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Dahl VN, Burke A, Fløe A, Bruchfeld J, Schön T, Wejse CM, Andersen AB, Svensson E, van Ingen J, Davies Forsman L. Advantages and limitations of virtual multi-disciplinary team meetings on difficult-to-treat mycobacteria. Int J Tuberc Lung Dis 2024; 28:212-213. [PMID: 38563342 DOI: 10.5588/ijtld.23.0551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Affiliation(s)
- V N Dahl
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark, International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
| | - A Burke
- Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - A Fløe
- Department of Respiratory Diseases, Aarhus University Hospital, Aarhus, Denmark; Departments of
| | - J Bruchfeld
- Infectious Diseases, and, Medicine, Division of Infectious Diseases, Karolinska Institutet, Solna, Sweden
| | - T Schön
- Infectious Diseases, and, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden, Department of Infectious Diseases, Region Östergötland and Kalmar County Hospital, Linköping University, Linköping, Sweden
| | - C M Wejse
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - A B Andersen
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - E Svensson
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
| | - J van Ingen
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - L Davies Forsman
- Infectious Diseases, and, Medicine, Division of Infectious Diseases, Karolinska Institutet, Solna, Sweden
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Hoefsloot W, Dacheva E, van der Laan R, Krol M, van Ingen J, Obradovic M, Liu X. Real-world treatment patterns in patients with nontuberculous mycobacterial lung disease in the Netherlands based on medication dispensing data. BMC Pulm Med 2023; 23:218. [PMID: 37340431 DOI: 10.1186/s12890-023-02460-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 04/28/2023] [Indexed: 06/22/2023] Open
Abstract
PURPOSE Real-world data on antibiotic management of nontuberculous mycobacterial lung disease (NTM-LD) is limited for many countries. This study aimed to evaluate real-world treatment practices of NTM-LD in the Netherlands using medication dispensing data. METHODS A retrospective longitudinal real-world study was conducted using IQVIA's Dutch pharmaceutical dispensing database. The data are collected monthly and include approximately 70% of all outpatient prescriptions in the Netherlands. Patients initiated on specific NTM-LD treatment regimens between October 2015 and September 2020 were included. The main areas of investigation were initial treatment regimens, persistence on treatment, treatment switching, treatment compliance in terms of medication possession rate (MPR) and restarts of treatment. RESULTS The database included 465 unique patients initiated on triple- or dual-drug regimens for the treatment of NTM-LD. Treatment switches were common and occurred approximately 1.6 per quarter throughout the treatment period. The average MPR of patients initiated on triple-drug therapy was 90%. The median time on therapy for these patients was 119 days; after six months and one year, 47% and 20% of the patients, respectively, were still on antibiotic therapy. Of 187 patients initiated on triple-drug therapy, 33 (18%) patients restarted antibiotic therapy after the initial treatment had been stopped. CONCLUSION When on therapy, patients were compliant with the NTM-LD treatment; however, many patients stopped their therapy prematurely, treatment switches often occurred, and part of patients had to restart their therapy after a longer treatment gap. NTM-LD management should be improved through greater guideline adherence and appropriate involvement of expert centers.
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Affiliation(s)
- W Hoefsloot
- Radboudumc Center for Infectious Diseases, Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, Netherlands.
| | | | | | - M Krol
- IQVIA, Amsterdam, Netherlands
| | - J van Ingen
- Radboudumc Center for Infectious Diseases, Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - M Obradovic
- Insmed Germany GmbH, Frankfurt am Main, Germany
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Gillis V, Dalloyaux D, Te Morsche R, van Ingen J, Sir O, Bleeker-Rovers C, Wertheim H, Wouters Y, Wanten G. Droplet Digital Polymerase Chain Reaction Enables Rapid Detection And Characterisation Of Bacteraemia In Chronic Parenteral Nutrition Patients. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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Gopie FA, Hassankhan A, Zijlmans W, de Lange WCM, Vreden SGS, van Ingen J. Non-tuberculous mycobacteria in sputum cultures in Suriname. Int J Tuberc Lung Dis 2021; 24:1106-1108. [PMID: 33126947 DOI: 10.5588/ijtld.20.0249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- F A Gopie
- Department of Pulmonary Medicine, Academic Hospital, Paramaribo, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - A Hassankhan
- Department of Psychology, Anton de Kom Universiteit van Suriname, Paramaribo
| | - W Zijlmans
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname, Department of Paediatrics, Diakonessenhuis Hospital, Paramaribo
| | - W C M de Lange
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, Tuberculosis Center Beatrixoord, University Medical Center Groningen, University of Groningen, Haren, The Netherlands
| | - S G S Vreden
- Department of Internal Medicine, Academic Hospital Paramaribo, Suriname
| | - J van Ingen
- Department of Medical Microbiology, Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands, ,
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5
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Hasse B, Hannan MM, Keller PM, Maurer FP, Sommerstein R, Mertz D, Wagner D, Fernández-Hidalgo N, Nomura J, Manfrin V, Bettex D, Hernandez Conte A, Durante-Mangoni E, Tang THC, Stuart RL, Lundgren J, Gordon S, Jarashow MC, Schreiber PW, Niemann S, Kohl TA, Daley CL, Stewardson AJ, Whitener CJ, Perkins K, Plachouras D, Lamagni T, Chand M, Freiberger T, Zweifel S, Sander P, Schulthess B, Scriven JE, Sax H, van Ingen J, Mestres CA, Diekema D, Brown-Elliott BA, Wallace RJ, Baddour LM, Miro JM, Hoen B, Athan E, Bayer A, Barsic B, Corey GR, Chu VH, Durack DT, Fortes CQ, Fowler V, Hoen B, Krachmer AW, Durante-Magnoni E, Miro JM, Wilson WR. International Society of Cardiovascular Infectious Diseases Guidelines for the Diagnosis, Treatment and Prevention of Disseminated Mycobacterium chimaera Infection Following Cardiac Surgery with Cardiopulmonary Bypass. J Hosp Infect 2019; 104:214-235. [PMID: 31715282 DOI: 10.1016/j.jhin.2019.10.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 10/08/2019] [Indexed: 02/09/2023]
Abstract
Mycobacterial infection-related morbidity and mortality in patients following cardiopulmonary bypass surgery is high and there is a growing need for a consensus-based expert opinion to provide international guidance for diagnosing, preventing and treating in these patients. In this document the International Society for Cardiovascular Infectious Diseases (ISCVID) covers aspects of prevention (field of hospital epidemiology), clinical management (infectious disease specialists, cardiac surgeons, ophthalmologists, others), laboratory diagnostics (microbiologists, molecular diagnostics), device management (perfusionists, cardiac surgeons) and public health aspects.
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Affiliation(s)
- B Hasse
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Switzerland.
