ОСОБЕННОСТИ ТЕЧЕНИЯ МИКОБАКТЕРИОЗА ЛЕГКИХ В ЗАВИСИМОСТИ ОТ ВЫЯВЛЕНИЯ ВОЗБУДИТЕЛЯ В МОКРОТЕ

Abstract

Objective: to evaluate treatment effectiveness in patients with mycobacterial pulmonary disease and its association with mycobacteria detection in sputum. Materials and methods. The study enrolled 196 patients with confirmed mycobacterial pulmonary disease. The diagnosis was established as per ATS/IDSA criteria (2007). The patients were divided into two groups: group 1 consisted of 108 patients with nontuberculous mycobacteria (NTM) detected in sputum; group 2 consisted of 60 patients with NTM detected in BAL and/or lung tissue samples. Female patients prevailed (78.6%). The average patients’ age was 56.9 ± 11.3 years. The time period from diagnosing pulmonary mycobacterial disease to commencementof combination antibacterial therapy varied from one month to 3.5 years. Patients were followed up during one year after treatment completion. Results. The most commonly identified NTM were MAC (M. аvium, M. intracellulare) and M. kansasii. The combination antibacterial therapy was administered to 168 (85.7%) patients. Clinical cure was more frequently achieved in the patients of group 2 compared to group 1 (21.7 and 3.7% respectively, р < 0.01). The frequency of clinical improvement without conversion of biological samples did not significantly differ between the groups (40 and 54.6% respectively, …). The frequency of relapse was similar in both groups and did not exceed 5%. Conclusion. The presence of NTM in BAL while the absence of NTM in sputum allows predicting more favourable disease course and better response to treatment.