medigraphic.com

2018, Number 5

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2018; 56 (5)

Nontuberculous mycobacteria in cervical lymphadenopathies of HIVpositive and HIV-negative adults

Hernández-Solís A, González-Villa M, Ramírez-González E, González-González H, de la Torriente-Mata R, Reding-Bernal A, Cícero-Sabido R

Language: Spanish
References: 28
Page: 456-461
PDF size: 1677.71 Kb.


ABSTRACT

Background: Tuberculosis is a global public health problem, especially in emerging countries. Mycobacterium tuberculosis is the main cause of cervical lymphadenopathy; nontuberculous mycobacteria are relatively common in children and rare in adults.
Objective: To identify and establish the frequency of infectious etiology by nontuberculous mycobacteria in Mexican adult patients with cervical lymphadenopathy.
Methods: The study included 85 patients over 18 years with cervical lymphadenopathy; 45 were HIV-positive, 40 were HIV-negative; they had no history of tuberculosis treatment and were selected from a third-level hospital. It was carried out a biopsy of the lymph node for the histopathological study, a search for acid-fast bacilli, a tube culture to indicate growth of Mycobacterium BACTEC (MGIT-960) and identification of mycobacterial strain by PCR-RFLP (restriction fragment length polymorfism) of hsp65.
Results: In 42 HIV-positive patients (93%), strains corresponded to Mycobacterium tuberculosis complex, two (4.4%) to M. intracellulare and one (2.2%) to M. gordonae. Among HIV-negative patients, 39 of strains (97.5%) corresponded to patients with M. tuberculosis complex and one strain (2.5%) to M. fortuitum.
Conclusion: The presence of nontuberculous mycobacteria was found in 4.7% of all cases. Despite this low frequency, it must be taken into account as a possible cause of lymphadenopathy, since its prompt identification enables introducing specific treatment.


REFERENCES

  1. Secretaría de Salud, Hospital General de México. Epidemiología y determinantes sociales en tuberculosis. México, Distrito Federal: Secretaría de Salud; 2014. Disponible en http://www.cenaprece. salud.gob.mx/programas/interior/micobacteriosis/descar gas/pdf/TByDSSMexicoCursoTB2014.pdf [Consultado el 7 de julio de 2015].

  2. Secretaría de Salud/Dirección General de Epidemiologia/CENSIDA. Vigilancia Epidemiológica de casos de VIH/SIDA en México. Registro Nacional de Casos de SIDA. Actualización al cierre de 2014. México: Secretaría de Salud; 2014. Disponible en http://www. censida.salud.gob.mx/descargas/epidemiologia/RN_CIER RE_2014.pdf [Consultado el 7 de julio de 2015].

  3. Salvador F, Los-Arcos I, Sánchez-Montalvá A, Tórtola T, Curran A, Villar A, et al. Epidemiology and diagnosis of tuberculous lymphadenitis in a tuberculosis lowburden country. Medicine (Baltimore). 2015;94(4):e509. doi: 10.1097/MD.0000000000000509.

  4. White MP, Bangash H, Goel KM, Jenkins PA. Nontuberculous mycobacterial lymphadenitis. Arch Dis Child. 1986;61(4):368-71. 2

  5. Jambo KC, Banda DH, Afran L, Kankwatira AM, Malamba RD, Allain TJ, et al. Asymptomatic HIV-infected Individuals on Antiretroviral Therapy Exhibit Impaired Lung CD4+ T-Cell Responses to Mycobacteria. Am J Respir Crit Care Med. 2014;190(8):938-47. doi: 10.1164/ rccm.201405-0864OC

  6. Piersimoni C, Scarparo C. Extrapulmonary Infections Associated with Nontuberculous Mycobacteria in Inmmunocompetent Persons. Emerg Infect Dis 2009;15 (9):1351-8.

  7. Huang Z, Xiong G, Luo Q, Jiang B, Li W, Xu X et al. Evaluation of the performance of the microscopic observation drug susceptibility assay for diagnosis of extrapulmonary tuberculosis in China: A preliminary study. Respirology 2014;19(1):132-7.

  8. Perdikogianni C, Galanakis E. Non-tuberculous mycobacterial cervical lymphadenitis in the immunocompetent child: diagnostic and treatment approach. Expert Rev Anti Infect Ther. 2014;12(8):959-65.

  9. Henkle E, Winthrop KL. Nontuberculous mycobacteria infections in immunosuppressed hosts. Clin Chest Med. 2015;36(1):91-9.

  10. Escobar-Escamilla N, Ramírez-González JE, González- Villa M, Torres-Mazadiego P, Mandujano-Martínez A, Barrón-Rivera C, et al. hsp65 Phylogenetic Assay for Molecular Diagnosis of Nontuberculous Mycobacteria Isolated in Mexico. Arch Med Res. 2014;45(1):90-7.