| | - M M Hannan
- Clinical Microbiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - P M Keller
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - F P Maurer
- Diagnostic Mycobacteriology Group, National and WHO Supranational Reference Center for Mycobacteria, Research Center, Borstel, Germany
| | - R Sommerstein
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - D Mertz
- Departments of Medicine, Health Research Methods, Evidence and Impact, and Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - D Wagner
- Department of Internal Medicine II, Division of Infectious Diseases, Medical Center - University of Freiburg, Freiburg i.Br, Germany
| | - N Fernández-Hidalgo
- Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Nomura
- Kaiser Permanente Infectious Diseases, Los Angeles Medical Center, CA, USA
| | - V Manfrin
- Infectious and Tropical Diseases Department, San Bortolo Hospital, Vincenca, Italy
| | - D Bettex
- Institute of Anesthesiology, University Hospital Zurich, Switzerland
| | - A Hernandez Conte
- Department of Anaesthesiology, Kaiser Permanente, Los Angeles Medical Center, CA, USA
| | - E Durante-Mangoni
- Infectious and Transplant Medicine, University of Campania 'L. Vanvitelli', Monaldi Hospital, Naples, Italy
| | - T H-C Tang
- Division of Infectious Diseases, Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - R L Stuart
- Monash Infectious Diseases, Monash Health, Australia
| | - J Lundgren
- Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark
| | - S Gordon
- Department of Infectious Diseases, Cleveland Clinic, OH, USA
| | - M C Jarashow
- Acute Communicable Disease Control, Los Angeles Department of Public Health, LA, USA
| | - P W Schreiber
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Switzerland
| | - S Niemann
- Molecular and Experimental Mycobacteriology Group, Research Center Borstel, Borstel, Germany and German Center for Infection Research (DZIF), partner site Hamburg - Lübeck - Borstel - Riems, Borstel, Germany
| | - T A Kohl
- Molecular and Experimental Mycobacteriology Group, Research Center Borstel, Borstel, Germany and German Center for Infection Research (DZIF), partner site Hamburg - Lübeck - Borstel - Riems, Borstel, Germany
| | - C L Daley
- Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, CO, USA
| | - A J Stewardson
- Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, Melbourne, Australia
| | - C J Whitener
- Penn State Health, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - K Perkins
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, USA
| | - D Plachouras
- Healthcare-associated Infections, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - T Lamagni
- National Infection Service, Public Health England, London, UK
| | - M Chand
- National Infection Service, Public Health England, London, UK; Guy's and St Thomas' NHS Foundation Trust, Imperial College London, UK
| | - T Freiberger
- Centre for Cardiovascular Surgery and Transplantation, Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - S Zweifel
- Ophthalmology Unit, University of Zurich, Switzerland
| | - P Sander
- National Center for Mycobacteria, Zurich, Switzerland, Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - B Schulthess
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - J E Scriven
- Department of Infection and Tropical Medicine, University Hospitals Birmingham, Birmingham, UK
| | - H Sax
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Switzerland
| | - J van Ingen
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C A Mestres
- Clinic for Cardiovascular Surgery, University Hospital and University of Zurich, Switzerland
| | - D Diekema
- Division of Infectious Diseases, University of Iowa, Carver College of Medicine, IA, USA
| | - B A Brown-Elliott
- Department of Microbiology, The University of Texas Health Science Center at Tyler, Tyler, TX, USA
| | - R J Wallace
- Department of Microbiology, The University of Texas Health Science Center at Tyler, Tyler, TX, USA
| | - L M Baddour
- Division of Infectious Diseases, Departments of Medicine and Cardiovascular Diseases, Mayo Clinic, College of Medicine and Science, Rochester, MN, USA
| | - J M Miro
- Infectious Diseases Service at the Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - B Hoen
- Department of Infectious Diseases and Tropical Medicine, University Medical Center of Nancy, Vandoeuvre Cedex, France.
| | | | | | - E Athan
- Infectious Diseases Department at Barwon Health, University of Melbourne and Deakin University, Australia
| | - A Bayer
- Geffen School of Medicine at UCLA Senior Investigator - LA Biomedical Research Institute at Harbor-UCLA, USA
| | - B Barsic
- Department for Infectious Diseases, School of Medicine, University of Zagreb, Croatia
| | - G R Corey
- Duke University Medical Center, Hubert-Yeargan Center for Global Health, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - V H Chu
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - D T Durack
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - C Q Fortes
- Division of Infectious Diseases, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - V Fowler
- Departments of Medicine and Molecular Genetics & Microbiology, Duke University Medical Center, Durham, NC, USA
| | - B Hoen
- Department of Infectious Diseases and Tropical Medicine, University Medical Center of Nancy, Vandoeuvre Cedex, France
| | - A W Krachmer
- Harvard Medical School, Division of Infectious Diseases at the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - E Durante-Magnoni
- Infectious and Transplant Medicine of the 'V. Monaldi' Teaching Hospital in Naples, University of Campania 'L. Vanvitelli', Italy
| | - J M Miro
- Infectious Diseases at the Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - W R Wilson
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, College of Medicine and Science, Rochester, MN, USA
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van Aerde KJ, van der Heijden EHFM, Henriet SS, Merkus PJ, Magis-Escurra C, Hoefsloot W, van Ingen J, van der Flier M. A case promoting use of ultrasound-guided sampling techniques to correctly diagnose MDR-TB in children. Int J Tuberc Lung Dis 2019; 23:236-238. [DOI: 10.5588/ijtld.18.0322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K. J. van Aerde
- Department of Paediatric Infectious Disease and Immunology, Amalia Children's Hospital, Radboud University Medical Centre (Radboudumc), Nijmegen, Radboudumc Institute for Molecular Life Sciences, Nijmegen
| | | | - S. S. Henriet
- Department of Paediatric Infectious Disease and Immunology, Amalia Children's Hospital, Radboud University Medical Centre (Radboudumc), Nijmegen, Radboudumc Institute for Molecular Life Sciences, Nijmegen
| | - P. J. Merkus
- Department of Paediatric Pulmonology, Amalia Children's Hospital, Radboudumc, Nijmegen
| | - C. Magis-Escurra
- Department of Pulmonology, Radboudumc Dekkerswald, Nijmegen-Groesbeek
| | - W. Hoefsloot
- Department of Pulmonology, Radboudumc Dekkerswald, Nijmegen-Groesbeek
| | - J. van Ingen
- Department of Medical Microbiology, Radboudumc, Nijmegen, The Netherlands
| | - M. van der Flier
- Department of Paediatric Infectious Disease and Immunology, Amalia Children's Hospital, Radboud University Medical Centre (Radboudumc), Nijmegen, Radboudumc Institute for Molecular Life Sciences, Nijmegen
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Jankovic M, Sabol I, Zmak L, Jankovic VK, Jakopovic M, Obrovac M, Ticac B, Bulat LK, Grle SP, Marekovic I, Samarzija M, van Ingen J. Microbiological criteria in non-tuberculous mycobacteria pulmonary disease: a tool for diagnosis and epidemiology. Int J Tuberc Lung Dis 2018; 20:934-40. [PMID: 27287647 DOI: 10.5588/ijtld.15.0633] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING The value of microbiological criteria in diagnosing non-tuberculous mycobacteria pulmonary disease (NTM-PD) and monitoring its epidemiology is unknown. OBJECTIVES To correlate the rate of NTM-PD based on microbiological criteria (American Thoracic Society/Infectious Diseases Society of America [ATS/IDSA] or stricter microbiological criteria) compared with the full ATS/IDSA criteria, to assess the positive predictive value (PPV) of different microbiological criteria in predicting NTM-PD, and to evaluate the clinical relevance of different NTM species. DESIGN Retrospective study of all patients with pulmonary NTM isolates in Croatia during an 8-year period. NTM species were divided into low, intermediate and high clinical relevance groups for additional analyses. RESULTS Good correlation between both microbiological and full ATS/IDSA criteria was observed. The PPV of stricter and ATS/IDSA microbiological criteria was respectively 93.3% and 59.8%. The usefulness of microbiological criteria varied between groups. ATS/IDSA microbiological criteria had a PPV of 89.8% in the high relevance group, while in the intermediate relevance group, the PPV of stricter and ATS/IDSA microbiological criteria was respectively 94.3% and 63.4%. CONCLUSIONS Microbiological criteria are useful in detecting NTM-PD, allowing laboratory-based monitoring. Stricter criteria should be used for species of low clinical relevance, and less stringent criteria for species of high relevance in the local setting.
