Korean J Clin Microbiol.  2012 Sep;15(3):98-103. 10.5145/KJCM.2012.15.3.98.

Nontuberculous Mycobacteria Isolated from Respiratory Specimens during Recent Two Years: Distribution and Clinical Significance

Affiliations
  • 1School of Medicine, Gachon University School of Medicine, Incheon, Korea.
  • 2Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea. seoyh@gilhospital.com
  • 3Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea.

Abstract

BACKGROUND
The isolation of nontuberculous mycobacteria (NTM) has been increasing worldwide as well as its clinical importance. The aim of this study was to investigate the distribution and clinical significance of NTM that has been isolated from respiratory specimens during a recent two-year period at a tertiary hospital.
METHODS
We analyzed respiratory samples that were obtained between January 2009 and December 2010 for AFB culture. We retrospectively reviewed the electronic medical records of these patients to obtain both clinical and radiologic information. NTM pulmonary disease was defined by using the guidelines provided by the America Thoracic Society/Infectious Diseases Society of America.
RESULTS
Among the 1,601 specimens that resulted in a positive AFB culture, 310 (19.4%) were NTM. In 189 patients, the most common isolate was M. avium-intracellulare complex (MAC) (127, 67.2%), which was then followed by M. abscessus (31, 16.4%), M. fortuitum (10, 5.3%), M. kansasii (9, 4.8%), and other NTM species. Of these, 93 (49.2%) patients were diagnosed with NTM pulmonary disease. MAC, M. abscessus, and M. kansasii were more virulent than the other species. None of the cases of NTM pulmonary disease were caused by M. fortuitum, M. chelonae, M. peregrinum, M. terrae complex, or M. gordonae.
CONCLUSION
In Korea, the prevalence of NTM isolates is increasing, as are the cases of pulmonary disease. The pathogenic potential of NTM differs enormously by species and as a result the treatment of NTM lung disease depends on which species has caused the infection. The isolation and identification of NTM isolated from respiratory specimens are mandatory in order for clinical microbiology laboratories to make an accurate diagnosis and suggest the proper treatment of the NTM disease.

Keyword

Mycobacteria; Nontuberculous mycobacteria; Respiratory specimen

MeSH Terms

Americas
Electronic Health Records
Humans
Korea
Lung Diseases
Nontuberculous Mycobacteria
Prevalence
Retrospective Studies

Reference

1. Medical Section of the American Lung Association. Diagnosis and treatment of disease caused by nontuberculous mycobacteria. This official statement of the American Thoracic Society was approved by the Board of Directors, March 1997. Am J Respir Crit Care Med. 1997. 156:S1–S25.
2. Subcommittee of the Joint Tuberculosis Committee of the British Thoracic Society. Management of opportunist mycobacterial infections: Joint Tuberculosis Committee Guidelines 1999. Thorax. 2000. 55:210–218.
3. Koh WJ, Kwon OJ, Yu CM, Jeon KM, Suh GY, Chung MP, et al. Recovery rate of nontuberculous mycobacteria from acid-fast-bacilli smear-positive sputum specimens. Tuberc Respir Dis. 2003. 54:22–32.
4. Lee JY, Choi HJ, Lee H, Joung EY, Huh JW, Oh YM, et al. Recovery rate and characteristics of nontuberculous mycobacterial isolates in a university hospital in Korea. Tuberc Respir Dis. 2005. 58:385–391.
5. Lee HW, Kim MN, Shim TS, Bai GH, Pai CH. Nontuberculous mycobacterial pulmonary infection in immunocompetent patients. Tuberc Respir Dis. 2002. 53:173–182.
6. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. ATS Mycobacterial Diseases Subcommittee. American Thoracic Society. Infectious Disease Society of America. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007. 175:367–416.
7. Park YS, Lee CH, Lee SM, Yang SC, Yoo CG, Kim YW, et al. Rapid increase of non-tuberculous mycobacterial lung diseases at a tertiary referral hospital in South Korea. Int J Tuberc Lung Dis. 2010. 14:1069–1071.
8. Lee JK, Kwon HY, Kwon JK, Lee HJ, Lee DW, Lee YJ, et al. Recovery rate of nontuberculous mycobacteria and the clinical course of nontuberculous mycobacterial pulmonary disease at a secondary hospital. Tuberc Respir Dis. 2009. 67:199–204.
9. Glassroth J. Pulmonary disease due to nontuberculous mycobacteria. Chest. 2008. 133:243–251.
10. Koh WJ, Kwon OJ, Lee KS. Nontuberculous mycobacterial pulmonary diseases in immunocompetent patients. Korean J Radiol. 2002. 3:145–157.
11. Marras TK, Daley CL. Epidemiology of human pulmonary infection with nontuberculous mycobacteria. Clin Chest Med. 2002. 23:553–567.
12. Yim JJ, Park YK, Lew WJ, Bai GH, Han SK, Shim YS. Mycobacterium kansasii pulmonary diseases in Korea. J Korean Med Sci. 2005. 20:957–960.
13. Ryoo SW, Shin S, Shim MS, Park YS, Lew WJ, Park SN, et al. Spread of nontuberculous mycobacteria from 1993 to 2006 in Koreans. J Clin Lab Anal. 2008. 22:415–420.
14. Simons S, van Ingen J, Hsueh PR, Van Hung N, Dekhuijzen PN, Boeree MJ, et al. Nontuberculous mycobacteria in respiratory tract infections, eastern Asia. Emerg Infect Dis. 2011. 17:343–349.
15. Chen CY, Chen HY, Chou CH, Huang CT, Lai CC, Hsueh PR. Pulmonary infection caused by nontuberculous mycobacteria in a medical center in Taiwan, 2005-2008. Diagn Microbiol Infect Dis. 2012. 72:47–51.
16. Koh WJ, Kwon OJ, Jeon K, Kim TS, Lee KS, Park YK, et al. Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens in Korea. Chest. 2006. 129:341–348.
17. Choi SP, Lee BK, Min JH, Kim JH. Pathogenic classification and clinical characteristics of nontuberculous mycobacterial pulmonary disease in a national tuberculosis hospital. Tuberc Respir Dis. 2005. 59:606–612.
18. Shin S, Kim EC, Yoon JH. Identification of nontuberculous mycobacteria by sequence analysis of the 16S ribosomal RNA, the heat-shock protein 65 and the RNA polymerase beta-subunit genes. Korean J Lab Med. 2006. 26:153–160.
19. Park CM, Heo SR, Park KU, Song J, Lee JH, Lee CT, et al. Isolation of nontuberculous mycobacteria using polymerase chain reaction-restriction fragment length polymorphism. Korean J Lab Med. 2006. 26:161–167.
20. Koh WJ, Kwon OJ. Diagnosis and treatment of nontuberculous mycobacterial lung disease. Korean J Med. 2008. 74:120–131.
21. Choi SP, Lee BK, Min JH, Kim JH. Pathogenic classification and clinical characteristics of nontuberculous mycobacterial pulmonary disease in a national tuberculosis hospital. Tuberc Respir Dis. 2005. 59:606–612.
22. Chung MJ, Lee KS, Koh WJ, Lee JH, Kim TS, Kwon OJ, et al. Thin-section CT findings of nontuberculous mycobacterial pulmonary diseases: comparison between Mycobacterium avium-intracellulare complex and Mycobacterium abscessus infection. J Korean Med Sci. 2005. 20:777–783.
Full Text Links
  • KJCM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr