Ann Clin Microbiol.  2013 Mar;16(1):13-18. 10.5145/ACM.2013.16.1.13.

The Increase of Nontuberculous Mycobacterial Isolation in the Specimens from Respiratory System in Jeju

• Oh MS
• Lee J

• KMID: 2169597
• DOI: http://doi.org/10.5145/ACM.2013.16.1.13

Abstract

BACKGROUND
Pulmonary tuberculosis is an infectious disease of the lungs caused by Mycobacterium tuberculosis complex (MTB) designated by law in Korea, and accurate diagnosis and urgent treatment are necessary for the maintenance of public health. Recently, nontuberculous mycobacteria (NTM) have been more frequently isolated in respiratory system specimens, which were confused with MTB. We investigated whether the incidence of NTM isolation is increasing in Jeju, Korea.
METHODS
The results of microbacterial cultures of acid fast bacilli (AFB) from respiratory system specimens were collected at Jeju National University Hospital, Jeju, Korea from 2004 to 2011. The incidences of MTN or NTM isolation were analyzed.
RESULTS
A total of 15,484 AFB cultures were performed in 6,281 patients. In 2004, 365 AFB cultures were requested, and the number increased to 1,550 in 2011. However, the culture-positive rate decreased from 18.7% in 2004 to 6.19% in 2011. Among the 573 cultured specimens, 506 MTB (88.3%, mean age of 49.7, male 63.2%) and 72 NTM (12.6%, mean age of 65.8, male 50.0%) were identified. The proportions of NTM isolations were less than 10% until 2009, but increased to 30% after 2010 (P<0.001). M. avium complex (MAC) was the most frequently isolated NTM, followed by M. abscessus.
CONCLUSION
The proportion of NTM isolation is increasing. A clinical diagnosis of pulmonary tuberculosis based on respiratory system specimens should be made with caution, especially in cases of positive AFB smears.

Keyword

Incidence; Jeju; Mycobacterium; Mycobacterium tuberculosis; Nontuberculous mycobacteria

MeSH Terms

Communicable Diseases
Humans
Incidence
Jurisprudence
Korea
Lung
Male
Mycobacterium
Mycobacterium tuberculosis
Nontuberculous Mycobacteria
Public Health
Respiratory System
Tuberculosis, Pulmonary

Figure

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  Fig. 1. The number of patients with AFB culture from 2004 to 2011.

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  Fig. 2. (A) The number of culture positive from 2004 to 2011. (B) The proportion of culture positive from 2004 to 2011.

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  Fig. 3. The culture methods changed at October of 2010 using solid media only into solid and liquid media together. There's no differe-nce in comparison of the culture positive rates between before and after the changes of the culture methods.

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  Fig. 4. The incidences of MTB and NTM isolates from 2004 to 2011.

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  Fig. 5. The proportions of NTM isolates were increased from 2004 to 2011, whereas those of MTB were decreased (P＜0.001).

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