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Affiliation(s)
- M Jankovic
- Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia
| | - I Sabol
- Division of Molecular Medicine, Laboratory of Molecular Virology and Bacteriology, Ruder Boskovic Institute, Zagreb, Croatia
| | - L Zmak
- National Mycobacteria Reference Laboratory, Croatian National Institute of Public Health, Zagreb, Croatia
| | - V Katalinic Jankovic
- National Mycobacteria Reference Laboratory, Croatian National Institute of Public Health, Zagreb, Croatia
| | - M Jakopovic
- Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia
| | - M Obrovac
- National Mycobacteria Reference Laboratory, Croatian National Institute of Public Health, Zagreb, Croatia
| | - B Ticac
- Mycobacteria Laboratory, Institute of Public Health, Rijeka, Croatia
| | - L Kardum Bulat
- Department for Respiratory Diseases, Clinical Hospital Centre, Rijeka, Croatia
| | - S Popovic Grle
- Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia
| | - I Marekovic
- Department of Clinical and Molecular Microbiology, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia
| | - M Samarzija
- Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia
| | - J van Ingen
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Alcaide F, Amlerová J, Bou G, Ceyssens PJ, Coll P, Corcoran D, Fangous MS, González-Álvarez I, Gorton R, Greub G, Hery-Arnaud G, Hrábak J, Ingebretsen A, Lucey B, Marekoviċ I, Mediavilla-Gradolph C, Monté MR, O'Connor J, O'Mahony J, Opota O, O'Reilly B, Orth-Höller D, Oviaño M, Palacios JJ, Palop B, Pranada AB, Quiroga L, Rodríguez-Temporal D, Ruiz-Serrano MJ, Tudó G, Van den Bossche A, van Ingen J, Rodriguez-Sanchez B. How to: identify non-tuberculous Mycobacterium species using MALDI-TOF mass spectrometry. Clin Microbiol Infect 2017; 24:599-603. [PMID: 29174730 DOI: 10.1016/j.cmi.2017.11.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/12/2017] [Accepted: 11/14/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The implementation of MALDI-TOF MS for microorganism identification has changed the routine of the microbiology laboratories as we knew it. Most microorganisms can now be reliably identified within minutes using this inexpensive, user-friendly methodology. However, its application in the identification of mycobacteria isolates has been hampered by the structure of their cell wall. Improvements in the sample processing method and in the available database have proved key factors for the rapid and reliable identification of non-tuberculous mycobacteria isolates using MALDI-TOF MS. AIMS The main objective is to provide information about the proceedings for the identification of non-tuberculous isolates using MALDI-TOF MS and to review different sample processing methods, available databases, and the interpretation of the results. SOURCES Results from relevant studies on the use of the available MALDI-TOF MS instruments, the implementation of innovative sample processing methods, or the implementation of improved databases are discussed. CONTENT Insight about the methodology required for reliable identification of non-tuberculous mycobacteria and its implementation in the microbiology laboratory routine is provided. IMPLICATIONS Microbiology laboratories where MALDI-TOF MS is available can benefit from its capacity to identify most clinically interesting non-tuberculous mycobacteria in a rapid, reliable, and inexpensive manner.
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Affiliation(s)
- F Alcaide
- Servei de Microbiología, Hospital Universitari de Bellvitge- IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J Amlerová
- Biomedical Center, Faculty of Medicine in Plzen, Plzen, Czech Republic
| | - G Bou
- Servicio de Microbiología, Hospital Universitario A Coruña, A Coruña, Spain
| | - P J Ceyssens
- Division of Bacterial Diseases, Scientific Institute of Public Health, Brussels, Belgium
| | - P Coll
- Hospital Sant Pau i Santa Creu, Servei de Microbiologia, Barcelona, Spain
| | - D Corcoran
- Laboratory of Medicine, Diagnostic Directorate, Cork University Hospital, Bishopstown, Cork, Ireland
| | - M-S Fangous
- Laboratoire de Bactériologie, Plateforme de Biologie, Hôpital Cavale Blanche, Brest, France
| | - I González-Álvarez
- Unidad Referencia Regional de Micobacterias, Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - R Gorton
- Health Services Laboratories, London, UK
| | - G Greub
- Institut de Microbiologie de l'Université de Lausanne, Lausanne, Switzerland; European Study Group on Genomics and Molecular Diagnosis (ESGMD), Switzerland
| | - G Hery-Arnaud
- Laboratoire de Bactériologie, Plateforme de Biologie, Hôpital Cavale Blanche, Brest, France
| | - J Hrábak
- Biomedical Center, Faculty of Medicine in Plzen, Plzen, Czech Republic
| | - A Ingebretsen
- Dept. of Microbiology, Oslo University Hospital, Oslo, Norway
| | - B Lucey
- Department of Biological Sciences, Cork Institute of Technology, Ireland
| | - I Marekoviċ
- University of Zagreb School of Medicine, University Hospital Centre Zagreb, Department of Clinical and Molecular Microbiology, Zagreb, Croatia
| | | | - M R Monté
- Laboratori de Microbiologia-CDB, Hospital Clínic de Barcelona-ISGlobal, Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Spain
| | - J O'Connor
- Department of Biological Sciences, Cork Institute of Technology, Ireland
| | - J O'Mahony
- Department of Biological Sciences, Cork Institute of Technology, Ireland
| | - O Opota
- Institut de Microbiologie de l'Université de Lausanne, Lausanne, Switzerland
| | - B O'Reilly
- Laboratory of Medicine, Diagnostic Directorate, Cork University Hospital, Bishopstown, Cork, Ireland
| | - D Orth-Höller
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - M Oviaño
- Servicio de Microbiología, Hospital Universitario A Coruña, A Coruña, Spain
| | - J J Palacios
- Unidad Referencia Regional de Micobacterias, Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - B Palop
- Laboratorio de Microbiología, Hospital Regional de Málaga, Málaga, Spain
| | - A B Pranada
- MVZ Dr. Eberhard & Partner Dortmund (ÜBAG), Department of Medical Microbiology, Dortmund, Germany
| | - L Quiroga
- Clinical Microbiology and Infectious Diseases Department, Instituto de Investigación Sanitaria Gregorio Marañón Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - D Rodríguez-Temporal
- Servei de Microbiología, Hospital Universitari de Bellvitge- IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M J Ruiz-Serrano
- European Study Group on Genomics and Molecular Diagnosis (ESGMD), Switzerland; Clinical Microbiology and Infectious Diseases Department, Instituto de Investigación Sanitaria Gregorio Marañón Hospital General Universitario Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain
| | - G Tudó
- Laboratori de Microbiologia-CDB, Hospital Clínic de Barcelona-ISGlobal, Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Spain
| | - A Van den Bossche
- Division of Bacterial Diseases, Scientific Institute of Public Health, Brussels, Belgium
| | - J van Ingen
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - B Rodriguez-Sanchez
- European Study Group on Genomics and Molecular Diagnosis (ESGMD), Switzerland; Clinical Microbiology and Infectious Diseases Department, Instituto de Investigación Sanitaria Gregorio Marañón Hospital General Universitario Gregorio Marañón, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain.
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Coitinho C, Greif G, van Ingen J, Laserra P, Robello C, Rivas C. First case of Mycobacterium heckeshornense cavitary lung disease in the Latin America and Caribbean region. New Microbes New Infect 2016; 9:63-5. [PMID: 26909156 PMCID: PMC4735480 DOI: 10.1016/j.nmni.2015.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/09/2015] [Indexed: 11/24/2022] Open
Abstract
A case of cavitary pulmonary disease caused by Mycobacterium heckeshornense in Uruguay is described. This is the first case reported in the Latin America and Caribbean region, showing that this species is a worldwide opportunistic human pathogen.
