Non-Tuberculous Mycobacteria in TB-Endemic Countries Are We Neglecting the Danger 英文参考文献.docVIP
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Non-Tuberculous Mycobacteria in TB-Endemic Countries Are We Neglecting the Danger 英文参考文献
Viewpoints
Non-TuberculousMycobacteriainTB-EndemicCountries:
AreWeNeglectingtheDanger?
KrishnamoorthyGopinath,SarmanSingh*
DivisionofClinicalMicrobiology,DepartmentofLaboratoryMedicine,AllIndiaInstituteofMedicalSciences,NewDelhi,India
Introduction
Nevertheless, we feel that besides this
argument, in a majority of the patients,
thediagnosisofNTMdiseasegetsmissed
inthesecountries.
pools in both developing and developed
countries.
There are more than 120 members of
the genus Mycobacterium, which are
diverse in pathogenicity, in vivo adapta-
tion, virulence, response to drugs, and
growth characteristics. Mycobacteria oth-
er than M. tuberculosis complex and M.
leprosy are known as Non-Tuberculous
Mycobacteria (NTM) and are known by
various acronyms. They attracted abrupt
attention only after the AIDS epidemic,
but most of the reports were published
from TB non-endemic countries [1] and
only rarely from TB-endemic countries.
This is probably because the chances of
missing NTM species are higher in TB-
OverlappingDisease
Manifestations:Reasonfor
Underreporting
GeographicalDistributionof
NTM
The overlapping clinical manifestations
of the diseases caused by M. tuberculosis
make the specific diagnosis of NTM
difficult.Eventhoughfeverislesscommon
inNTMpulmonarydisease,mostpatients
willpresentinachestx-raywithsporadic
infiltrations, nodular lesions, and cavities
indistinguishable from pulmonary tuber-
culosis, and disease caused by M. kansasii
in HIV-infected patients often mimics
pulmonarytuberculosis[6,7,8,9].Mycobac-
terium avium-intracellulare commonly causes
disseminated diseases in AIDS patients.
Someworkersalsoconsiderthatthelow
detectionrate ofNTMisduetodiversity
in the environmental and climatic condi-
tions in the HIV-TB-endemic countries,
butthisargumentisnotsupportedbythe
literature[3–5].Inmostofthesurveys,the
rateofhumanNTMinfectionsisestimat-
edbynon-specificantibodyassaysorskin
tests[6].Hence,thesefindingsmaynotbe
a reliable source of information. The
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