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Mycobacterium Avium Complex

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261. HIV-related opportunistic infections

infections (TB and disseminated Mycobacterium avium complex ), but may also develop with other OIs. Primary and secondary prophylaxis against OIs is essential in the prevention of an initial or recurrent episode of OIs in HIV-infected patients. Prophylaxis against many OIs can be discontinued for patients who respond to ART and maintain a CD4+ count above the recommended threshold for more than 3 months. However, if the CD4+ count decreases below that threshold, prophylaxis should be resumed. Definition (...) HIV-related opportunistic infections (OIs) are clinical syndromes that arise as a consequence of impaired immunity in advanced stages of HIV infection. These illnesses tend to occur most often in patients who have untreated HIV infection or who fail to benefit from antiretroviral treatment. Tuberculosis, Pneumocystis jiroveci pneumonia, candidiasis, cryptococcosis, toxoplasmosis, cytomegalovirus, and Mycobacterium avium complex infections are among the HIV-related OIs often encountered in clinical

2018 BMJ Best Practice

262. Assessment of unintentional weight loss

Pulmonary cachexia syndrome Cystic fibrosis Microscopic polyangiitis Renal cachexia syndrome Diabetes mellitus Adrenal insufficiency Hypopituitarism Pheaochromocytoma Rheumatoid arthritis Systemic lupus erythematosus Granulomatosis with polyangiitis (Wegener's) Polyarteritis nodosa Systemic sclerosis (scleroderma) Sarcoidosis Mixed connective tissue disease (overlap syndromes) Adult-onset Still disease HIV infection Tuberculosis (extrapulmonary) Mycobacterium avium-intracellulare (MAI) Histoplasmosis (...) ://www.ncbi.nlm.nih.gov/pubmed/26577421?tool=bestpractice.com Pathophysiology The pathophysiology varies depending on the aetiology. Weight homeostasis is a complex process that includes the availability of food, physical activity, possible environmental exposures, and hormonal control with peptides such as leptin, cholecystokinin, and ghrelin. Guyenet SJ, Schwartz MW. Regulation of food intake, energy balance, and body fat mass: implications for the pathogenesis and treatment of obesity. J Clin Endocrinol Metab

2018 BMJ Best Practice

263. HIV-related opportunistic infections

infections (TB and disseminated Mycobacterium avium complex ), but may also develop with other OIs. Primary and secondary prophylaxis against OIs is essential in the prevention of an initial or recurrent episode of OIs in HIV-infected patients. Prophylaxis against many OIs can be discontinued for patients who respond to ART and maintain a CD4+ count above the recommended threshold for more than 3 months. However, if the CD4+ count decreases below that threshold, prophylaxis should be resumed. Definition (...) HIV-related opportunistic infections (OIs) are clinical syndromes that arise as a consequence of impaired immunity in advanced stages of HIV infection. These illnesses tend to occur most often in patients who have untreated HIV infection or who fail to benefit from antiretroviral treatment. Tuberculosis, Pneumocystis jiroveci pneumonia, candidiasis, cryptococcosis, toxoplasmosis, cytomegalovirus, and Mycobacterium avium complex infections are among the HIV-related OIs often encountered in clinical

2018 BMJ Best Practice

264. Handbook on tuberculosis laboratory diagnostic methods in the European Union

diagnosis of tuberculosis 7 2 Quality assurance 7 3 Latent TB infections 7 4 Smear microscopy 7 5 Culture for Mycobacterium tuberculosis complex 7 6 Identification of Mycobacterium tuberculosis and drug resistance in cultures and sputum using molecular assays 8 7 First- and second-line drug susceptibility testing for Mycobacterium tuberculosis complex 8 8 Molecular typing of Mycobacterium tuberculosis complex isolates 8 9 Use and validation of disinfectants for M. tuberculosis 8 10 Information (...) 45 4.9.1 Quality control parameters 45 References 45 5. Culture tests for Mycobacterium tuberculosis complex 47 5.1 Background and principles 47 5.2 Biohazards and biosafety in the TB laboratory 47 5.2.1 Minimum WHO recommendations for TB culture/drug susceptibility testing facilities 48 5.3 Specimen collection, storage and transport 49 5.3.1 Sample collection 49 5.3.2 Storage of specimens 50 5.3.3 Transportation of specimens 50 5.4 Homogenisation and decontamination of specimens 50 5.4.1