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Affiliation(s)
- C Coitinho
- Comisión Honoraria de Lucha Anti-Tuberculosa y Enfermedades Prevalentes (CHLA-EP), Montevideo, Uruguay
| | - G Greif
- Institut Pasteur de Montevideo, Montevideo, Uruguay
| | - J van Ingen
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - P Laserra
- Comisión Honoraria de Lucha Anti-Tuberculosa y Enfermedades Prevalentes (CHLA-EP), Montevideo, Uruguay
| | - C Robello
- Institut Pasteur de Montevideo, Montevideo, Uruguay; Departamento de Bioquímica, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - C Rivas
- Comisión Honoraria de Lucha Anti-Tuberculosa y Enfermedades Prevalentes (CHLA-EP), Montevideo, Uruguay
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10
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Neerincx AH, Geurts BP, Habets MFJ, Booij JA, van Loon J, Jansen JJ, Buydens LMC, van Ingen J, Mouton JW, Harren FJM, Wevers RA, Merkus PJFM, Cristescu SM, Kluijtmans LAJ. Identification of
Pseudomonas aeruginosa
and
Aspergillus fumigatus
mono- and co-cultures based on volatile biomarker combinations. J Breath Res 2016; 10:016002. [DOI: 10.1088/1752-7155/10/1/016002] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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11
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Simons SO, van der Laan T, de Zwaan R, Kamst M, van Ingen J, Dekhuijzen PNR, Boeree MJ, van Soolingen D. Molecular drug susceptibility testing in the Netherlands: performance of the MTBDR plus and MTBDR sl assays. Int J Tuberc Lung Dis 2015; 19:828-33. [DOI: 10.5588/ijtld.15.0043] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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12
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de Beer JL, Ködmön C, van Ingen J, Supply P, van Soolingen D. Second worldwide proficiency study on variable number of tandem repeats typing of Mycobacterium tuberculosis complex. Int J Tuberc Lung Dis 2015; 18:594-600. [PMID: 24903798 DOI: 10.5588/ijtld.13.0531] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The quality of variable number of tandem repeats (VNTR) typing of Mycobacterium tuberculosis was first investigated in 2009 in 37 laboratories worldwide. The results revealed an inter- and intra-laboratory reproducibility of respectively 60% and 72%. These data spurred an improvement in laboratory-specific assays and global standardisation of VNTR typing. OBJECTIVE To measure the effects of the technical improvements and increased standardisation, a test panel consisting of 30 M. tuberculosis complex DNA samples was distributed for VNTR typing in 41 participating laboratories from 36 countries. RESULTS The inter- and intra-laboratory reproducibility increased overall to respectively 78% and 88%. The 33 laboratories that participated in both the first and second proficiency studies improved their inter- and intra-laboratory reproducibility from 62% and 72% to respectively 79% and 88%. The largest improvement in reproducibility was detected in 10 laboratories that use an in-house polymerase chain reaction technique and perform amplicon sizing using gel electrophoresis. Detailed error analysis revealed a reduction in the number of systematic errors, sample exchange events and non-amplifiable loci. CONCLUSION This second worldwide proficiency study indicates a substantial increase in the reproducibility of VNTR typing of M. tuberculosis. This will contribute to a more meaningful interpretation of molecular epidemiological and phylogenetic studies on the M. tuberculosis complex.
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Affiliation(s)
- J L de Beer
- National Tuberculosis Reference Laboratory, Center for Infectious Diseases Research, Diagnostics and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - C Ködmön
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - J van Ingen
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - P Supply
- Institut National de la Santé et de la Recherche Médicale, Lille, France
| | - D van Soolingen
- National Tuberculosis Reference Laboratory, Center for Infectious Diseases Research, Diagnostics and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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13
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Simons SO, van der Laan T, Mulder A, van Ingen J, Rigouts L, Dekhuijzen PNR, Boeree MJ, van Soolingen D. Rapid diagnosis of pyrazinamide-resistant multidrug-resistant tuberculosis using a molecular-based diagnostic algorithm. Clin Microbiol Infect 2014; 20:1015-20. [PMID: 24890253 DOI: 10.1111/1469-0691.12696] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 05/23/2014] [Accepted: 05/23/2014] [Indexed: 12/01/2022]
Abstract
There is an urgent need for rapid and accurate diagnosis of pyrazinamide-resistant multidrug-resistant tuberculosis (MDR-TB). No diagnostic algorithm has been validated in this population. We hypothesized that pncA sequencing added to rpoB mutation analysis can accurately identify patients with pyrazinamide-resistant MDR-TB. We identified from the Dutch national database (2007-11) patients with a positive Mycobacterium tuberculosis culture containing a mutation in the rpoB gene. In these cases, we prospectively sequenced the pncA gene. Results from the rpoB and pncA mutation analysis (pncA added to rpoB) were compared with phenotypic susceptibility testing results to rifampicin, isoniazid and pyrazinamide (reference standard) using the Mycobacterial Growth Indicator Tube 960 system. We included 83 clinical M. tuberculosis isolates containing rpoB mutations in the primary analysis. Rifampicin resistance was seen in 72 isolates (87%), isoniazid resistance in 73 isolates (88%) and MDR-TB in 65 isolates (78%). Phenotypic reference testing identified pyrazinamide-resistant MDR-TB in 31 isolates (48%). Sensitivity of pncA sequencing added to rpoB mutation analysis for detecting pyrazinamide-resistant MDR-TB was 96.8%, the specificity was 94.2%, the positive predictive value was 90.9%, the negative predictive value was 98.0%, the positive likelihood was 16.8 and the negative likelihood was 0.03. In conclusion, pyrazinamide-resistant MDR-TB can be accurately detected using pncA sequencing added to rpoB mutation analysis. We propose to include pncA sequencing in every isolate with an rpoB mutation, allowing for stratification of MDR-TB treatment according to pyrazinamide susceptibility.
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Affiliation(s)
- S O Simons
- Department of Respiratory Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
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14
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De Beer JL, Ködmön C, van der Werf MJ, van Ingen J, van Soolingen D, the ECDC MDR-TB molecular surveillance project participants C. Molecular surveillance of multi- and extensively drug-resistant tuberculosis transmission in the European Union from 2003 to 2011. Euro Surveill 2014; 19. [DOI: 10.2807/1560-7917.es2014.19.11.20742] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The European Centre for Disease Prevention and Control (ECDC) initiated a project on the molecular surveillance of multi- and extensively drug-resistant tuberculosis (MDR-/XDR-TB) transmission in the European Union (EU) in the period from 2009 to 2011. In total, 2,092 variable number of tandem repeat (VNTR) patterns of MDR-/XDR-TB Mycobacterium tuberculosis isolates were collected, originating from 24 different countries in the period 2003 to 2011. Of the collected VNTR patterns, 45% (n=941) could be assigned to one of the 79 European multiple-country molecular fingerprint clusters and 50% of those (n=470) belonged to one extremely large cluster caused by Beijing strains of one genotype. We conclude that international transmission of MDR-/XDR-TB plays an important role in the EU, especially in the eastern part, and is significantly related to the spread of one strain or clone of the Beijing genotype. Implementation of international cluster investigation in EU countries should reveal underlying factors of transmission, and show how TB control can be improved regarding case finding, contact tracing, infection control and treatment in order to prevent further spread of MDR-/XDR-TB in the EU.
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Affiliation(s)
- J L De Beer
- National Tuberculosis Reference Laboratory, Laboratory for Infectious Diseases and Perinatal Screening (LIS), Centre for Infectious Disease Control (CIB), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - C Ködmön
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - M J van der Werf
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - J van Ingen
- Department of Medical Microbiology, Department of Medical Microbiology Nijmegen, The Netherlands
| | - D van Soolingen
- National Tuberculosis Reference Laboratory, Laboratory for Infectious Diseases and Perinatal Screening (LIS), Centre for Infectious Disease Control (CIB), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department of Medical Microbiology, Department of Medical Microbiology Nijmegen, The Netherlands
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15
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Kolwijck E, Friedrich SO, Karinja MN, van Ingen J, Warren RM, Diacon AH. Early stationary phase culture supernatant accelerates growth of sputum cultures collected after initiation of anti-tuberculosis treatment. Clin Microbiol Infect 2013; 20:O418-20. [PMID: 24188165 DOI: 10.1111/1469-0691.12441] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 10/21/2013] [Accepted: 10/30/2013] [Indexed: 11/28/2022]
Abstract
We investigated the effect of Mycobacterium tuberculosis culture supernatant added to sputum cultures collected during the first 8 weeks of anti-tuberculosis treatment. With ongoing treatment duration, time to culture positivity decreased significantly in supernatant-enriched cultures, possibly due to stimulation of dormant or slowly metabolizing M. tuberculosis cells.
