Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens.
- Author:
Won Jung KOH
1
;
O Jung KWON
;
Hyoung Suk HAM
;
Gee Young SUH
;
Man Pyo CHUNG
;
Ho Joong KIM
;
Daehee HAN
;
Tae Sung KIM
;
Kyung Soo LEE
;
Nam Yong LEE
;
Eun Mi PARK
;
Young Kil PARK
;
Gill Han BAI
Author Information
1. Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ojkwon@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Atypical mycobacteria;
Mycobacterium avium complex;
Mycobacterium chelonae;
Lung diseases;
Korea
- MeSH:
Diagnosis;
Epidemiology;
Humans;
Korea;
Lung Diseases;
Multivariate Analysis;
Mycobacterium avium Complex;
Mycobacterium chelonae;
Nontuberculous Mycobacteria*;
Radiography;
Sputum;
Tertiary Care Centers;
Thorax
- From:Korean Journal of Medicine
2003;65(1):10-21
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: We studied the clinical significance of nontuberculous mycobacteria (NTM) recovered from respiratory specimens for six months in a tertiary referral center. METHODS: We identified all NTM isolates from sputum or bronchial washing from October, 2001 to March, 2002, using polymerase chain reaction-restriction fragment length polymorphism analysis method amplifying the rpoB gene. Patients were classified as having definite, probable, or unlikely NTM disease as defined by the American Thoracic Society and the British Thoracic Society guidelines. RESULTS: 261 isolates of NTM recovered from 162 patients. In 162 patients, M. avium complex (MAC) was the most common species comprising 29.6% (n=48), which was followed by M. fortuitum complex (n=46, 28.4%), M. abscessus (n=26, 16.0%). 29 (17.9%) patients had definite NTM disease, and 13 (8.0%) had probable NTM disease. The common organisms involved in NTM diseases were MAC (n=23, 54.8%), M. abscessus (n=12, 28.6%). In a univariate analysis, predictive factors that were related to NTM disease were BMI <18.5 kg/m2, presence of symptoms, previous history of antituberculous treatment, positive sputum smear, presence of infiltrative, nodular or cavitary lesions at chest radiography, and isolation of MAC or M. abscessus. In a multivariate analysis, isolation of MAC or M. abscessus (OR 16.3, 95% CI 4.2~62.7, p<0.001), cavity at chest radiography (OR 4.8, 95% CI 1.4~16.6, p=0.012), and positive sputum smear (OR 4.3, 95% CI 1.4~13.3, p=0.012) were found to be variables independently associated with pulmonary disease. CONCLSUION: Epidemiology of NTM pulmonary disease in Korea is different from that in other countries. A high index of clinical suspicion as well as an accurate identification of the isolates would be required for the diagnosis of NTM pulmonary disease.
