Tuberc Respir Dis.  2013 Nov;75(5):199-204.

Increasing Recovery of Nontuberculous Mycobacteria from Respiratory Specimens over a 10-Year Period in a Tertiary Referral Hospital in South Korea

• Koh WJ
• Chang B
• Jeong BH
• Jeon K
• Kim SY
• Lee NY
• Ki CS
• Kwon OJ

Abstract

BACKGROUND
The number of patients with pulmonary disease caused by nontuberculous mycobacteria (NTM) has been increasing worldwide. The aim of this study was to evaluate long-term trends in the NTM recovery rate from respiratory specimens over a 10-year period in a tertiary referral hospital in South Korea.
METHODS
We retrospectively reviewed the records of mycobacterial cultures of respiratory specimens at Samsung Medical Center from January 2001 to December 2011.
RESULTS
During the study period, 32,841 respiratory specimens from 10,563 patients were found to be culture-positive for mycobacteria. These included 12,619 (38%) Mycobacterium tuberculosis and 20,222 (62%) NTM isolates. The proportion of NTM among all positive mycobacterial cultures increased from 43% (548/1,283) in 2001 to 70% (3,341/4,800) in 2011 (p<0.001, test for trend). The recovery rate of NTM isolates from acid-fast bacilli smear-positive specimens increased from 9% (38/417) in 2001 to 64% (1,284/1,997) in 2011 (p<0.001, test for trend). The proportion of positive liquid cultures was higher for NTM than for M. tuberculosis (p<0.001). The most frequently isolated NTM were Mycobacterium avium-intracellulare complex (53%) and Mycobacterium abscessus-massiliense complex (25%).
CONCLUSION
The recovery rate of NTM from respiratory specimens in South Korea has increased steadily.

Keyword

Nontuberculous Mycobacteria; Mycobacterium tuberculosis; Epidemiology; Korea

MeSH Terms

Epidemiology
Humans
Korea
Lung Diseases
Mycobacterium
Mycobacterium avium Complex
Mycobacterium tuberculosis
Nontuberculous Mycobacteria*
Republic of Korea*
Retrospective Studies
Tertiary Care Centers*
Tuberculosis

Figure

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  Figure 1 Changes in the rate of recovery of mycobacteria from respiratory specimens. The annual percentage of nontuberculous mycobacteria (NTM) isolated (filled circles) from requested specimens increased, while that of Mycobacterium tuberculosis (open circles) remained stable.

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  Figure 2 Changes in the proportions of Mycobacterium tuberculosis and nontuberculous mycobacteria (NTM) of all positive mycobacterial cultures during the study period. The proportion of NTM increased significantly.

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  Figure 3 Changes in the proportion of Mycobacterium tuberculosis and nontuberculous mycobacteria (NTM) of acid-fast bacilli smear-positive respiratory specimens. The proportion of NTM increased rapidly during the study period. AFB: acid-fast bacilli.

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  Figure 4 Prevalence of nontuberculous mycobacteria (NTM) species in respiratory specimens. Mycobacterium avium-intracellulare complex (MAC) and Mycobacterium abscessus-massiliense complex accounted for the majority of the isolated NTM species.

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