PT  - JOURNAL ARTICLE
AU  - Neranjan Dissanayake
AU  - Dushantha Madegedara
AU  - Dhammika MaganaArachchi
AU  - Udani Karunarathna
AU  - Duminda Yasaratne
AU  - Chathuranga De Silva
AU  - Chandana Kulathunga
AU  - Samadara Nakandala
AU  - Prasanne Wijerathne
AU  - Chathura Wirasinghe
TI  - High burden of rapidly growing non-tuberculosis mycobacteria in patients with respiratory disease undergoing elective bronchoscopy
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - 3395
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/3395.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/3395.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Background: Pathogenecity of pulmonary non-tuberculous Mycobacteria (NTM) is less well understood than that of M. tuberculosis (MTB) complex. Both will show identical results on acid-fast staining (AFS), but culture characteristics are commonly used for differentiation in the local setting.Objective: To assess the pattern of mycobacterial culture among patients with respiratory illness and negative sputum for AFS, in a pulmonary tuberculosis (PTB) prevalent environment.Method: Bronchoalveolar lavage samples from 120 patients were inoculated onto solid media (Lowenstein-Jensen and Middlebrook 7H-10) at 280C and 370C, in both light and dark conditions. All patients were negative for sputum AFS. Indications for bronchoscopy were bronchiectasis, cavitatory lung disease and smear negative PTB.Results: 67 patients yielded positive colonies within 8 weeks. 37 colonies were positive for AFS, of which 31 were rapidly growing Mycobacteria (RGM; <7 days) and 6 were slowly growing Mycobacteria (>7 days). Rapid colony growth strongly favours towards NTM. PCR based restriction fragment length polymorphism analyses on NTM are in progress. Concomitant sterile water, instrument cleanser fluid and saline samples did not yield culture growth.Conclusion: We observed a high prevalence (>25%) of RGM in the study population. This raises major concerns on possible over-diagnosis of PTB leading to inappropriate therapy and false categorization of patients, in limited resource settings where sputum AFS results play a central role in managing PTB in clinical practice.