Extensively Drug-Resistant Mycobacterium tuberculosis from Aspirates, Rural South Africa

EID Journal Home > Volume 16, Number 3–March 2010

Volume 16, Number 3–March 2010
CME ACTIVITY
Extensively Drug-Resistant Mycobacterium tuberculosis from Aspirates, Rural South Africa

Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians. Medscape, LLC designates this educational activity for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test and/or complete the evaluation at www.medscapecme.com/journal/eid; (4) view/print certificate.

Learning Objectives
Upon completion of this activity, participants will be able to:

Recognize how concomitant HIV infection can affect the diagnosis of tuberculosis
Describe procedures and patient characteristics in the current study
Identify how aspirate cultures can help identify extensively drug-resistant tuberculosis
Specify the percentage of patients with tuberculosis who were diagnosed with aspirate but not sputum cultures.
CME Editor
Karen L. Foster, Writer/Editor, Emerging Infectious Diseases. Disclosure: Karen L. Foster has disclosed no relevant financial relationships.

CME Author
Charles P. Vega, MD, Associate Professor; Residency Director, Department of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.

Authors
Disclosures: Scott K. Heysell, MD, MPH; Anthony P. Moll, MBChB; Neel R. Gandhi, MD; François J. Eksteen, MD; Palav Babaria, MD; Yacoob Coovadia, MBBCh, FCPath; Lynn Roux; Gerald Friedland, MD; and N. Sarita Shah, MD, have disclosed no relevant financial relationships. Umesh Lalloo, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for AstraZeneca Pharmaceuticals LP, GlaxoSmithKline, and Boehringer Ingelheim Pharmaceuticals, Inc.; served as a speaker or a member of a speakers bureau for AstraZeneca Pharmaceuticals LP, GlaxoSmithKline, Boehringer Ingelheim Pharmaceuticals, Inc.; received grants for clinical research from the National Institutes of Health.

Abstract
The yield from aspirating lymph nodes and pleural fluid for diagnosing extensively drug-resistant (XDR) tuberculosis is unknown. Mycobacterium tuberculosis was cultured from lymph node or pleural fluid aspirates of 21 patients; 7 (33%) cultures grew XDR M. tuberculosis. Additive diagnostic yield for XDR M. tuberculosis was found in parallel culture of sputum and fluid aspirate.

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