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Title: Nontuberculous mycobacterial disease in northern Australia: a case series and review of the literature.
Authors: O'Brien, D P
Currie, B J
Krause, V L
Affiliation: Infectious Diseases Unit, Royal Darwin Hospital, Casuarina, Northern Territory, Australia..
Issue Date: Oct-2000
Citation: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2000-10; 31(4): 958-67
Abstract: We performed a retrospective/prospective review of all cases of disease due to nontuberculous mycobacteria (NTM) reported in the Northern Territory, Australia, during the period 1989-1997. Fifty-eight cases were reported, with an average yearly incidence of 3.9 cases per 100,000 persons. The number increased significantly for the second half of the study period (39 vs. 19 cases; P<.02). The yearly incidence of pulmonary Mycobacterium avium/Mycobacterium intracellulare complex (MAC) disease not associated with human immunodeficiency virus (HIV) infection was 2.1 cases per 100,000 population. MAC was the most common isolate (78%) and pulmonary disease the most frequent clinical presentation (62%). Disease due to NTM or MAC was not found more commonly in rural areas. Significant risks for non-HIV-associated pulmonary MAC disease included male sex (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.0-4.5) and age >50 years (OR, 26.5; 95% CI, 10.9-67.3), but aboriginal people appeared underrepresented (OR, 0.77; 95% CI, 0.30-1.87). Mycobacterium tuberculosis was almost 5 times more likely than NTM to be the cause of non-HIV-associated mycobacterial pulmonary disease (153 vs. 32 cases; OR, 4.79; 95% CI, 3.22-7.14). Mycobacterial lymphadenitis in aboriginal children was more likely to be tuberculous than nontuberculous (OR, 6.5; 95% CI, 1.4-41.7), but not in nonaboriginal children (OR, 1.0). With treatment, 66% of the cases of non-HIV-associated pulmonary MAC disease had favorable outcomes, and 7% of patients had progressive fatal disease. Outcomes of therapy for lymphadenitis and skin/soft-tissue disease were excellent, but those of HIV-associated disseminated MAC disease were poor.
DOI: 10.1086/318136
ISSN: 1058-4838
Type: Journal Article
Subjects: AIDS-Related Opportunistic Infections
Lung Diseases
Middle Aged
Mycobacterium Infections
Mycobacterium avium-intracellulare Infection
Northern Territory
Oceanic Ancestry Group
Prospective Studies
Retrospective Studies
Risk Factors
Skin Diseases, Bacterial
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