Mall1cirrus: Новая страница: «Information about bacteraemia caused by Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacteria (NTM) in human immunodeficiency virus (HIV)-non-infected…»

2017-02-23T17:04:51Z

Новая страница: «Information about bacteraemia caused by Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacteria (NTM) in human immunodeficiency virus (HIV)-non-infected…»

Новая страница

Information about bacteraemia caused by Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacteria (NTM) in human immunodeficiency virus (HIV)-non-infected [http://en.wikipedia.org/wiki/Tryptophan_synthase Tryptophan synthase] (non-HIV) patients is still limited. This study aimed to investigate the clinical and microbiological characteristics of mycobacterial bacteraemia in HIV-infected and non-HIV patients. Patients with mycobacterial bacteraemia were identified, according to recommended guidelines [7], from January 2000 to June 2008 at the mycobacteriology laboratory of National Taiwan University Hospital, a 2000-bed teaching hospital in Taiwan. Prior to 2000, blood specimens were inoculated on Lowenstein�CJensen slants and Middlebrook?7H11 medium (BBL; Becton-Dickinson Diagnostic Instrument Systems, Sparks, MD, USA). From 2000 to 2004, they were inoculated on Lowenstein�CJensen slants and in the fluorometric BACTEC system (BACTEC Mycobacterium Growth Indicator Tube?960 system, Becton-Dickinson). After January 2005, all blood samples tested for mycobacteria were inoculated directly in BACTEC?9240 Myco/F Lytic bottles (Becton Dickinson) and incubated for 4?weeks. NTM isolates were identified to the species level using conventional biochemical methods [7]. Spoligotyping was performed with a standardized protocol to identify and differentiate the MTB complex isolates [8,9]. Molecular typing of Mycobacterium avium subspecies was performed with five primer sets, IS900, IS901, IS1245, DT1, and DT6, as described previously [10,11]. Treatment of NTM infections [http://www.selleckchem.com/PI3K.html PI3K inhibitor] was considered appropriate if the regimen was in accordance with the American Thoracic Society guidelines [1]. Improved condition was defined as subsidence of symptoms accompanied by negative culture, and persistent disease was [http://www.selleckchem.com/products/ch5424802.html Alectinib clinical trial] defined as a condition that did not fit both criteria after appropriate treatment. Among 71 patients with mycobacterial bacteraemia, 47 (66.2%) were HIV-infected (Table?1). M.?avium complex (MAC) (54.9%) and MTB (38.0%) were the two most common mycobacteria associated with bacteraemia. However, MAC was more common than MTB in HIV-infected patients. The patients were followed up for a mean of 234?��?218?days (median, 183?days) between the diagnosis and the end of treatment or death. Information on the outcome was available for 65 patients, and the overall mortality rate was 33.8%. The mortality rate was lower in HIV-infected patients than in non-HIV patients (27.9% vs. 50.0%; p?0.078). This could be attributed to a younger age (39.3?��?11.1?years vs. 54.8?��?18.6?years; p?0.001), fewer underlying diseases, better nutritional status (albumin level, 3.1?��?0.6?g/dL vs. 2.75?��?0.5 g/dL; p?0.049) and more appropriate treatment (97.7% vs. 77.3%; p?0.015) in HIV-infected patients, although the mean CD4 count in HIV-infected patients was only 10.5?��?12.3/��L. Patients without HIV infection had more underlying diabetes, haematological cancer, autoimmune disease, and steroid usage.

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Mall1cirrus: Новая страница: «Information about bacteraemia caused by Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacteria (NTM) in human immunodeficiency virus (HIV)-non-infected…»