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Extrapulmonary mycobacteria isolations

Abstract number: 1733_1489

Karabela S., Nikolaou S., Raftopoulou A., Anagnostou S., Kouseris I., Makrigiannis N., Koletou M., Kanavaki S.

Aim: To study the extrapulmonary mycobacteria isolations, in an eight years period (1998–2005).

Material: 21177 extrapulmonary clinical specimens.

Methods: Microscopy by Ziehl Neelsen stain. Culture by the classical method on solid Löwenstein-Jensen (LJ) medium, as well as, by the automated system Bactec MGIT 960 (Becton Dickinson). Identification by molecular hybridisation, using the commercial kits: InnoLipa V2 (Innogenetics), Accuprobe (Gen Probe, bioMérieux) and Genotype Mycobacterium CM and AS (Hain Life, Science).

Sensitivity testing by the classical method of proportion on LJ solid medium, as well as, by the automated system, Bactec MGIT 960 (Becton Dickinson) and the molecular hybridisation technique, Geno Type MTBDR, (Hain Life Science)

Results:

- The number of extrapulmonary specimens tested increased through out the study period, from 2197 (13%) in 1998 to 3322 (18.2%) in 2005.

- 685/21177 (3.2%) clinical specimens grew a mycobacterium.

- 622/685 (90.8%) of mycobacteria were M. tuberculosis (MTB), while

- 63/685 (9.2%) were Non TB (NTB) mycobacteria.

a. Concerning MTB isolations, most common clinical sources were pleural fluid 243/622 (39%), urine 91/622 (14.6%), lymph nodes 83/622 (13.3%) and pus 81/622 (13%). Drug resistance of MTB isolates showed that 35/622 (5.6%) were resistant to isoniazide (INH), 15/622 (2.4%) to rifampicin (RIF) and 12/622 (1.9%) were MDR (INH+RIF)

b. Concerning NTB isolations, 52/63 (82.5%) were M. avium, 9/63 (14.3%) were M. chelonae, 1/63 (1.6%) was M. peregrinum and 1/63 (1.6%) was M. fortuitum. Most common clinical sites for the NTB isolates were for M. avium, lymph nodes 21/63 (33.3%), blood 20/63 (31.7%) and pleural fluid 8/63 (12.7%), while for M. chelonae blood 9/9 (100%), for M. peregrinum pleural fluid and for M. fortuitum a lymph node.

Conclusions: The vast majority of extrapulmonary specimens grew an MTB. Most common clinical sources for extrapulmonary MTB isolations were pleural fluid and urine, while for NTB extrapulmonary isolations, lymph nodes and blood. Concerning drug resistance and multidrug resistance of MTB, they are significantly lower in extrapulmonary compared to pulmonary specimens, according previous studies of our laboratory.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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