PDF(Pubmed)
Abstract：
BACKGROUND: Nontuberculous mycobacteria (NTM) are the cause of chronic lung disease called NTM lung disease (NTM-LD). There are about 180 known species of NTM. Nowadays the number of NTM-LD is increasing.
OBJECTIVE: To evaluate the clinical significance of NTM isolated from specimens and assess the frequency and clinical relevance of isolation of NTM in the Regional Center of Pulmonology in Bydgoszcz, hospital of Northern Poland.
METHODS: Clinical, radiological, and microbiological data were collected from all patients from whom NTM was isolated between 2013 and 2022. Data were reviewed retrospectively. Diagnostic criteria for NTM-LD published by the American Thoracic Society (ATS) were used to determine clinical relevance.
METHODS: The study comprised 81,985 clinical specimens submitted for mycobacterial culture in the Department of Microbiology at the Regional Center of Pulmonology in Bydgoszcz between 2013 and 2022. Clinical specimens were processed according to the standard procedure in mycobacteria laboratories in Poland. NTM strains were identified using analysis of mycolic acids by chromatography as well as GenoType NTM-DR, GenoType Mycobacterium AS, and GenoType Mycobacterium CM.
RESULTS: There were 395 patients with NTM strains between 2013 and 2022. Out of them, 149 cases met the diagnostic criteria of NTM-LD and were classified as definite cases. M. kansasii (n = 77) was the most common species in the group (51.68%), followed by M. avium complex (n = 46). Patients with NTM-LD were 22-88 years old (median age was 60 years). There were 81 men and 68 women. The most common symptoms were cough, hemoptysis, and fever. Radiological X-ray images were dominated by infiltrative lesions in the upper and middle lobe of the right lung with cavities; the changes were in the upper lobe of the left lung and on both sides of the chest. They were smokers in 61%. The most common concomitant diseases were chronic obstructive pulmonary disease (COPD), diabetes mellitus, pulmonary carcinoma, and human immunodeficiency virus (HIV) infection, and other immunodeficiencies. The most common treatment was isoniazid, ethambutol, rifampicin, and ofloxacin for 18 months with a minimum of 12 months of culture negativity.
CONCLUSIONS: NTM-LD infections are present with other pulmonary illnesses and extrapulmonary diseases and may be connected to primary immunologic deficiencies. These diseases concern patients of all ages and have various clinical manifestations. M. kansasii and MAC are the most prevalent NTM isolates among respiratory samples in Northern Poland. In addition, an increase in MAC and a decrease in M. kansasii both in cultivation and the cause of NTM-LD were reported.
OBJECTIVE: To evaluate the clinical significance of NTM isolated from specimens and assess the frequency and clinical relevance of isolation of NTM in the Regional Center of Pulmonology in Bydgoszcz, hospital of Northern Poland.
METHODS: Clinical, radiological, and microbiological data were collected from all patients from whom NTM was isolated between 2013 and 2022. Data were reviewed retrospectively. Diagnostic criteria for NTM-LD published by the American Thoracic Society (ATS) were used to determine clinical relevance.
METHODS: The study comprised 81,985 clinical specimens submitted for mycobacterial culture in the Department of Microbiology at the Regional Center of Pulmonology in Bydgoszcz between 2013 and 2022. Clinical specimens were processed according to the standard procedure in mycobacteria laboratories in Poland. NTM strains were identified using analysis of mycolic acids by chromatography as well as GenoType NTM-DR, GenoType Mycobacterium AS, and GenoType Mycobacterium CM.
RESULTS: There were 395 patients with NTM strains between 2013 and 2022. Out of them, 149 cases met the diagnostic criteria of NTM-LD and were classified as definite cases. M. kansasii (n = 77) was the most common species in the group (51.68%), followed by M. avium complex (n = 46). Patients with NTM-LD were 22-88 years old (median age was 60 years). There were 81 men and 68 women. The most common symptoms were cough, hemoptysis, and fever. Radiological X-ray images were dominated by infiltrative lesions in the upper and middle lobe of the right lung with cavities; the changes were in the upper lobe of the left lung and on both sides of the chest. They were smokers in 61%. The most common concomitant diseases were chronic obstructive pulmonary disease (COPD), diabetes mellitus, pulmonary carcinoma, and human immunodeficiency virus (HIV) infection, and other immunodeficiencies. The most common treatment was isoniazid, ethambutol, rifampicin, and ofloxacin for 18 months with a minimum of 12 months of culture negativity.
