Pathogenic Classification and Clinical Characteristics of Nontuberculous Mycobacterial Pulmonary Disease in a National Tuberculosis Hospital.
10.4046/trd.2005.59.6.606
- Author:
Sun Pil CHOI
1
;
Bong Keun LEE
;
Jin Hong MIN
;
Jin Hee KIM
Author Information
1. Department of Medicine, National Masan Tuberculosis Hospital, Masan, Korea.
- Publication Type:Original Article
- Keywords:
Nontuberculous mycobacterium;
Mycobacterium avium complex;
Mycobaterium abscessus;
Lung disease
- MeSH:
Classification*;
Hospitals, Chronic Disease*;
Humans;
Lung Diseases*;
Mycobacterium avium Complex;
Nontuberculous Mycobacteria;
Sputum;
Tuberculosis*
- From:Tuberculosis and Respiratory Diseases
2005;59(6):606-612
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: It has been reported that nontuberculosis mycobacterium(NTM) isolates account for approximately 10% of patients with a positive Acid-Fast Bacilli(AFB) smear. Therefore, it is necessary to consider NTM pulmonary disease when such a positive test is encountered. The aim of this study was to evaluate the etiologies and clinical characteristics of patients with NTM pulmonary disease who had been treated at a national tuberculosis hospital. METHODS: The NTM isolates were recovered from the sputum or bronchial washing specimens submitted to a clinical laboratory of National Masan TB Hospital from August 2002 to July 2003. All samples were identified using a polymerase chain reaction-restriction fragment length polymorphism analysis method, which amplifies the rpoB gene. The patients were diagnosed with NTM disease according to the American Thoracic Society diagnostic criteria. RESULTS: One hundred NTM isolates were recovered from 57 patients. Of the 100 isolates, M. avium complex(MAC) was the most common species, which was found 55%(n=55) of patients, followed by M. abscessus(n=25), and M. fortuitum(n=9). 26(45.6%) patients had NTM disease. Twenty-six (45.6%) patients had NTM disease according to The American Thoracic Society classification. The main organisms involved in NTM disease were MAC(n=19, 73.1%) and M. abscessus(n=5, 19.2%). The pathogenic potential was 67.9% in M. intracellulare and 41.7% in M. abscessus. The predictive factors related to NTM disease were a positive sputum smear (OR 6.4, p=0.02) and the isolation of either MAC or M. abscessus(OR 6.9, p=0.007). Fifteen patients(57.7%) were cured. There were no significant factors associated with the treatment success. CONCLUSION: There was a relatively high proportion of NTM disease in NTM isolates and the common species were MAC and M. abscessus. The predictive factors for NTM disease were a positive sputum smear and the isolation of either MAC or M. abscessus.