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Affiliation(s)
- E Kolwijck
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Division of Medical Physiology, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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16
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Jankovic M, Samarzija M, Sabol I, Jakopovic M, Katalinic Jankovic V, Zmak L, Ticac B, Marusic A, Obrovac M, van Ingen J. Geographical distribution and clinical relevance of non-tuberculous mycobacteria in Croatia. Int J Tuberc Lung Dis 2013; 17:836-41. [PMID: 23676172 DOI: 10.5588/ijtld.12.0843] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING The clinical relevance of non-tuberculous mycobacteria (NTM) in Croatia is unknown. OBJECTIVE To estimate the isolation rate of NTM, record geographical differences and assess the burden of pulmonary NTM disease in Croatia. DESIGN Nationwide retrospective cohort study of all Croatian residents with NTM isolated by culture in the period from 2006 to 2010. Microbiological criteria of the American Thoracic Society were used to establish a laboratory-based case definition of possible and probable NTM disease. RESULTS Of 1187 individuals with pulmonary NTM isolates, 8.6% met the possible and 5.5% met the probable disease criteria. We estimated an annual incidence of probable pulmonary NTM disease of 0.23 per 100,000 population. This estimated annual incidence was 0.35/100,000 in the coastal region and 0.17/100,000 in the continental region. Species distribution differed between coastal and continental Croatia. NTM isolation frequency increased over the study period. CONCLUSION Geography plays an important role in NTM species distribution and possible disease. The overall burden of NTM pulmonary disease in Croatia is still low compared to that of tuberculosis, but it is higher in the coastal region compared to the continental region.
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Affiliation(s)
- M Jankovic
- Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia.
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17
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Magis-Escurra C, Alffenaar J, Hoefnagels I, Dekhuijzen P, Boeree M, van Ingen J, Aarnoutse R. Pharmacokinetic studies in patients with nontuberculous mycobacterial lung infections. Int J Antimicrob Agents 2013; 42:256-61. [DOI: 10.1016/j.ijantimicag.2013.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 05/09/2013] [Accepted: 05/15/2013] [Indexed: 11/16/2022]
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18
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Coitinho C, Greif G, Robello C, van Ingen J, Rivas C. Identification of Mycobacterium tuberculosis complex by polymerase chain reaction of Exact Tandem Repeat-D fragment from mycobacterial cultures. Int J Mycobacteriol 2012; 1:146-8. [DOI: 10.1016/j.ijmyco.2012.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 07/22/2012] [Indexed: 10/27/2022] Open
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19
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Greif G, Coitinho C, Rivas C, van Ingen J, Robello C. Molecular analysis of isoniazid-resistant Mycobacterium tuberculosis isolates in Uruguay [Short communication]. Int J Tuberc Lung Dis 2012; 16:947-9. [DOI: 10.5588/ijtld.11.0559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- G. Greif
- Unidad de Biología Molecular, Institut Pasteur de Montevideo, Montevideo, Uruguay
| | - C. Coitinho
- Departamento de Laboratorio, Comisión Honoraria de Lucha Anti-Tuberculosis y Enfermedades Prevalentes, Montevideo, Uruguay
| | - C. Rivas
- Departamento de Laboratorio, Comisión Honoraria de Lucha Anti-Tuberculosis y Enfermedades Prevalentes, Montevideo, Uruguay
| | - J. van Ingen
- Department of Clinical Microbiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - C. Robello
- Unidad de Biología Molecular, Institut Pasteur de Montevideo, Montevideo, Uruguay; Departamento de Bioquímica, Facultad de Medicina, Montevideo, Uruguay
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20
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Hoefsloot W, van Ingen J, Peters EJG, Magis-Escurra C, Dekhuijzen PNR, Boeree MJ, van Soolingen D. Mycobacterium genavense in the Netherlands: an opportunistic pathogen in HIV and non-HIV immunocompromised patients. An observational study in 14 cases. Clin Microbiol Infect 2012; 19:432-7. [PMID: 22439918 DOI: 10.1111/j.1469-0691.2012.03817.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Mycobacterium genavense is an opportunistic non-tuberculous mycobacterium previously mostly associated with HIV-infected patients with CD4 counts below 100/μL. In this retrospective observational study of medical charts we studied all Dutch patients in whom M. genavense was detected between January 2002 and January 2010. Of the 14 patients identified, 13 (93%) showed clinically relevant M. genavense disease. All patients with M. genavense disease were severely immunocompromised, including HIV-infected patients, solid organ transplant recipients, those with chronic steroid use in combination with other immune modulating drugs, recipients of chemotherapy for non-Hodgkin lymphoma, and those with immunodeficiency syndromes. Two patients had non-disseminated pulmonary M. genavense disease. Of the 12 patients treated, eight (75%) showed a favourable outcome. Four patients died in this study, three despite treatment for M. genavense disease. We conclude that M. genavense is a clinically relevant pathogen in severely immunocompromised patients that causes predominantly disseminated disease with serious morbidity and mortality. M. genavense is increasingly seen among non-HIV immunocompromised patients.
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Affiliation(s)
- W Hoefsloot
- Department of Pulmonary Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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21
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van Ingen J, Aarnoutse R, de Vries G, Boeree MJ, van Soolingen D. Low-level rifampicin-resistant Mycobacterium tuberculosis strains raise a new therapeutic challenge. Int J Tuberc Lung Dis 2011; 15:990-2. [PMID: 21682979 DOI: 10.5588/ijtld.10.0127] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In an outbreak of multidrug-resistant tuberculosis, the outbreak strain had an Asp516Tyr rpoB gene mutation. Phenotypically, low-level rifampicin (RMP) resistance (minimum inhibitory concentration [MIC] 1-2 mg/l) was observed. Based on drug susceptibility test results, three patients were treated with 12-15 month rifabutin-based regimens and one with a 12-month RMP-based regimen. We retrospectively performed pharmacokinetic calculations to assess the potential for RMP treatment, from which we conclude that MICs for RMP up to 1 μg/ml may be safely overcome by applying 20 mg/kg RMP doses in treatment regimens.
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Affiliation(s)
- J van Ingen
- Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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22
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Bowles EC, Freyée B, van Ingen J, Mulder B, Boeree MJ, van Soolingen D. Xpert MTB/RIF®, a novel automated polymerase chain reaction-based tool for the diagnosis of tuberculosis. Int J Tuberc Lung Dis 2011; 15:988-9. [PMID: 21682978 DOI: 10.5588/ijtld.10.0574] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
There is an urgent need for new point of care tests for tuberculosis (TB). Xpert MTB/RIF® is a real-time polymerase chain reaction-based system that detects Mycobacterium tuberculosis DNA and rifampicin (RMP) resistance modulating mutations directly from clinical samples in 2 h. The sensitivity for detecting M. tuberculosis in culture-positive samples was 93.8% (60/64) and exceeded smear microscopy (40/64, 62.5%). The specificity for detecting M. tuberculosis was 92.0% (23/25) and for RMP resistance it was 100% (8/8). The test is simple to conduct and requires basic sputum handling facilities only. These characteristics render it a promising close-to-patient test for TB in various settings.
