Abstract
BackgroundInformation on non-tuberculosis mycobacterial (NTM) diseases remains limited in Singapore and other Southeast Asian countries. This study aimed to delineate epidemiological and clinical features of pulmonary NTM disease.MethodsA retrospective review was performed on all NTM isolates identified in Singapore General Hospital from 2012 to 2016 using the 2007 ATS/IDSA diagnostic criteria.ResultsA total of 2026 NTM isolates from 852 patients were identified. M. abscessus-chelonae group (1010, 49.9%) was the most commonly isolated and implicated in pulmonary NTM disease. Pulmonary cases (352, 76%) had the highest prevalence among patients diagnosed with NTM diseases (465/852, 54.6%) with no gender difference. Male patients were older (68.5 years, P = 0.014) with a higher incidence of chronic obstructive pulmonary disease (COPD) (23.6%, P < 0.001) and recurrent cough with phlegm production (51.6%, P = 0.035). In contrast, more female patients had bronchiectasis (50%, P < 0.001) and haemoptysis (37.6%, P = 0.042). Age and COPD were associated with multiple NTM species isolation per patient.ConclusionsM. abscessus-chelonae group was the commonest NTM species isolated in Singapore. Pulmonary NTM infection has the highest frequency with male and female patients associated with a higher incidence of COPD and bronchiectasis respectively. Age and COPD were associated with multiple NTM species isolation per patient.
Highlights
Information on non-tuberculosis mycobacterial (NTM) diseases remains limited in Singapore and other Southeast Asian countries
Specimen source and NTM species distribution A total of 2026 NTM isolates from 852 patients were identified during the 5-year study period
[63] we found that age ≥ 65 years and chronic obstructive pulmonary disease (COPD) were significantly associated with multispecies isolation with Odds ratio (OR) of 1.7 and 2.2 respectively
Summary
Information on non-tuberculosis mycobacterial (NTM) diseases remains limited in Singapore and other Southeast Asian countries. Non-tuberculous mycobacteria (NTM) has been increasingly implicated in a broad range of infectious diseases worldwide [1,2,3,4]. These environmental microbes are found primarily in water and soil. The interaction between host immune system and the pathogenicity of the organisms plays a key role in disease susceptibility [6]. Well-defined host risk factors include advanced age, male gender, slender and older Caucasian women, immune defects, structural pulmonary diseases, alpha1-antitrypsin deficiency [7,8,9,10,11]. Other predisposing factors include low body-mass index, skeletal abnormalities and gastroesophageal reflux [11, 14]
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