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This Article Full Text Full Text (PDF) All Versions of this Article: 34/4/926    most recent 09031936.00039009v1 Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Hoefsloot, W. Articles by van Soolingen, D. PubMed PubMed Citation Articles by Hoefsloot, W. Articles by van Soolingen, D.

Clinical relevance of Mycobacterium malmoense isolation in the Netherlands

¹ Dept of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, and ² National Mycobacteria Reference Laboratory, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.

CORRESPONDENCE: W. Hoefsloot, Radboud University Nijmegen Medical Center, Dept of Pulmonary Diseases (454), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: w.hoefsloot{at}long.umcn.nl

Keywords: Atypical mycobacteria, atypical mycobacterium infections, Mycobacterium malmoense

Received: March 9, 2009
Accepted April 9, 2009

Uncertainty exists about the clinical relevance of Mycobacterium malmoense isolation, especially in pulmonary samples. We therefore determined clinical relevance, treatment and outcome of M. malmoense isolation in the Netherlands.

A retrospective medical file study was conducted for all patients in the Netherlands from whom Mycobacterium malmoense had been isolated between January 2002 and January 2006. Diagnostic criteria for nontuberculous mycobacterial (NTM) disease published by the American Thoracic Society (ATS) were used to determine clinical relevance. Treatment was compared with guidelines published by the British Thoracic Society.

In total, 51 patients were found from whom M. malmoense was isolated. Of these, 40 (78%) patients had pulmonary isolates and 32 (80%) of them met the ATS diagnostic criteria. Cavitary disease was most common (n = 28; 88%). Patients with pulmonary disease were mostly males, with an average age of 56 yrs and pre-existing chronic obstructive pulmonary disease. Cervical lymphadenitis was the most common extrapulmonary disease type. Adherence to treatment guidelines was poor. A good clinical response to treatment was observed in 70% and 73% of patients treated for pulmonary and extrapulmonary disease, respectively.

In conclusion, M. malmoense is a clinically highly relevant NTM in the Netherlands causing serious pulmonary morbidity. Adherence to treatment guidelines is not satisfactory.