M Jankovic1, I Sabol2, L Zmak3, V Katalinic Jankovic3, M Jakopovic1, M Obrovac3, B Ticac4, L Kardum Bulat5, S Popovic Grle1, I Marekovic6, M Samarzija1, J van Ingen7. 1. Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia. 2. Division of Molecular Medicine, Laboratory of Molecular Virology and Bacteriology, Ruder Boskovic Institute, Zagreb, Croatia. 3. National Mycobacteria Reference Laboratory, Croatian National Institute of Public Health, Zagreb, Croatia. 4. Mycobacteria Laboratory, Institute of Public Health, Rijeka, Croatia. 5. Department for Respiratory Diseases, Clinical Hospital Centre, Rijeka, Croatia. 6. Department of Clinical and Molecular Microbiology, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia. 7. Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Abstract
SETTING: The value of microbiological criteria in diagnosing non-tuberculous mycobacteria pulmonary disease (NTM-PD) and monitoring its epidemiology is unknown. OBJECTIVES: To correlate the rate of NTM-PD based on microbiological criteria (American Thoracic Society/Infectious Diseases Society of America [ATS/IDSA] or stricter microbiological criteria) compared with the full ATS/IDSA criteria, to assess the positive predictive value (PPV) of different microbiological criteria in predicting NTM-PD, and to evaluate the clinical relevance of different NTM species. DESIGN: Retrospective study of all patients with pulmonary NTM isolates in Croatia during an 8-year period. NTM species were divided into low, intermediate and high clinical relevance groups for additional analyses. RESULTS: Good correlation between both microbiological and full ATS/IDSA criteria was observed. The PPV of stricter and ATS/IDSA microbiological criteria was respectively 93.3% and 59.8%. The usefulness of microbiological criteria varied between groups. ATS/IDSA microbiological criteria had a PPV of 89.8% in the high relevance group, while in the intermediate relevance group, the PPV of stricter and ATS/IDSA microbiological criteria was respectively 94.3% and 63.4%. CONCLUSIONS: Microbiological criteria are useful in detecting NTM-PD, allowing laboratory-based monitoring. Stricter criteria should be used for species of low clinical relevance, and less stringent criteria for species of high relevance in the local setting.
SETTING: The value of microbiological criteria in diagnosing non-tuberculous mycobacteria pulmonary disease (NTM-PD) and monitoring its epidemiology is unknown. OBJECTIVES: To correlate the rate of NTM-PD based on microbiological criteria (American Thoracic Society/Infectious Diseases Society of America [ATS/IDSA] or stricter microbiological criteria) compared with the full ATS/IDSA criteria, to assess the positive predictive value (PPV) of different microbiological criteria in predicting NTM-PD, and to evaluate the clinical relevance of different NTM species. DESIGN: Retrospective study of all patients with pulmonary NTM isolates in Croatia during an 8-year period. NTM species were divided into low, intermediate and high clinical relevance groups for additional analyses. RESULTS: Good correlation between both microbiological and full ATS/IDSA criteria was observed. The PPV of stricter and ATS/IDSA microbiological criteria was respectively 93.3% and 59.8%. The usefulness of microbiological criteria varied between groups. ATS/IDSA microbiological criteria had a PPV of 89.8% in the high relevance group, while in the intermediate relevance group, the PPV of stricter and ATS/IDSA microbiological criteria was respectively 94.3% and 63.4%. CONCLUSIONS: Microbiological criteria are useful in detecting NTM-PD, allowing laboratory-based monitoring. Stricter criteria should be used for species of low clinical relevance, and less stringent criteria for species of high relevance in the local setting.
Authors: Charles L Daley; Jonathan M Iaccarino; Christoph Lange; Emmanuelle Cambau; Richard J Wallace; Claire Andrejak; Erik C Böttger; Jan Brozek; David E Griffith; Lorenzo Guglielmetti; Gwen A Huitt; Shandra L Knight; Philip Leitman; Theodore K Marras; Kenneth N Olivier; Miguel Santin; Jason E Stout; Enrico Tortoli; Jakko van Ingen; Dirk Wagner; Kevin L Winthrop Journal: Eur Respir J Date: 2020-07-07 Impact factor: 16.671
Authors: Charles L Daley; Jonathan M Iaccarino; Christoph Lange; Emmanuelle Cambau; Richard J Wallace; Claire Andrejak; Erik C Böttger; Jan Brozek; David E Griffith; Lorenzo Guglielmetti; Gwen A Huitt; Shandra L Knight; Philip Leitman; Theodore K Marras; Kenneth N Olivier; Miguel Santin; Jason E Stout; Enrico Tortoli; Jakko van Ingen; Dirk Wagner; Kevin L Winthrop Journal: Clin Infect Dis Date: 2020-08-14 Impact factor: 9.079
Authors: Charles L Daley; Jonathan M Iaccarino; Christoph Lange; Emmanuelle Cambau; Richard J Wallace; Claire Andrejak; Erik C Böttger; Jan Brozek; David E Griffith; Lorenzo Guglielmetti; Gwen A Huitt; Shandra L Knight; Philip Leitman; Theodore K Marras; Kenneth N Olivier; Miguel Santin; Jason E Stout; Enrico Tortoli; Jakko van Ingen; Dirk Wagner; Kevin L Winthrop Journal: Clin Infect Dis Date: 2020-08-14 Impact factor: 9.079
Authors: Helena Modrá; Vít Ulmann; Jan Caha; Dana Hübelová; Ondřej Konečný; Jana Svobodová; Ross Tim Weston; Ivo Pavlík Journal: Int J Environ Res Public Health Date: 2019-10-17 Impact factor: 3.390