2018 European Centre for Disease Prevention and Control - Technical Guidance

265. Acute Respiratory Illness in Immunocompromised Patients

are the mainstay imaging modalities in evaluating the immunocompromised host with ARI, nuclear scintigraphy using gallium-67 (Ga-67) or Tc-99m diethylenetriamine penta acetate (DTPA) radiotracers have quite specific but rarely used indications in this setting. Ga-67 can be used to help diagnose Mycobacterium avium intracellulare, Mycobacterium tuberculosis, and lymphoma based on increased radiotracer activity in hilar and mediastinal lymph nodes. However, this finding is nonspecific, and distinguishing between (...) . Generally, the complexity and severity of a patient’s clinical condition should dictate the selection of appropriate imaging procedures or treatments. Only those examinations generally used for evaluation of the patient’s condition are ranked. Other imaging studies necessary to evaluate other co-existent diseases or other medical consequences of this condition are not considered in this document. The availability of equipment or personnel may influence the selection of appropriate imaging procedures

2019 American College of Radiology

266. CRACKCast Episode 183 – The Immunocompromised Patient

and are found in high concentrations in blood and spleen recognize infected cells and respond by directly killing these cells secrete cytokines that activate macrophages to destroy phagocytosed microbes important in defense against intracellular microbes particularly viruses and intracellular bacteria such as L. monocytogenes. CELLULAR IMMUNE DYSFUNCTION Bacteria Listeria monocytogenes Salmonella sp. Mycobacterium tuberculosis Mycobacterium avium-intracellulare Legionella sp. Nocardia sp. Fungi Cryptococcus (...) the respiratory or gastrointestinal tract. Immunoglobulin E (IgE), surface of mast cells and basophils responsible for immediate-type hypersensitivity reactions important in defense against helminthic pathogens. IgG widely distributed in tissues accounts for 75% of the total immunoglobulin mass. It crosses the placenta and provides fetal immunity during the first 6 months of life Congenital or acquired deficiencies of IgG lead to infection with encapsulated organisms Complement complex interaction of 30

2018 CandiEM

267. Cough Due to Tuberculous and Other Chronic Infections

resolution was fasterin the absence of cavitary lung disease. All studies on cough prevalence in Mycobacterium avium complex (MAC) lung disease, other nontuberculous mycobacterial infections, fungal lung disease, and paragonimiasis were of poor quality and were excluded from the evidence review. ABBREVIATIONS: ACF = active case ?nding; ART = antiretroviral therapy; CD4 = CD4-positive T lymphocytes; CHEST = American College of Chest Physicians; DOTS = Directly Observed Treatment, Short Course; GRADE (...) resistance, poor adherence, and/or drug malabsorption compared with results in other in- dividualswithpulmonaryTB.CoughiscommoninpatientswithlunginfectionsduetoMAC, other nontuberculous mycobacteria, fungal diseases, and paragonimiasis. CHEST2018;153(2):467-497 KEY WORDS: cough; evidence-based medicine; fungal infections; Mycobacterium avium complex; nontuberculous mycobacterial; paragonimiasis; TB Summary of Recommendations and Suggestions 1. For patients with cough in high TB prevalence countries

2018 American College of Chest Physicians

269. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology Full Text available with Trip Pro

of the Gastrointestinal Tract VIII. Intra-abdominal Infections IX. Bone and Joint Infections X. Urinary Tract Infections XI. Genital Infections XII. Skin and Soft Tissue Infections XIII. Arthropod-Borne Infections XIV. Viral Syndromes XV. Blood and Tissue Parasite Infections EXECUTIVE SUMMARY INTRODUCTION Unlike other areas of the diagnostic laboratory, clinical microbiology is a science of interpretive judgment that is becoming more complex, not less. Even with the advent of laboratory automation and the integration (...) container, RT, 2 h Abbreviations: AFB, acid-fast bacilli; CDC, Centers for Disease Control and Prevention; EDTA, ethylenediaminetetraacetic acid; NAAT, nucleic acid amplification test; RT, room temperature. a Contact the microbiology laboratory regarding appropriate collection and transport devices and procedures as transport media such as Cary-Blair or parasite preservative transport for stool specimens, boric acid for urines, and specialized containers for Mycobacterium tuberculosis are often critical

2018 Infectious Diseases Society of America

270. Evaluation of the GenoType Mycobacteria Direct for direct detection of Mycobacterium tuberculosis complex obtained from sputum samples. Full Text available with Trip Pro

Evaluation of the GenoType Mycobacteria Direct for direct detection of Mycobacterium tuberculosis complex obtained from sputum samples. An increase in the prevalence of tuberculosis (TB) in recent years has accelerated the search for novel tools for the rapid diagnosis of TB infection. This study evaluated the GenoType Mycobacteria Direct (GTMD) assay (Hain Lifescience) for direct detection of the Mycobacterium tuberculosis complex (MTBC) from sputum samples and compared it with conventional (...) methods. The GTMD test is a commercial assay produced using strip techniques and works based on a nucleic acid sequence-based amplification technique. This test allows 23S rRNA amplification-based detection of MTBC, Mycobacterium avium, Mycobacterium intracellulare, Mycobacterium kansasii and Mycobacterium malmoense directly from decontaminated clinical samples within 6 h. In the present study, 115 sputum samples were processed to detect acid-fast bacilli (AFB) using two microscopy methods (carbol

