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Fast Growers vs Slow Growers: Who Is at Risk for an Atypical Microbacterial Infection?
October 2010, Vol 138, No. 4_MeetingAbstracts
Poster Presentations: Wednesday, November 3, 2010 | October 2010
Fast Growers vs Slow Growers: Who Is at Risk for an Atypical Microbacterial Infection? Ryu P. Tofts, MBChB; Michael Alvarez, DO; Lysette Cardona, MD; Laurence Smolley, MD; Eduardo Oliveira, MD; Gustavo Ferrer, MD Cleveland Clinic Florida, Weston, FL Chest. 2010;138(4_MeetingAbstracts):683A. doi:10.1378/chest.10309
Abstract PURPOSE: To describe a case-series of Acid-Fast Bacilli (AFB) positive smears in terms of prevalence, demographics, and co-morbidities. METHODS: A retrospective chart review of all AFB positive smears in 150-bed hospital over a 5-year period. The samples were divided into mycobacteria tuberculosis (MTB) and Non-Tuberculous Mycobacterium (NTM). These were subdivided into Fast growers (Group 1) and Slow-growers (Group 2). NTM were stratified according to co-morbidities looking for significant correlations: Chronic Obstructive Pulmonary Disease (COPD), Gastro-esophageal reflux disease (GERD) Asthma, Diabetes, Connective Tissue Disorders, Previous tuberculosis, and HIV/AIDS. A Fisher’s exact test was used to determine significance amongst the stratified groups. RESULTS: We identified 101 cases, 3 were MTB and 98 were NTM. Group 1 had 32 Fast Growers, with M. fortuitum being the most prevalent (46.9 %). Group 2 had 66 Slow Growers with M. avium complex being the most prevalent (92.8 %.) 59.2 % were female and 40.8 % were male. COPD was the most prevalent co-morbidity (28.6 %,) followed by GERD ( 22.8 %). Asthma, Diabetes Mellitus, and Bronchiectasis occurred in 9.2 % of the population individually. When stratified according to comorbidities, Group 1 and Group 2 had no statistically significant correlation with COPD, GERD, Asthma, Diabetes Mellitus, CTD, Bronchiectasis, HIV/AIDS and previous TB exposure. There was also no statistically significant correlation with male in group1 or group2. However females were 2.5 times more likely to have a slow grower than a fast growers (p=.03). CONCLUSION: There was a much higher prevalence of NTM than M Tuberculosis in our hospital. We did not find any statistically significant correlation between fast and slow growers when stratified amongst co-morbidities. Previous studies had sited a statistical significant relationship with GERD; however our study failed to show this correlation. Slow growers, specifically mycobacterium avium complex, were more prevalent, which correlates with previous studies. CLINICAL IMPLICATIONS: In our study there were no significant populations for either slow-growing or fast-growing mycobacterium species. DISCLOSURE: Michael Alvarez, No Financial Disclosure Information; No Product/Research Disclosure Information 12:45 PM - 2:00 PM
Poster Presentations: Wednesday, November 3, 2010 | October 2010
Fast Growers vs Slow Growers: Who Is at Risk for an Atypical Microbacterial Infection? Ryu P. Tofts, MBChB; Michael Alvarez, DO; Lysette Cardona, MD; Laurence Smolley, MD; Eduardo Oliveira, MD; Gustavo Ferrer, MD Cleveland Clinic Florida, Weston, FL Chest. 2010;138(4_MeetingAbstracts):683A. doi:10.1378/chest.10309
Abstract PURPOSE: To describe a case-series of Acid-Fast Bacilli (AFB) positive smears in terms of prevalence, demographics, and co-morbidities. METHODS: A retrospective chart review of all AFB positive smears in 150-bed hospital over a 5-year period. The samples were divided into mycobacteria tuberculosis (MTB) and Non-Tuberculous Mycobacterium (NTM). These were subdivided into Fast growers (Group 1) and Slow-growers (Group 2). NTM were stratified according to co-morbidities looking for significant correlations: Chronic Obstructive Pulmonary Disease (COPD), Gastro-esophageal reflux disease (GERD) Asthma, Diabetes, Connective Tissue Disorders, Previous tuberculosis, and HIV/AIDS. A Fisher’s exact test was used to determine significance amongst the stratified groups. RESULTS: We identified 101 cases, 3 were MTB and 98 were NTM. Group 1 had 32 Fast Growers, with M. fortuitum being the most prevalent (46.9 %). Group 2 had 66 Slow Growers with M. avium complex being the most prevalent (92.8 %.) 59.2 % were female and 40.8 % were male. COPD was the most prevalent co-morbidity (28.6 %,) followed by GERD ( 22.8 %). Asthma, Diabetes Mellitus, and Bronchiectasis occurred in 9.2 % of the population individually. When stratified according to comorbidities, Group 1 and Group 2 had no statistically significant correlation with COPD, GERD, Asthma, Diabetes Mellitus, CTD, Bronchiectasis, HIV/AIDS and previous TB exposure. There was also no statistically significant correlation with male in group1 or group2. However females were 2.5 times more likely to have a slow grower than a fast growers (p=.03). CONCLUSION: There was a much higher prevalence of NTM than M Tuberculosis in our hospital. We did not find any statistically significant correlation between fast and slow growers when stratified amongst co-morbidities. Previous studies had sited a statistical significant relationship with GERD; however our study failed to show this correlation. Slow growers, specifically mycobacterium avium complex, were more prevalent, which correlates with previous studies. CLINICAL IMPLICATIONS: In our study there were no significant populations for either slow-growing or fast-growing mycobacterium species. DISCLOSURE: Michael Alvarez, No Financial Disclosure Information; No Product/Research Disclosure Information 12:45 PM - 2:00 PM