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SICU intern meeting DDx of NTMMTB MTB ARDS

Review article. Non-tuberculous mycobacterial infection ~From: Clinical Microbiology, karolinska University Laboratory, Solna, Stockholm, SwedenImaging of Non-tuberculous(Atypical) Mycobacterial Pulmonary Infection~From:Department of radiology, Royal Brompton Hospital, London, U.K.. NTM (Non tub

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SICU intern meeting DDx of NTMMTB MTB ARDS

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    1. SICU intern meeting DDx of NTM&MTB MTB & ARDS by Ri ???/ VS???

    2. Review article Non-tuberculous mycobacterial infection ~From: Clinical Microbiology, karolinska University Laboratory, Solna, Stockholm, Sweden Imaging of Non-tuberculous(Atypical) Mycobacterial Pulmonary Infection ~From:Department of radiology, Royal Brompton Hospital, London, U.K.

    3. NTM (Non tuberculous mycobacteria) Ubiquitous enviromental organism Lung infection following inhalation of NTM is the most common NTM disease but soft tissue infections may occur in connection with contaminated trauma or surgery

    5. Diagnosis Criteria of NTM

    6. Compare sensitivity of Acid fast stain of sputum smear and culture(NTM & MTB)

    7. Runyons Classification

    8. MTB PCR in relation to AFB

    9. Diagnosis of NTM A positive AFB smear combined with negative MTB-PCR denotes infection with NTM DNA-DNA hybridization for the M.avium-complex 16S rDNA-sequencing remain the gold standard in sophisticated species diagnosis of cultured NTM

    11. No1. M.avium-intracelluar

    12. No.1 M.avium-intracelluar

    13. No.1 M.avium-intracelluar

    14. No.2 M. kansasii

    15. No.2 M.kansasi

    16. No.3 M. xenopi

    17. N0.4 M.malmonense

    18. N0.6 M.malmoense

    19. Treatment NTM Medical treatment of most NTM pulmonary infection should continue at least sputum culture have been negative for 12 month The cure rate by medical treatment has been low in MAC lung disease, and early active thoracic surgery should always be considered in localized disease The successful outcome of NTM treatment was 74%

    20. Treatment of NTM Sensitivity testing in vitro to antimycobacterial drugs against NTM dose not always preclude the in vivo efficacy Only in case of relapse or suspected development of resistance of the NTM strain, sensitivity testing should be performed.

    21. ARDS ARDS is characterized by diffuse alveolar capillary damage, leading to severe pulmonary edema, respiratory failure, and arterial hypoxemia refractory to oxygen therapy.

    23. Conclusion 1 The anti- NTM drug susptibility patternis often typical for the species. Therefore, the correct and exact species identification is a key issue for clinical NTM isolation.

    24. Conclusion 2 NTM infection is not diagnosed on routine bacteriological screening of sputum or bronchial washings and the instigation of investigation to identify an NTM species may be prompted by the suggestion of the radiologist based on imaging feature alone.

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