  11. Graham SM. Non-tuberculosis opportunistic infections and other lung diseases in HIV-infected infants and children. Int J Tuberc Lung Dis. 2005;9(6):592-602.

  12. Shankar EM, Vignesh R, Ellegård R, Barathan M, Chong YK, Bador MK et al. HIV-Mycobacterium tuberculosis coinfection: a danger-couple model' of disease pathogenesis. Pathog Dis. 2014;70(2):110-8.

  13. Prevots DR, Marras TK. Epidemiology of human pulmonary infection with nontuberculous mycobacteria: a review. Clin Chest Med. 2015;36(1):13-34.

  14. Hernández-Solís A, Cicero-Sabido R, Olivera H, Rivero V, Ramírez E, Escobar-Gutiérrez A. Tuberculosis is still a major cause of cervical lymphadenopathies in adults from developing countries. Epidemiol Infect. 2003;131(3): 1071-6.

  15. Griffith DE, Aksamit T, Brown-Elliot BA, Catanzaro A, Daley C, Gordin F et al. An Official ATS/IDSA Statement: Diagnosis treatment and prevention of nontuberculous mycobacterial diseases. Am J Respir Care Med. 2007; 175(4):367-416.

  16. Secretaría de Salud. Centro Nacional de Excelencia Tecnológica en Salud. Diagnóstico y tratamiento de las infecciones por micobacterias no tuberculosas. Guía de Práctica Clínica. México: Secretaría de Salud; 2014. Disponible en http://www.cenetec.salud.gob.mx/descargas/ gpc/CatalogoMaestro/IMSS-650-14-Micobacteriosis Notuberculosa/650GER.pdf

  17. Telenti A, Marchesi F, Balz M, Baally F, Bottger EC, Bodmer T. Rapid identification of mycobacteria to the species level by polymerase chain reaction and restriction enzyme analysis. J Clin Microbiol. 1993;31(2):175-8.

  18. Brunello F, Ligozzi M, Cristelli E, Bonora S, Tortoli E, Fontana R. Identification of 54 mycobacterial species by PCR-restriction fragment length polymorphism analysis of the hsp65 gene. J Clin Microbiol. 2001;39(8):2799-806.

  19. Chimara E, Ferrazoli L, Ueky SYM, Martins MC, Durham AM, Arbeit RD, et al. Reliable identification of mycobacterial species by PCR-restriction enzyme analysis (PRA)-hsp65 in a reference laboratory and elaboration of a sequence based extended algorithm of PRA-hsp65 patterns. BMC Microbiol. 2008;8:48. 4

  20. Devallois A, Goh KS, Rastogi N. Rapid identification of Mycobacteria to species level by PCR-restriction fragment length polymorphism analysis of the hsp65 gene and proposition of an algorithm to differentiate 34 mycobacterial species. J Clin Microbiol. 1997;35(11): 2969-73.

  21. Wasserman S, Meintjes G. The diagnosis, management and prevention of HIV-associated tuberculosis. S Afr Med J. 2014;104(12):886-93.

  22. Philley JV, Griffith DE. Treatment of slowly growing mycobacteria. Clin Chest Med. 2015;36(1):79-90.

  23. Kasperbauer SH, De Groote MA. The treatment of rapidly growing mycobacterial infections. Clin Chest Med. 2015; 36(1):67-78.

  24. Satta G, McHugh TD, Mountford J, Abubakar I, Lipman M. Managing pulmonary nontuberculous mycobacterial infection. Time for a patient-centered approach. Ann Am Thorac Soc. 2014:11(1);117-21.

  25. Post FA, Grint D, Werlinrud AM, Panteleev A, Riekstina V, Malashenkov EA, et al.; HIV-TB Study Group. Multidrug- resistant tuberculosis in HIV positive patients in Eastern Europe. J Infect. 2014;68(3):259-63.

  26. Cortés-Torres N, González-y-Merchand JA, González- Bonilla C, García-Elorriaga G. Molecular analysis of mycobacteria isolated in Mexican patients with different immunodeficiencies in a tertiary care hospital. Arch Med Res. 2013;44(7):562-69.

  27. Van Ingen J, Ferro BE, Hoefsloot W, Boerse MJ, van Solingen D. Drug treatment of pulmonary non tuberculous mycobacterial disease in HIV-negative patient the evidence. Expert Rev Anti Infect Ther. 2013;11(10):1065-77.

  28. Vittor AY, Garland JM, Gilman RH. Molecular diagnosis of TB in the HIV positive population. Ann Global Health. 2014;80(6):476-85.




2020     |     www.medigraphic.com