Non-tuberculous mycobacterial infections in the Scottish Borders: identification, management and treatment outcomes – a retrospective review

Non-tuberculous mycobacteria are opportunist pathogens increasingly recognised as a cause of pulmonary and extrapulmonary disease. Treatment is complicated, prolonged and potentially toxic, and due to a limited evidence base, potentially contentious and idiosyncratic. This is a retrospective review...

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Bibliographic Details
Published in:The Journal of the Royal College of Physicians of Edinburgh 2011-12, Vol.41 (4), p.294-303
Main Authors: McCallum, AD, Watkin, SW, Faccenda, JF
Format: Article
Language:English
Subjects:
Anti-Infective Agents - therapeutic use
Guideline Adherence
Humans
Lung Diseases - drug therapy
Lung Diseases - epidemiology
Lung Diseases - microbiology
Mycobacterium
Mycobacterium avium
Mycobacterium Infections - drug therapy
Mycobacterium Infections - epidemiology
Mycobacterium Infections - microbiology
Practice Guidelines as Topic
Respiratory Tract Diseases - drug therapy
Respiratory Tract Diseases - epidemiology
Respiratory Tract Diseases - microbiology
Scotland
State Medicine
Treatment Outcome
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Summary:Non-tuberculous mycobacteria are opportunist pathogens increasingly recognised as a cause of pulmonary and extrapulmonary disease. Treatment is complicated, prolonged and potentially toxic, and due to a limited evidence base, potentially contentious and idiosyncratic. This is a retrospective review of nontuberculous mycobacteria cases in the NHS Borders Health Board between 1992 and 2010. We consider incidence, species identified, drug sensitivity testing and treatment outcome with reference to the British and American Thoracic Society guidelines. Thirty-eight cases of non-tuberculous mycobacteria isolates were identified; 84.21% were pulmonary and 42.11% were Mycobacterium avium complex. Incidence rose from 1.92/100,000 in 1993 to 4.43/100,000 in 2010. The British Thoracic Society guidelines were followed in 45.45% of cases. A total of 36.36% were successfully treated with another 36.36% still being treated with antimicrobials. There is a clear need for more research on treatment for this group of ‘emerging pathogens’ and it remains to be seen if concordance with current guidelines will improve treatment outcomes.
ISSN:1478-2715
2042-8189
DOI:10.4997/JRCPE.2011.403