2010 Journal of Medical Microbiology

271. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline Full Text available with Trip Pro

species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as Mycobacterium avium complex, Mycobacterium kansasii , and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. A panel of experts was carefully

2020 EvidenceUpdates

272. CRACKCast Episode 132 – HIV/AIDS

prophylaxis is indicated and is cost-effective. Prophylaxis is started for PCP when CD4+ counts are less than 200 cells/μL, for toxoplasmosis, when CD4+ counts are less than 100 cells/μL and, for Mycobacterium avium complex (MAC) infection, when CD4+ counts are less than 50 cells/μL (Table 124.2). [2] List 5 risk factors for HIV / AIDS Contact with semen, blood, vaginal secretions, and breast milk of viremic individuals These fluids must come into contact with damaged tissue / mucous membrane / entry (...) , spleen, or nodes), onset at age >1 mo Cytomegalovirus retinitis (with loss of vision) Encephalopathy, HIV related Herpes simplex: chronic ulcers (>1 mo duration) or bronchitis, pneumonitis, or esophagitis (onset at age >1 mo) Histoplasmosis, disseminated or extrapulmonary Isosporiasis, chronic intestinal (>1 mo duration) Lymphoma, Burkitt’s (or equivalent term) Kaposi’s sarcoma Lymphoma, immunoblastic (or equivalent term) Lymphoma, primary, of brain Mycobacterium avium complex or Mycobacterium

2017 CandiEM

273. CRACKCast E094 – Gastroenteritis

species Rotavirus—South America, Asia, Africa Recent camping Giardia, Aeromonas, Cryptosporidium Recent antibiotics: Increase in C. difficile infection Daycare exposure: Rotavirus Exposure to raw seafood: Non Cholera Vibrio Anal-receptive sex—men who have sex with men: Shigella, Campylobacter, Salmonella HIV-positive status: Mycobacterium avium-intracellular complex, microsporidia, CMV, Giardia Outbreaks: Cruise ships—norovirus Contaminated local water, food, products, restaurants; organism usually (...) work-up. What additional steps may be required? Usual bacterial suspects plus (don’t forget primary HIV induced diarrhea, HAART induced, and salmonella / vibrio!): Cytomegalovirus Cyclospora Cryptosporidium Isospora Mycobacterium avium-intracellulare complex Giardia Workup: Stool examination & cultures C Diff toxins and salmonella PCR CMV and MAI if CD4+ count <200 Acid fast smear for Cryptosporidium, Cystoisospora, Isospora, and Cyclospora sigmoidoscopy *If above workup negative consider small

2017 CandiEM

274. Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea Full Text available with Trip Pro

organisms including, but not limited to, Cryptosporidium , Cyclospora , Cystoisospora , microsporidia, Mycobacterium avium complex, and cytomegalovirus (strong, moderate). 13. Diagnostic testing is not recommended in most cases of uncomplicated traveler’s diarrhea unless treatment is indicated. Travelers with diarrhea lasting 14 days or longer should be evaluated for intestinal parasitic infections (strong, moderate). Testing for C. difficile should be performed in travelers treated with antimicrobial (...) Hemochromatosis or hemoglobinopathy Y. enterocolitica , Salmonella AIDS, immunosuppressive therapies Cryptosporidium , Cyclospora , Cystoisospora , microsporidia, Mycobacterium avium –intercellulare complex, cytomegalovirus Anal-genital, oral-anal, or digital-anal contact Shigella , Salmonella , Campylobacter , E. histolytica , Giardia lamblia , Cryptosporidium as well as sexually transmitted infections Exposure or Condition Pathogen(s) Foodborne Foodborne outbreaks in hotels, cruise ships, resorts

2017 Infectious Diseases Society of America

275. Diagnosis of Tuberculosis in Adults and Children: Official ATS/IDSA/CDC Clinical Practice Guidelines

tests (NAATs) should be available with rapid turnaround times from specimen collection. Table 2. Essential Laboratory Tests for the Detection of Mycobacterium tuberculosis Test Time Required I. Nucleic acid amplification test, detection (NAAT -TB) 1 d II. Nucleic acid amplification test, resistance markers (NAAT -R) 1–2 d III. Acid-fast bacilli microscopy 1 d IV. Growth detection Liquid Solid Up to 6–8 wk (average 10–14 d) (average 3–4 wk) V. Identification of Mycobacterium tuberculosis complex (...) Health, Nashville, Tennessee, 14 Wisconsin State Laboratory of Hygiene, Madison, and 15 University of Arkansas for Medical Sciences, Little Rock Background. Individuals infected with Mycobacterium tuberculosis (Mtb) may develop symptoms and signs of disease (tuber- culosis disease) or may have no clinical evidence of disease (latent tuberculosis infection [LTBI]). Tuberculosis disease is a leading cause of infectious disease morbidity and mortality worldwide, yet many questions related to its