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Affiliation(s)
- E C Bowles
- Department of Clinical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
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23
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van Ingen J, de Zwaan R, Enaimi M, Dekhuijzen PNR, Boeree MJ, van Soolingen D. Re-analysis of 178 previously unidentifiable Mycobacterium isolates in the Netherlands in 1999-2007. Clin Microbiol Infect 2011; 16:1470-4. [PMID: 19930269 DOI: 10.1111/j.1469-0691.2009.03127.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nontuberculous mycobacteria (NTM) that cannot be identified to the species level by reverse line blot hybridization assays and sequencing of the 16S rRNA gene comprise a challenge for reference laboratories. However, the number of 16S rRNA gene sequences added to online public databases is growing rapidly, as is the number of Mycobacterium species. Therefore, we re-analysed 178 Mycobacterium isolates with 53 previously unmatched 16S rRNA gene sequences, submitted to our national reference laboratory in 1999–2007. All sequences were again compared with the GenBank database sequences and the isolates were re-identified using two commercially available identification kits, targeting separate genetic loci. Ninety-three out of 178 isolates (52%) with 20 different 16S rRNA gene sequences could be assigned to validly published species. The two reverse line blot assays provided false identifications for three recently described species and 22 discrepancies were recorded in the identification results between the two reverse line blot assays. Identification by reverse line blot assays underestimates the genetic heterogeneity among NTM. This heterogeneity can be clinically relevant because particular sub-groupings of species can cause specific disease types. Therefore, sequence-based identification is preferable, at least at the reference laboratory level, although the exact targets needed for clinically useful results remain to be established. The number of NTM species in the environment is probably so high that unidentifiable clinical isolates should be given a separate species status only if this is clinically meaningful.
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Affiliation(s)
- J van Ingen
- Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
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24
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van den Boogaard J, Semvua HH, van Ingen J, Mwaigwisya S, van der Laan T, van Soolingen D, Kibiki GS, Boeree MJ, Aarnoutse RE. Low rate of fluoroquinolone resistance in Mycobacterium tuberculosis isolates from northern Tanzania. J Antimicrob Chemother 2011; 66:1810-4. [DOI: 10.1093/jac/dkr205] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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van Ingen J, Aarnoutse RE, Donald PR, Diacon AH, Dawson R, Plemper van Balen G, Gillespie SH, Boeree MJ. Why Do We Use 600 mg of Rifampicin in Tuberculosis Treatment? Clin Infect Dis 2011; 52:e194-9. [DOI: 10.1093/cid/cir184] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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van Ingen J. Strategies to Improve Outcome of Drug Treatment for Mycobacterium abscessus Pulmonary Disease. Clin Infect Dis 2011; 52:1281-2. [DOI: 10.1093/cid/cir148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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27
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Wellenberg GJ, de Haas PEW, van Ingen J, van Soolingen D, Visser IJR. Multiple strains of Mycobacterium avium subspecies hominissuis infections associated with aborted fetuses and wasting in pigs. Vet Rec 2010; 167:451-4. [PMID: 20852249 DOI: 10.1136/vr.c4274] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A herd of pigs being reared for breeding and fattening, in which there had been incidences of abortion and wasting, reduced growth rates and an increase in mortality for the past year, were tested for Mycobacterium infection by pathological examinations, skin test, serology and Mycobacterium culture. In one placenta, and also in the lung tissues of fetuses, Ziehl-Neelsen staining revealed acid-fast bacilli in combination with infiltrations of neutrophils, macrophages and multinucleated giant cells. Acid-fast bacilli were also found in the mesenteric lymph nodes, liver and/or spleen and jejunum of pigs with wasting and in slaughtered animals. The specimen cultures were identified as Mycobacterium avium subspecies hominissuis using IS1245-specific PCR and IS1245 restriction fragment length polymorphism (RFLP). IS1245 RFLP revealed that the herd was infected with multiple M avium subspecies hominissuis strains belonging to at least two different clades. It is suggested that this infection may have played a more important role in the economic losses of the pig farm than had been assumed previously.
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Affiliation(s)
- G J Wellenberg
- Animal Health Service (GD-Deventer), 7400 AA, Deventer, The Netherlands.
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28
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Verweij KE, Kamerik AR, van Ingen J, van Dijk JH, Sikwangala P, Thuma P, Nouwen JL, van Soolingen D. Application of modern microbiological diagnostic methods for tuberculosis in Macha, Zambia. Int J Tuberc Lung Dis 2010; 14:1127-1131. [PMID: 20819257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
SETTING Macha, Zambia. OBJECTIVE To assess the benefits of auramine-O staining fluorescence microscopy and Mycobacterial Growth Indicator Tube (MGIT) liquid culture with molecular identification in tuberculosis (TB) diagnostics. DESIGN One hundred patients suspected of TB were subjected to three sputum sample examinations applying Ziehl-Neelsen (ZN) and auramine-O staining and MGIT culture. Positive cultures were identified using the GenoType CM assay; cultures identified as Mycobacterium tuberculosis complex were the gold standard for a diagnosis of TB. RESULTS The 100 patients produced 271 sputum samples; of these, 30 patients had positive cultures. M. tuberculosis complex bacilli were isolated in 17 (56.7%) patients, non-tuberculous mycobacteria (NTM) in 11 (36.7%) and other acid-fast bacilli in two. Forty-eight samples (17.7%) were contaminated. Auramine-O detected 16 (57.1%) patients culture-positive for mycobacteria and 12 patients with culture-proven TB, vs. respectively 8 (28.6%, P = 0.008) and 7 (41.2%, P = 0.044) for ZN. Three of eight auramine-positive/ZN-negative patients were culture-positive for NTM only. CONCLUSION The auramine-O method significantly increases sensitivity, although the higher NTM detection rate implies that this does not in itself lead to a more accurate diagnosis of TB. MGIT culture is highly sensitive, although contamination rates were a drawback; the high frequency of NTM isolation warrants a robust identification method.
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Affiliation(s)
- K E Verweij
- Medical/Malaria Institute, Macha Hospital, Choma, Zambia.
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29
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van Ingen J, Hoefsloot W, Dekhuijzen PNR, Boeree MJ, van Soolingen D. The changing pattern of clinical Mycobacterium avium isolation in the Netherlands. Int J Tuberc Lung Dis 2010; 14:1176-1180. [PMID: 20819265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
SETTING National Mycobacteria Reference Laboratory, The Netherlands. OBJECTIVE To assess the role of factors other than laboratory improvements in the increasing frequency of isolation of non-tuberculous mycobacteria (NTM) in the Netherlands; laboratory improvements are often considered key factors in this increase. DESIGN Laboratory database study. All clinically isolated NTM referred to the national reference laboratory between January 2000 and January 2007 were retrieved from the laboratory database and categorised by species, patient age group and sample origin. Data were compared with national demographic data. RESULTS Clinical Mycobacterium avium isolates accounted for most of the increase in referred NTM. The number of respiratory M. avium samples in patients aged >40 years increased over time. This age group increased in size during the study. In this age group, the prevalence of chronic obstructive pulmonary disease (COPD) increased during the study period. M. avium isolation from lymph nodes in children remained stable, whereas extra-pulmonary M. avium isolation in the middle age group, including human immunodeficiency virus associated bloodstream isolates, decreased. CONCLUSIONS The increasing NTM notification in the Netherlands is unlikely to have been a result of laboratory improvements alone: the ageing population with an increasing prevalence of COPD is likely as important. Environmental characteristics may specifically favour M.avium.
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Affiliation(s)
- J van Ingen
- Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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van Ingen J, de Zwaan R, Enaimi M, Richard Dekhuijzen P, Boeree M, van Soolingen D. Re-analysis of 178 previously unidentifiable Mycobacterium isolates in the Netherlands in 1999–2007. Clin Microbiol Infect 2010. [DOI: 10.1111/j.1469-0691.2010.03123.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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van Ingen J, Verhagen AFTM, Dekhuijzen PNR, van Soolingen D, Magis-Escurra C, Boeree MJ, de Lange WCM. Surgical treatment of non-tuberculous mycobacterial lung disease: strike in time. Int J Tuberc Lung Dis 2010; 14:99-105. [PMID: 20003702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
SETTING The Netherlands. OBJECTIVE To describe our experiences with the adjunctive role and benefits of surgery for lung disease due to non-tuberculous mycobacteria (NTM), specifically addressing its indications and timing. DESIGN Retrospective medical file review of eight patients who underwent surgical treatment for NTM lung disease in the period January 2000 to January 2009, and review of the available literature. RESULTS Therapy-resistant cavitary NTM disease was the most frequent indication for surgery; two patients underwent pneumonectomy for an infected destroyed lung. Mycobacterium avium was the most common causative agent. Surgery resulted in culture conversion in seven patients; one patient died 2 months after pneumonectomy. No relapses have been noted in the other seven after an average of 19 months of follow-up. CONCLUSIONS Adjunctive surgical treatment for NTM lung disease yields encouraging results, similar to previously published case series. Careful patient selection, based on extent and type of disease as well as on cardiopulmonary fitness, is important. Potential benefits of surgery should be considered for every individual patient in whom NTM lung disease is diagnosed and re-evaluated after 6 months of treatment. Where possible, surgery should be pursued and conducted in a timely fashion.
