The role of mycobacteremia screening in enhancing non-tuberculous mycobacteria detection in hospitalized persons with HIV
Among hospitalized severely immunocompromised persons with HIV (PWH), non-tuberculous mycobacteria (NTM) may be under-diagnosed due to non-specific symptoms undifferentiable with other opportunistic infections. To evaluate the prevalence of NTM mycobacteremia and how screening for mycobacteremia ass...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2025.1517418/full |
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| author | Mengjiao Miao Hongyan Zhu Ziyao Liu Jinjin Yang Yiting Zhang Chenyu Ma Jiamin Qin Yaling Chen Hongxia Wei Wei Chen Yongfeng Yang Zhiliang Hu Zhiliang Hu Zhiliang Hu |
| author_facet | Mengjiao Miao Hongyan Zhu Ziyao Liu Jinjin Yang Yiting Zhang Chenyu Ma Jiamin Qin Yaling Chen Hongxia Wei Wei Chen Yongfeng Yang Zhiliang Hu Zhiliang Hu Zhiliang Hu |
| author_sort | Mengjiao Miao |
| collection | DOAJ |
| description | Among hospitalized severely immunocompromised persons with HIV (PWH), non-tuberculous mycobacteria (NTM) may be under-diagnosed due to non-specific symptoms undifferentiable with other opportunistic infections. To evaluate the prevalence of NTM mycobacteremia and how screening for mycobacteremia assistant with identification of NTM infections, this study retrospectively analyzed 1,136 hospitalized PWH with CD4 counts <200 cells/μL, who underwent mycobacteremia screening at a tertiary hospital in Nanjing, China, between July 2018 and December 2023. The prevalence of non-tuberculous mycobacteremia was 5.8% (95% CI, 4.6–7.3%), with a higher prevalence of 8.6% (95% CI, 6.7–10.9%) in patients with CD4 counts <50 cells/μL, compared to 1.4% (95% CI, 0.6–3.0%) in those with CD4 counts ≥50 cells/μL. Mycobacterium avium complex (MAC) was the predominant pathogen, representing 95% (95% CI, 86.7–98.3%) of positive blood cultures, though it accounted for only 66.2% (95% CI, 54.3–76.3%) of NTM species isolated from respiratory samples. The sensitivity of mycobacterial blood cultures (MBC) in diagnosing all culture-proven NTM infections was 63.9% (95% CI, 54.0–72.8%), increasing to 75.7% (95% CI, 64.8–84.0%) in patients with CD4 counts <50 cells/μL. Notably, mycobacteremia served as the sole microbiological evidence in approximately 25% of all culture-proven NTM infections during initial hospitalization, where other specimen sources failed to yield conclusive evidence. These findings underscore the importance of mycobacteremia screening in improving the detection of NTM infections among severely immunocompromised hospitalized patients, especially those with CD4 counts <50 cells/μL, and highlight the value of incorporating MBC into diagnostic protocols to enhance clinical management of these high-risk individuals. |
| format | Article |
| id | doaj-art-3cc8471b5b6c4a9d99e2bb2dcc624aa3 |
| institution | Kabale University |
| issn | 1664-302X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Microbiology |
| spelling | doaj-art-3cc8471b5b6c4a9d99e2bb2dcc624aa32025-01-31T06:39:58ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2025-01-011610.3389/fmicb.2025.15174181517418The role of mycobacteremia screening in enhancing non-tuberculous mycobacteria detection in hospitalized persons with HIVMengjiao Miao0Hongyan Zhu1Ziyao Liu2Jinjin Yang3Yiting Zhang4Chenyu Ma5Jiamin Qin6Yaling Chen7Hongxia Wei8Wei Chen9Yongfeng Yang10Zhiliang Hu11Zhiliang Hu12Zhiliang Hu13Department of Infectious Disease, School of Public Health of Nanjing Medical University, The Second Hospital of Nanjing, Nanjing, ChinaDepartment of Infectious Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Infectious Disease, School of Public Health of Nanjing Medical University, The Second Hospital of Nanjing, Nanjing, ChinaDepartment of Infectious Disease, School of Public Health of Nanjing Medical University, The Second Hospital of Nanjing, Nanjing, ChinaDepartment of Infectious Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Infectious Disease, School of Public Health of Nanjing Medical University, The Second Hospital of