2017 American Thoracic Society

276. Float Tanks: Review of Current Guidance and Considerations for Public Health Inspectors

, Department of Health; 2015. p. 5. Available from: http://ww2.health.wa.gov.au/~/media/Files/Corporate/gene ral%20documents/water/PDF/Guidelines-for-Float- Tanks.ashx. 16. Moraga-McHaley SA, Landen M, Krapfl H, Sewell CM. Hypersensitivity pneumonitis with Mycobacterium avium complex among spa workers. Int J Occup Environ Health. 2013 Jan-Mar;19(1):55-61. 17. U.S. Centers for Disease Control and Prevention. The Model Aquatic Health Code (MAHC): an all-inclusive model public swimming pool and spa code

2017 National Collaborating Centre for Environmental Health

277. Antibiotic treatment for nontuberculous mycobacteria lung infection in people with cystic fibrosis. Full Text available with Trip Pro

Antibiotic treatment for nontuberculous mycobacteria lung infection in people with cystic fibrosis. Nontuberculous mycobacteria are mycobacteria, other than those in the Mycobacterium tuberculosis complex, and are commonly found in the environment. Nontuberculous mycobacteria species (most commonly Mycobacterium avium complex and Mycobacterium abscessus) are isolated from the respiratory tract of approximately 5% to 40% of individuals with cystic fibrosis; they can cause lung disease in people (...) evidence for the effectiveness of different antimicrobial treatment for nontuberculous mycobacteria lung disease in people with cystic fibrosis. Until such evidence becomes available, it is reasonable for clinicians to follow published clinical practice guidelines for the diagnosis and treatment of nodular or bronchiectatic pulmonary disease due to Mycobacterium avium complex or Mycobacterium abscessus in patients with cystic fibrosis.

2016 Cochrane

278. Arikayce - antibiotic containing the active substance amikacin

application for Arikayce (amikacin) On 8 June 2016, Insmed Limited officially notified the Committee for Medicinal Products for Human Use (CHMP) that it wishes to withdraw its application for a marketing authorisation for Arikayce intended for the treatment of Mycobacterium avium complex (MAC) lung disease. What is Arikayce? Arikayce is an antibiotic containing the active substance amikacin. It was to be available as a suspension for inhalation. What was Arikayce expected to be used for? Arikayce (...) was expected to be used to treat adults with a lung infection caused by Mycobacterium avium complex (MAC), a group of bacteria commonly found in the environment, such as in soil and water. It was to be used in patients whose infection has persisted despite previous treatment. Arikayce was designated an ‘orphan medicine’ (a medicine to be used in rare diseases) on 8 April 2014 for treating infections caused by MAC and similar bacteria. Further information on the orphan designation can be found here. How

2016 European Medicines Agency - EPARs

279. Pathology tests for active mycobacterial infection

amplification test for the detection of Mycobacterium tuberculosis complex in patients with signs and symptoms consistent with active tuberculosis. Fee: To be advised MBS item number Nucleic acid amplification test for the detection of non-tuberculous mycobacteria species in patients with a compatible clinical disease. Fee: To be advised 7. Summary of Public Consultation Feedback/Consumer Issues No specific Consumer impact statement was provided in the assessment. 8. Mycoba The use an addit intende for who (...) patients with other specimen types such as HIV-positive with M. avium complex (MAC) disease or patients with disseminated bacteraemia. NAAT testing identifies a complex of mycobacteria however, there are different NAAT tests for different types of mycobacteria. ESC considered that under certain circumstances for one patient for the same episode multiple NAAT tests may be required. ESC agreed that the proposed comparators were appropriate. However, ESC noted that culture is an imperfect reference

2015 Medical Services Advisory Committee

280. Cough Due to TB and Other Chronic Infections: CHEST Guideline and Expert Panel Report Full Text available with Trip Pro

. The Xpert MTB/RIF assay on sputum is more cost-effective than clinical diagnosis. To our knowledge, no published comparative studies addressed whether the rate of cough resolution is a reliable determinant of the response to treatment or whether the rate of cough resolution was faster in the absence of cavitary lung disease. All studies on cough prevalence in Mycobacterium avium complex (MAC) lung disease, other nontuberculous mycobacterial infections, fungal lung disease, and paragonimiasis were

2018 EvidenceUpdates

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