CONCLUSIONS: NTM-LD infections are present with other pulmonary illnesses and extrapulmonary diseases and may be connected to primary immunologic deficiencies. These diseases concern patients of all ages and have various clinical manifestations. M. kansasii and MAC are the most prevalent NTM isolates among respiratory samples in Northern Poland. In addition, an increase in MAC and a decrease in M. kansasii both in cultivation and the cause of NTM-LD were reported.
摘要：
背景：非结核分枝杆菌（NTM）是慢性肺部疾病的病因，称为NTM肺病（NTM-LD）。有大约180种已知的NTM。如今,NTM-LD的数量正在增加。
目的：评估从标本中分离的NTM的临床意义，并评估比得哥什地区肺科中心分离NTM的频率和临床相关性，波兰北部医院
方法：临床，放射学,从2013年至2022年分离NTM的所有患者收集微生物学数据。对数据进行了回顾性审查。美国胸科学会（ATS）发布的NTM-LD诊断标准用于确定临床相关性。
方法：该研究包括2013年至2022年间在比得哥什地区肺病中心微生物学系提交的用于分枝杆菌培养的81,985份临床标本。根据波兰分枝杆菌实验室的标准程序处理临床标本。通过色谱法以及GenoTypeNTM-DR对霉菌酸进行分析来鉴定NTM菌株，基因型分枝杆菌AS,和基因型分枝杆菌CM。
结果：2013年至2022年期间，有395例NTM菌株患者。在他们当中,149例符合NTM-LD诊断标准,均为确诊病例。M.kansasii（n=77）是该组中最常见的物种（51.68％），其次是M.avium复合物（n=46）。NTM-LD患者年龄为22-88岁（中位年龄为60岁）。有81名男性和68名女性。最常见的症状是咳嗽,咯血,和发烧。放射学X线图像以右肺上叶和中叶的浸润性病变为主，并有空洞；变化在左肺上叶和胸部两侧。吸烟者占61%。最常见的伴随疾病是慢性阻塞性肺疾病（COPD），糖尿病,肺癌,和人类免疫缺陷病毒（HIV）感染，和其他免疫缺陷。最常见的治疗方法是异烟肼，乙胺丁醇,利福平,和氧氟沙星18个月，至少12个月的培养阴性。
结论：NTM-LD感染存在于其他肺部疾病和肺外疾病中，可能与原发性免疫缺陷有关。这些疾病涉及所有年龄段的患者，并具有各种临床表现。在波兰北部的呼吸道样本中，M.kansasii和MAC是最普遍的NTM分离株。此外,据报道，在栽培和NTM-LD的原因中，MAC的增加和M.kansasii的减少。
目的：评估从标本中分离的NTM的临床意义，并评估比得哥什地区肺科中心分离NTM的频率和临床相关性，波兰北部医院
方法：临床，放射学,从2013年至2022年分离NTM的所有患者收集微生物学数据。对数据进行了回顾性审查。美国胸科学会（ATS）发布的NTM-LD诊断标准用于确定临床相关性。
方法：该研究包括2013年至2022年间在比得哥什地区肺病中心微生物学系提交的用于分枝杆菌培养的81,985份临床标本。根据波兰分枝杆菌实验室的标准程序处理临床标本。通过色谱法以及GenoTypeNTM-DR对霉菌酸进行分析来鉴定NTM菌株，基因型分枝杆菌AS,和基因型分枝杆菌CM。
结果：2013年至2022年期间，有395例NTM菌株患者。在他们当中,149例符合NTM-LD诊断标准,均为确诊病例。M.kansasii（n=77）是该组中最常见的物种（51.68％），其次是M.avium复合物（n=46）。NTM-LD患者年龄为22-88岁（中位年龄为60岁）。有81名男性和68名女性。最常见的症状是咳嗽,咯血,和发烧。放射学X线图像以右肺上叶和中叶的浸润性病变为主，并有空洞；变化在左肺上叶和胸部两侧。吸烟者占61%。最常见的伴随疾病是慢性阻塞性肺疾病（COPD），糖尿病,肺癌,和人类免疫缺陷病毒（HIV）感染，和其他免疫缺陷。最常见的治疗方法是异烟肼，乙胺丁醇,利福平,和氧氟沙星18个月，至少12个月的培养阴性。
结论：NTM-LD感染存在于其他肺部疾病和肺外疾病中，可能与原发性免疫缺陷有关。这些疾病涉及所有年龄段的患者，并具有各种临床表现。在波兰北部的呼吸道样本中，M.kansasii和MAC是最普遍的NTM分离株。此外,据报道，在栽培和NTM-LD的原因中，MAC的增加和M.kansasii的减少。