Nanjing, Nanjing, ChinaClinical Research Center, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Infectious Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Infectious Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, ChinaClinical Research Center, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Infectious Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Infectious Disease, School of Public Health of Nanjing Medical University, The Second Hospital of Nanjing, Nanjing, ChinaDepartment of Infectious Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, ChinaCenter for Global Health, School of Public Health, Nanjing Medical University, Nanjing, ChinaAmong hospitalized severely immunocompromised persons with HIV (PWH), non-tuberculous mycobacteria (NTM) may be under-diagnosed due to non-specific symptoms undifferentiable with other opportunistic infections. To evaluate the prevalence of NTM mycobacteremia and how screening for mycobacteremia assistant with identification of NTM infections, this study retrospectively analyzed 1,136 hospitalized PWH with CD4 counts <200 cells/μL, who underwent mycobacteremia screening at a tertiary hospital in Nanjing, China, between July 2018 and December 2023. The prevalence of non-tuberculous mycobacteremia was 5.8% (95% CI, 4.6–7.3%), with a higher prevalence of 8.6% (95% CI, 6.7–10.9%) in patients with CD4 counts <50 cells/μL, compared to 1.4% (95% CI, 0.6–3.0%) in those with CD4 counts ≥50 cells/μL. Mycobacterium avium complex (MAC) was the predominant pathogen, representing 95% (95% CI, 86.7–98.3%) of positive blood cultures, though it accounted for only 66.2% (95% CI, 54.3–76.3%) of NTM species isolated from respiratory samples. The sensitivity of mycobacterial blood cultures (MBC) in diagnosing all culture-proven NTM infections was 63.9% (95% CI, 54.0–72.8%), increasing to 75.7% (95% CI, 64.8–84.0%) in patients with CD4 counts <50 cells/μL. Notably, mycobacteremia served as the sole microbiological evidence in approximately 25% of all culture-proven NTM infections during initial hospitalization, where other specimen sources failed to yield conclusive evidence. These findings underscore the importance of mycobacteremia screening in improving the detection of NTM infections among severely immunocompromised hospitalized patients, especially those with CD4 counts <50 cells/μL, and highlight the value of incorporating MBC into diagnostic protocols to enhance clinical management of these high-risk individuals.https://www.frontiersin.org/articles/10.3389/fmicb.2025.1517418/fullnon-tuberculous mycobacteriamycobacteremiaHIVmycobacterial avium complexscreening |
| spellingShingle | Mengjiao Miao Hongyan Zhu Ziyao Liu Jinjin Yang Yiting Zhang Chenyu Ma Jiamin Qin Yaling Chen Hongxia Wei Wei Chen Yongfeng Yang Zhiliang Hu Zhiliang Hu Zhiliang Hu The role of mycobacteremia screening in enhancing non-tuberculous mycobacteria detection in hospitalized persons with HIV Frontiers in Microbiology non-tuberculous mycobacteria mycobacteremia HIV mycobacterial avium complex screening |
| title | The role of mycobacteremia screening in enhancing non-tuberculous mycobacteria detection in hospitalized persons with HIV |
| title_full | The role of mycobacteremia screening in enhancing non-tuberculous mycobacteria detection in hospitalized persons with HIV |
| title_fullStr | The role of mycobacteremia screening in enhancing non-tuberculous mycobacteria detection in hospitalized persons with HIV |
| title_full_unstemmed | The role of mycobacteremia screening in enhancing non-tuberculous mycobacteria detection in hospitalized persons with HIV |
| title_short | The role of mycobacteremia screening in enhancing non-tuberculous mycobacteria detection in hospitalized persons with HIV |
| title_sort | role of mycobacteremia screening in enhancing non tuberculous mycobacteria detection in hospitalized persons with hiv |
| topic | non-tuberculous mycobacteria mycobacteremia HIV mycobacterial avium complex screening |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2025.1517418/full |
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