Imran Ahmed, Kauser Jabeen, Rumina Hasan.
Non-tuberculous Mycobacteria in Extra-pulmonary Specimens: Role of Nosocomial Transmission.
Infect Dis J Jan ;22(3):581-3.

Background: Non-tuberculous mycobacteria (NTM) cause infections not only in immuno-compromised but also in immuno-competent individuals. Healthcare associated NTM infections have been reported. Assessment of clinical significance of an NTM isolate is vital before embarking on the rapy. Treatment of NTM infections requires identification of isolate and susceptibility. There is a lack of data on healthcare associated NTM infections from Pakistan. Objective: This study was performed to determine NTM isolates and their clinical significance from extra-pulmonary clinical specimens submitted at a tertiary care hospital laboratory. Methods: Extra-pulmonary NTM isolated from 25955 specimens over 24 months (January 2010-December 2011) were included. All isolates were identified using conventional tests. Clinical details were extracted from laboratory data. Drug susceptibility testing was performed by broth microdilution. Results: A total of 12 NTM were isolated from extra-pulmonary specimens over the study period. Clinical significance could be determined in 9/12 specimens. Seven NTM isolates from 3 patients were post-surgical and were likely to be healthcare associated. Conclusion: This is the first study reporting healthcare associated NTM infections from extra-pulmonary clinical specimens from Pakistan. Isolation of NTM from clinical specimens should prompt evaluation of their clinical significance. Healthcare associated NTM infections should be suspected in non-healing post-surgical wounds.

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