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Affiliation(s)
- J van Ingen
- University Lung Centre Dekkerswald, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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van Ingen J, Boeree M, Dekhuijzen PR, van Soolingen D. Environmental sources of rapid growing nontuberculous mycobacteria causing disease in humans. Clin Microbiol Infect 2009; 15:888-93. [DOI: 10.1111/j.1469-0691.2009.03013.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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van Ingen J, Boeree MJ, Kösters K, Wieland A, Tortoli E, Dekhuijzen PNR, van Soolingen D. Proposal to elevate Mycobacterium avium complex ITS sequevar MAC-Q to Mycobacterium vulneris sp. nov. Int J Syst Evol Microbiol 2009; 59:2277-82. [PMID: 19620376 DOI: 10.1099/ijs.0.008854-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The Mycobacterium avium complex (MAC) consists of four recognized species, Mycobacterium avium, Mycobacterium colombiense, Mycobacterium intracellulare and Mycobacterium chimaera, and a variety of other strains that may be members of undescribed taxa. We report on two isolates of a scotochromogenic, slowly growing, non-tuberculous Mycobacterium species within the M. avium complex from a lymph node and an infected wound after a dogbite of separate patients in The Netherlands. The extrapulmonary infections in immunocompetent patients suggested a high level of virulence. These isolates were characterized by a unique nucleotide sequence in the 16S rRNA gene, 99% similar to Mycobacterium colombiense, and the MAC-Q 16S-23S internal transcribed spacer (ITS) sequence. Sequence analyses of the hsp65 gene revealed 97% similarity to M. avium. The rpoB gene sequence was 98% similar to M. colombiense. Phenotypically, the scotochromogenicity, positive semi-quantitative catalase and heat-stable catalase tests, negative tellurite reductase and urease tests and susceptibility to hydroxylamine and oleic acid set these isolates apart from related species. High-performance liquid chromatography analysis of cell-wall mycolic acid content revealed a unique pattern, related to that of M. avium and M. colombiense. Together, these findings supported a separate species status within the Mycobacterium avium complex. We propose elevation of scotochromogenic M. avium complex strains sharing this 16S gene and MAC-Q ITS sequence to separate species status, for which the name Mycobacterium vulneris sp. nov. is proposed. The type strain is NLA000700772T (=DSM 45247T=CIP 109859T).
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Affiliation(s)
- J van Ingen
- Department of Pulmonary Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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Hoefsloot W, van Ingen J, de Lange WCM, Dekhuijzen PNR, Boeree MJ, van Soolingen D. Clinical relevance of Mycobacterium malmoense isolation in the Netherlands. Eur Respir J 2009; 34:926-31. [DOI: 10.1183/09031936.00039009] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Thiel S, van Ingen J, Turaev L, Uzakova G, van Soolingen D, Hoffmann H. Mechanisms of Heteroresistance to Isoniazid and Rifampin of M. tuberculosis in Tashkent, Uzbekistan. Pneumologie 2009. [DOI: 10.1055/s-0029-1213940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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van Ingen J, Bendien SA, de Lange WCM, Hoefsloot W, Dekhuijzen PNR, Boeree MJ, van Soolingen D. Clinical relevance of non-tuberculous mycobacteria isolated in the Nijmegen-Arnhem region, The Netherlands. Thorax 2009; 64:502-6. [PMID: 19213773 DOI: 10.1136/thx.2008.110957] [Citation(s) in RCA: 164] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The frequency of clinical isolation of non-tuberculous mycobacteria (NTM) in the Netherlands is increasing, but its clinical relevance is often uncertain. OBJECTIVE To assess the frequency and clinical relevance of isolation of NTM in four associated hospitals in a single region in the Netherlands. METHODS Medical files of all patients from whom NTM were isolated between January 1999 and January 2005 were reviewed retrospectively. Diagnostic criteria for non-tuberculous mycobacterial disease published by the American Thoracic Society (ATS) were used to determine clinical relevance. RESULTS 232 patients were found, from whom NTM were isolated from the respiratory tract in 91% of cases. Patients were mostly white men, with an average age of 60 years and pre-existing pulmonary disease. Fifty-three of 212 patients (25%) with pulmonary isolates met the ATS diagnostic criteria for pulmonary NTM disease; this percentage differed by species. Most patients were treated with rifampicin, ethambutol and clarithromycin. Treatment outcome for pulmonary NTM disease was suboptimal but differed by species: overall, improvement was seen in 67% of treated patients, but in only 50% of those with pulmonary M avium disease. Lymphadenitis was the most common extrapulmonary disease type. CONCLUSIONS Twenty-five per cent of all patients with pulmonary NTM isolates met the ATS criteria. Clinical relevance differs by species. NTM isolation increases over time. Species distribution differs from that of neighbouring countries and the M avium complex isolates have traits different from those reported in the USA. Adherence to diagnostic and treatment guidelines can be improved.
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Affiliation(s)
- J van Ingen
- Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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van Ingen J, Boeree MJ, Wright A, van der Laan T, Dekhuijzen PNR, van Soolingen D. Second-line drug resistance in multidrug-resistant tuberculosis cases of various origins in the Netherlands. Int J Tuberc Lung Dis 2008; 12:1295-1299. [PMID: 18926040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
SETTING The Netherlands. OBJECTIVE To investigate the frequency of resistance to second-line drugs among multidrug-resistant tuberculosis (MDR-TB) cases and its correlation with patients' geographic origin. DESIGN Retrospective laboratory database study of multidrug-resistant Mycobacterium tuberculosis complex strains isolated in the Netherlands between January 1993 and October 2007. RESULTS We found 153 patients with MDR-TB, of whom 18 (12%) were native Dutch. Complete second-line drug susceptibility testing was performed for 131 MDR-TB patients. Resistance to second-line drugs was noted in primary samples of 28 (21%) MDR-TB patients. Resistance to a single second-line drug was most frequent (24/28 [86%]; 9 to prothionamide [PTH], 6 to para-aminosalicylic acid, 4 to amikacin [AMK], 4 to ciprofloxacin and 1 to cycloserine). Four MDR-TB patients had strains resistant to multiple second-line drugs; two were extensively drug-resistant M. bovis. In MDR-TB patients of European and Central Asian origin, resistance to second-line drugs was most frequent and involved the widest range of drugs. PTH resistance was frequent among African and American MDR-TB patients, while AMK resistance was frequent among South-East Asians. CONCLUSION Resistance to second-line drugs is infrequent among MDR-TB patients in the Netherlands. Most second-line drug resistance is recorded among immigrants, with substantial differences in second-line drug resistance in MDR-TB patients originating from different geographical areas.
