Access

You are not currently logged in.

Access your personal account or get JSTOR access through your library or other institution:

login

Log in to your personal account or through your institution.

Nontuberculous Mycobacterial Disease in Northern Australia: A Case Series and Review of the Literature

Daniel P. O'Brien, Bart J. Currie and Vicki L. Krause
Clinical Infectious Diseases
Vol. 31, No. 4 (Oct., 2000), pp. 958-967
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/4461345
Page Count: 10
  • Download ($42.00)
  • Subscribe ($19.50)
  • Cite this Item
Nontuberculous Mycobacterial Disease in Northern Australia: A Case Series and Review of the Literature
Preview not available

Abstract

We performed a retrospective/prospective review of all cases of disease due to nontuberculous mycobacteria (NTM) reported in the Northern Territory, Australia, during the period 1989-1997. Fifty-eight cases were reported, with an average yearly incidence of 3.9 cases per 100,000 persons. The number increased significantly for the second half of the study period (39 vs. 19 cases; P < .02). The yearly incidence of pulmonary Mycobacterium avium/Mycobacterium intracellulare complex (MAC) disease not associated with human immunodeficiency virus (HIV) infection was 2.1 cases per 100,000 population. MAC was the most common isolate (78%) and pulmonary disease the most frequent clinical presentation (62%). Disease due to NTM or MAC was not found more commonly in rural areas. Significant risks for non-HIV-associated pulmonary MAC disease included male sex (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.0-4.5) and age >50 years (OR, 26.5; 95% CI, 10.9-67.3), but aboriginal people appeared underrepresented (OR, 0.77; 95% CI, 0.30-1.87). Mycobacterium tuberculosis was almost 5 times more likely than NTM to be the cause of non-HIV-associated mycobacterial pulmonary disease (153 vs. 32 cases; OR, 4.79; 95% CI, 3.22-7.14). Mycobacterial lymphadenitis in aboriginal children was more likely to be tuberculous than nontuberculous (OR, 6.5; 95% CI, 1.4-41.7), but not in nonaboriginal children (OR, 1.0). With treatment, 66% of the cases of non-HIV-associated pulmonary MAC disease had favorable outcomes, and 7% of patients had progressive fatal disease. Outcomes of therapy for lymphadenitis and skin/soft-tissue disease were excellent, but those of HIV-associated disseminated MAC disease were poor.

Page Thumbnails

  • Thumbnail: Page 
958
    958
  • Thumbnail: Page 
959
    959
  • Thumbnail: Page 
960
    960
  • Thumbnail: Page 
961
    961
  • Thumbnail: Page 
962
    962
  • Thumbnail: Page 
963
    963
  • Thumbnail: Page 
964
    964
  • Thumbnail: Page 
965
    965
  • Thumbnail: Page 
966
    966
  • Thumbnail: Page 
967
    967