Abstract
BackgroundPulmonary nontuberculous mycobacteria (NTM) disease is of increasing public health concern in China. Information is limited regarding risk factors associated with this disease in China. The objective of this study was to describe the epidemiology of pulmonary disease due to NTM in Southern China.MethodsWe retrospectively reviewed the medical records of pulmonary NTM patients registered in the Guangzhou Chest Hospital with positive mycobacterial cultures during 2013–2016. We described sex, age, residence, treatment history, laboratory examination results and comorbidities of pulmonary NTM patients.ResultsAmong the 607 NTM cases, the most prevalent species were Mycobacterium avium complex (44.5%), Mycobacterium abscessus complex (40.5%), Mycobacterium kansasii (10.0%) and Mycobacterium fortuitum (2.8%). The male:female ratio was significantly lower among patients infected with rapidly growing mycobacteria (RGM) than among those with slowly growing mycobacteria (SGM). The risk of developing SGM disease significantly increased with advancing age. In addition, pulmonary RGM diseases were more common in migrant population than resident population. Notably, patients with pulmonary RGM diseases were significantly more likely to have bronchiectasis underlying noted than those with SGM diseases. No significant difference was observed in in vitro drug susceptibility among NTM species.ConclusionOur data illustrate that the M. avium complex is the most predominant causative agent of pulmonary NTM disease in Southern China. Female, migrant population, the presence of bronchiectasis are independent risk factors for pulmonary diseases due to RGM. In addition, the prevalence of SGM increases significantly with advancing age.
Highlights
Pulmonary nontuberculous mycobacteria (NTM) disease is of increasing public health concern in China
We aimed to identify demographic and clinical factors associated with pulmonary NTM diseases between slowly growing mycobacteria (SGM) and rapidly growing mycobacteria (RGM)
The male:female ratio was significantly lower among patients infected with RGM than among those with SGM [adjusted odds ratio: 0.526, 95% confidence interval: 0.429–0.862; P = 0.005]
Summary
Pulmonary nontuberculous mycobacteria (NTM) disease is of increasing public health concern in China. The objective of this study was to describe the epidemiology of pulmonary disease due to NTM in Southern China. China has achieved impressive reductions in TB prevalence and mortality over the past 20 years [8], NTM infections have become a serious issue, accounting for about one quarter of mycobacterial patient isolates according to the national population-based data [9], triggering public health concerns. National epidemiological data have revealed that NTM species distribution differs significantly by region, reflecting the diversity of species distribution in the local environment [3]. The objective of this study was to describe the prevalence of NTM species among pulmonary NTM patients in regional tuberculosis clinical centre in Southern China between 2013 and 2016. We aimed to identify demographic and clinical factors associated with pulmonary NTM diseases between slowly growing mycobacteria (SGM) and rapidly growing mycobacteria (RGM)
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