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Affiliation(s)
- J van Ingen
- Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Hofmann-Thiel S, van Ingen J, Feldmann K, Turaev L, Uzakova GT, Murmusaeva G, van Soolingen D, Hoffmann H. Mechanisms of heteroresistance to isoniazid and rifampin of Mycobacterium tuberculosis in Tashkent, Uzbekistan. Eur Respir J 2008; 33:368-74. [PMID: 18829680 DOI: 10.1183/09031936.00089808] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Heteroresistance of Mycobacterium tuberculosis (MTB) is defined as the coexistence of susceptible and resistant organisms to anti-tuberculosis (TB) drugs in the same patient. Heteroresistance of MTB is considered a preliminary stage to full resistance. To date, no mechanism causing heteroresistance of MTB has been proven. Clinical specimens and cultures from 35 TB patients from Tashkent, Uzbekistan, were analysed using the Genotype MTBDR assay (Hain Lifescience, Nehren, Germany), which is designed to detect genetic mutations associated with resistance to rifampin and isoniazid. Cases of heteroresistance were further subjected to genotyping using mycobacterial interspersed repetitive unit-variable-number tandem repeat typing, spoligotyping and IS6110 fingerprinting. Heteroresistance to rifampin and/or isoniazid was found in seven cases (20%). In five of them, heteroresistance was caused by two different strains and in two by a single strain of the Beijing genotype. The latter cases had a history of relapse of their TB. For the first time, two different mechanisms of heteroresistance in tuberculosis have been proven using a stepwise molecular-biological approach: 1) superinfection with two different strains, which is of interest for clinical infection control practitioners; and 2) splitting of a single strain into susceptible and resistant organisms. The latter mechanism is most likely to be related to poor treatment quality and could serve as a quality marker for tuberculosis therapy programmes in the future.
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Affiliation(s)
- S Hofmann-Thiel
- IML, Institute of Microbiology & Laboratory Medicine, Supranational Reference Laboratory (SNRL), Asklepios Fachkliniken, Robert-Koch-Allee 2, D-82131 Gauting, Germany.
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Hoefsloot W, Boeree MJ, van Ingen J, Bendien S, Magis C, de Lange W, Dekhuijzen PNR, van Soolingen D. The rising incidence and clinical relevance of Mycobacterium malmoense: a review of the literature. Int J Tuberc Lung Dis 2008; 12:987-993. [PMID: 18713494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
The incidence of Mycobacterium malmoense infections compared to other non-tuberculous mycobacteria (NTM) has increased since 1980, especially in northern Europe. Based on various epidemiological and clinical reports outside northern Europe, there is a wide distribution of these infections. Infections with M. malmoense cause pulmonary disease comparable with tuberculosis (TB). The main extra-pulmonary disease type is paediatric cervical lymphadenitis. M. malmoense isolates are clinically significant in about 70-80% of patients. Like other NTM infections, M. malmoense is often found in patients with chronic obstructive pulmonary disease (COPD) and may cause serious morbidity and mortality when inadequately treated. The best treatment consists of a 2-year regimen with rifampicin and ethambutol. The literature on infections with M. malmoense is reviewed with respect to epidemiology, clinical presentation, treatment and outcome.
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Affiliation(s)
- W Hoefsloot
- Department of Pulmonary Diseases, Radboud University Nijmegen, Nijmegen, The Netherlands.
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Magis-Escurra C, Miedema JR, de Lange WCM, van Ingen J, Dekhuijzen PNR, Boeree MJ. [Characteristics and treatment of tuberculosis patients in Dekkerswald, 2000-2005]. Ned Tijdschr Geneeskd 2008; 152:622-626. [PMID: 18410023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To describe the patient population in Dekkerswald, Nijmegen, one of two tuberculosis (TB) centres in The Netherlands. DESIGN Descriptive, retrospective study. METHOD Examination of medical records for all TB patients hospitalised between 2000 and 2005, including demographic, social, clinical and follow-up data. RESULTS Data from 166 patients were analysed. Tertiary referrals accounted for 98% of all hospitalisations. Most patients (68%) were referred for clinical reasons, and 32% were referred for social reasons. Drug resistance was encountered in 23% of patients; 9% had multidrug-resistant TB. Ten percent of patients were seropositive for HIV. Toxicity and side-effects of treatment often led to changes in treatment (40%). Patients had pulmonary TB (59%), extrapulmonary TB (23%) or both (17%). Overall, 141 patients (85%) completed treatment. The TB-related mortality rate was 5%. CONCLUSION In Dekkerswald, there is a selected patient population that is characterised by drug-resistance, comorbidity, side-effects, extrapulmonary disease and social issues. Due to the low prevalence of TB in The Netherlands, knowledge and experience regarding complex types of TB are limited. Centralisation of patient care is important to preserve and optimise this expertise.
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Affiliation(s)
- C Magis-Escurra
- Universitair Medisch Centrum St Radboud, Universitair Longcentrum Nijmegen, afd. Longziekten, locatie Dekkerswald, Nijmeegsebaan 31, 6561 KE Groesbeek.
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van Soolingen D, van Ingen J, Kremer K, Ferreira S, de Haas P, Sebek M, Borgdorff M, Supply P. S88 VNTR typing as the next gold standard in the molecular epidemiology of tuberculosis. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70057-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dofferhoff AS, Bom VJ, de Vries-Hospers HG, van Ingen J, vd Meer J, Hazenberg BP, Mulder PO, Weits J. Patterns of cytokines, plasma endotoxin, plasminogen activator inhibitor, and acute-phase proteins during the treatment of severe sepsis in humans. Crit Care Med 1992; 20:185-92. [PMID: 1371097 DOI: 10.1097/00003246-199202000-00007] [Citation(s) in RCA: 134] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study the patterns of plasma concentrations of endotoxin, tumor necrosis factor-alpha (TNF), interleukin-6 (IL-6), plasminogen activator inhibitor-1, C-reactive protein, and serum amyloid A during the treatment of human sepsis. DESIGN A prospective case series study. SETTING ICU of the Department of Internal Medicine, University Hospital Groningen, The Netherlands. PATIENTS Twenty consecutive patients (11 female, 9 male, mean age 67 yrs) with clinically defined sepsis. Eighteen patients were admitted from the outpatient emergency ward; two patients were already inpatients. The control group (n = 7) comprised patients with nonseptic shock. MEASUREMENTS AND MAIN RESULTS Ten (50%) septic patients had detectable endotoxemia (greater than 5 (ng/L). TNF concentrations on admission were increased in 94% of the septic patients, whereas IL-6 and plasminogen activator inhibitor plasma concentrations were increased in all septic patients. The septic group showed significantly (p less than .05) higher concentrations of TNF, IL-6, plasminogen activator inhibitor-1, C-reactive protein, and serum amyloid A compared with the nonseptic patients. In the septic group, we found a correlation of both IL-6 and plasminogen activator inhibitor concentrations with severity of illness (r2 = .33, p less than .05; r2 = .22, p less than .05, respectively). After the start of antibiotic treatment, high concentrations of TNF and plasminogen activator inhibitor persisted in the nonsurvivors in contrast to decreasing concentrations in most of the survivors. After an initial increase in seven patients, IL-6 concentrations decreased in all septic patients and also in nonsurvivors. CONCLUSIONS This study confirms previous findings that: a) TNF is a major mediator involved in the pathogenesis of septic shock; b) plasminogen activator inhibitor activity is significantly increased in septic patients and might be involved in the pathogenesis of disseminated intravascular coagulation associated with sepsis; and c) IL-6 is involved in the pathophysiology of septic shock, although further studies are needed to determine whether IL-6 is directly involved in mediating the lethal complications of septic shock or whether it should be considered an "alarm hormone" that reflects endothelial cell injury. Our findings also suggest that the concentrations and trends of these mediators during treatment are valuable for monitoring septic patients.
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Affiliation(s)
- A S Dofferhoff
- Department of Internal Medicine, University Hospital Groningen, The Netherlands
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Affiliation(s)
- W van der Bij
- Department of Internal Medicine, University Hospital, Groningen, The Netherlands
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Jager J, Andriessen MP, van Ingen J. Bone lesions mimicking disseminated malignancy after remission of thoracic sarcoidosis. Neth J Med 1990; 36:204-6. [PMID: 2355998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A case of chronic sarcoidosis is presented with extensive involvement of the central skeleton, mimicking disseminated malignancy. The skeletal lesions occurred several years after spontaneous remission of thoracic sarcoidosis and were not accompanied by recurrence of active thoracic disease. Bone lesions in sarcoidosis are associated with lesions of skin and nasal mucosa.
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Affiliation(s)
- J Jager
- Department of Internal Medicine, State University Hospital Groningen
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