnosis was confirmed by American Thoracic Society (ATS) guidelines and CT scans were reviewed in both lung and mediastinal windows. The average age of patients was 63 ± 14.54 years and 52.9% were male. The majority of patients had cough (91.2%) and sputum production (76.5%). Clinically, 41.2% of patients had previous history of TB (14/34), 38.2% had cardiac diseases (13/34), and 35.3% had diabetes mellitus (12/34). The most common CT findings in our study were nodular lesions (100%) and bronchiectasis (85.29%). Regarding the severity, grade I bronchiectasis was the most prevalent. Other prominent findings were tree-in-bud sign (88.2%), consolidation (52.94%), and lobar fibrosis and volume loss (67.6%). There was no significant zonal distribution of findings. In conclusion, nodular lesions and bronchiectasis are the most frequent features in CT scan of M. simiae pulmonary infection.
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Jeong SH, Kim SY, Lee H, Ham JS, Hwang KB, Hwang S, Shin SH, Chung MJ, Lee SH, Shin SJ, Koh WJ. Nontuberculous Mycobacterial Lung Disease Caused by Mycobacterium simiae: The First Reported Case in South Korea. Tuberc Respir Dis (Seoul) 2015; 78:432-5. [PMID: 26508940 PMCID: PMC4620346 DOI: 10.4046/trd.2015.78.4.432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 08/10/2015] [Accepted: 08/28/2015] [Indexed: 11/24/2022] Open
Abstract
This is a report of the first South Korean case of a lung disease caused by Mycobacterium simiae. The patient was a previously healthy 52-year-old female. All serial isolates were identified as M. simiae by multi-locus sequencing analysis, based on hsp65, rpoB, 16S-23S rRNA internal transcribed spacer, and 16S rRNA fragments. A chest radiography revealed deterioration, and the follow-up sputum cultures were persistently positive, despite combination antibiotic treatment, including azithromycin, ethambutol, and rifampin. To the best of our knowledge, this is the first confirmed case of a lung disease caused by M. simiae in South Korea.
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Affiliation(s)
- Suk Hyeon Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su-Young Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Soo Ham
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keum Bit Hwang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Subin Hwang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Hye Shin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung Jin Chung
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Sung Jae Shin
- Department of Microbiology, Yonsei University College of Medicine, Seoul, Korea
| | - Won-Jung Koh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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15
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García-Martos P, García-Agudo L, González-Moya E, Galán F, Rodríguez-Iglesias M. [Infections due to Mycobacterium simiae]. Enferm Infecc Microbiol Clin 2014; 33:e37-43. [PMID: 25444043 DOI: 10.1016/j.eimc.2014.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 05/26/2014] [Accepted: 07/22/2014] [Indexed: 10/24/2022]
Abstract
Mycobacterium simiae is a slow-growing photochromogenic environmental mycobacterium, first described in 1965. Rarely associated with human infections, possibly due to its limited pathogenicity, it mainly produces lung infection in immunocompetent elderly patients with underlying lung disease, and in disseminated infections in immunosuppressed young patients with AIDS. A microbiological culture is needed to confirm the clinical suspicion, and genetic sequencing techniques are essential to correctly identify the species. Treating M. simiae infections is complicated, owing to the multiple resistance to tuberculous drugs and the lack of correlation between in vitro susceptibility data and in vivo response. Proper treatment is yet to be defined, but must include clarithromycin combined with other antimicrobials such as moxifloxacin and cotrimoxazole. It is possible that M. simiae infections are undiagnosed.
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Affiliation(s)
| | | | | | - Fátima Galán
- Servicio de Microbiología, Hospital Puerta del Mar, Cádiz, España
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16
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Camarena Miñana JJ, González Pellicer R. Micobacterias atípicas y su implicación en patología infecciosa pulmonar. Enferm Infecc Microbiol Clin 2011; 29 Suppl 5:66-75. [DOI: 10.1016/s0213-005x(11)70046-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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17
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Nontuberculous Mycobacteria and the Lung: From Suspicion to Treatment. Lung 2010; 188:269-82. [DOI: 10.1007/s00408-010-9240-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 03/19/2010] [Indexed: 10/19/2022]
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18
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Abstract
Despite using modern microbiological diagnostic approaches, the aetiological agents of pneumonia remain unidentified in about 50% of cases. Some bacteria that grow poorly or not at all in axenic media used in routine clinical bacteriology laboratory but which can develop inside amoebae may be the agents of these lower respiratory tract infections (RTIs) of unexplained aetiology. Such amoebae-resisting bacteria, which coevolved with amoebae to resist their microbicidal machinery, may have developed virulence traits that help them survive within human macrophages, i.e. the first line of innate immune defence in the lung. We review here the current evidence for the emerging pathogenic role of various amoebae-resisting microorganisms as agents of RTIs in humans. Specifically, we discuss the emerging pathogenic roles of Legionella-like amoebal pathogens, novel Chlamydiae (Parachlamydia acanthamoebae, Simkania negevensis), waterborne mycobacteria and Bradyrhizobiaceae (Bosea and Afipia spp.).
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Affiliation(s)
- Frédéric Lamoth
- Infectious Diseases Service, University of Lausanne, Lausanne, Switzerland
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