Rickettsial Infections in Monkeys, Malaysia

were white, and 18 (85.7%) were Asian/Pacific Islander. Mycobacterium tuberculosis and NTM were identified in samples from 3 (14.3%) and 18 (85.7%) of the 21 patients, respectively. Of the 18 patients with NTM-positive samples, 4 (22.2%) had definite NTM lung disease (all of these patients were Asian/Pacific Islander); 2 (11.1%) had probable NTM lung disease; and 12 (66.7%) had possible NTM lung disease. M. chelonae (identified by DNA sequencing) was the causative agent for most of the definite cases (n = 3, 75%), and the largest proportion of possible cases was caused by M. avian complex bacteria (n = 5, 41.7%). Our finding that 22.2% (4/18) of the patients in Honolulu with NTM-positive clinical samples during June–December 2011 received a definite diagnosis of NTM lung disease is slightly higher than but consistent with reports from other regions, which show that 9.8%–17.0% of such patients receive a definite NTM disease diagnosis (4,5). For unclear reasons, the number of NTM disease cases appears to be highest in Asian/Pacific Islander populations. Determining the reason(s) for this discrepancy should be the subject of future research efforts.