%0 Journal Article
%T Acid-Fast Bacilli Other than Mycobacteria in Tuberculosis Patients Receiving Directly Observed Therapy Short Course in Cross River State, Nigeria
%A Benjamin Thumamo Pokam
%A Anne E. Asuquo
%J Tuberculosis Research and Treatment
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/301056
%X The information on the contribution of non tuberculous mycobacteria (NTM) to mycobacterial infections in Africa is scarce due to limited laboratory culture for its isolation and identification. One hundred and thirty-seven sputum smear positive patients were recruited into a study on the molecular epidemiology of Mycobacterium tuberculosis in Cross River State. Following sputum culture, 97 pure isolates were obtained and identified using Capilia TB-Neo and further confirmed by the GenoType Mycobacterium CM kit. Of the 97 isolates, 81 (83.5%) isolates were Capilia TB-Neo positive while 16 (16.5%) were Capilia TB-Neo negative. Further confirmation with the GenoType Mycobacterium CM kit revealed that 4 (25%) of the 16 isolates belonged to NTM and included M. fortuitum I, M. fortuitum II/M magaritense, M. abscessus, and M. avium ssp. The remaining 12 (75%) Capilia TB-Neo negative isolates were not members of the genus Mycobacterium despite their AFB appearance. Six (33.3%) of the Capilia TB-Neo negative were from HIV positive tuberculosis patients. All subjects in this study were placed on DOTS shortly after the AFB results were obtained. The implication of isolation of 16.5% nontuberculous isolates further emphasizes the need for culture of sputum specimen especially in HIV positive patients prior to administration of antituberculosis therapy. 1. Introduction Mycobacterium tuberculosis is the most important causative agent of tuberculosis (TB) while nontuberculous mycobacteria (NTM) may play a key role in etiology of TB-like syndromes [1]. Data on nontuberculous mycobacterial disease in sub-Saharan Africa are limited, due mainly to the lack of laboratory culture facilities for the identification of mycobacterial species. Consequently, many laboratories do not discriminate between M. tuberculosis and NTM for similar reasons [2¨C4]. Treatment of TB patients in most sub-Saharan African countries including Nigeria is based solely on the results of microscopic smear positivity. As such, all sputum smear positive diagnosed patients are indiscriminately placed on DOTS, the current international TB treatment strategy. The implication is that NTM is inappropriately managed with first-line antituberculous drug [4, 5], worsening the patient¡¯s condition and raising the risk of drug resistance. Although it is known that most sputum smear positive patients are truly TB patients [6], the continued increase in TB drug resistance raises the question on the impact of this indiscriminate use of TB drugs to treat all diagnosed sputum smear positive patients. In assessing the
%U http://www.hindawi.com/journals/trt/2012/301056/