Abstract
Infectious diseases caused by nontuberculous mycobacteria (NTM) are increasingly becoming a major global problem. Additionally, Mycobacteroides abscessus subsp. abscessus (MAB) infections are refractory to macrolides. This study was conducted to investigate the epidemiology of rapidly growing mycobacteria (RGM) species isolated from clinical specimens in Japan and assess differences in the regional distribution of lower respiratory specimens (LRS)- and non-lower respiratory specimens (NLRS)-derived species. 532 strains (427 LRS, 92 NLRS and 15 unknown specimens) were isolated in nine areas of Japan. We collected 418 specimens from Bio Medical Laboratories (BML), Inc., and 114 specimens from 45 hospitals in Japan. Their epidemiological differences were examined according to the specimen type, region, and climate. Fifteen species were identified. The proportion of M. abscessus group (MAG) strains was significantly lower in NLRS than in LRS (35.9% vs. 68.4%). The proportion of MAG strains was higher in northern Japan than in other regions (83.7% vs. 60.5%). Variations in strain abundance among RGM species was evident in regions with a mean annual temperature below 15 °C. We conclude that the proportions of MAG strains differed between NLRS and LRS in Japan. In addition, the mean annual temperature likely influenced the distribution of RGM species.
Highlights
Infectious diseases caused by nontuberculous mycobacteria (NTM) are increasingly becoming a major global problem
In this study, we investigated the epidemiology of rapidly growing mycobacteria (RGM) species isolated from clinical specimens in Japan and the differences in the regional distribution of LRS- and non-lower respiratory specimens (NLRS)-derived species
The top three species isolated from LRS and NLRS were the same; the relative proportion of M. abscessus group (MAG) was significantly lower in NLRS (35.9%, 33/92) than in LRS (68.4%, 292/427; P < 0.001; odds ratio (OR) 0.26; 95% confidence interval [CI] 0.16–0.42; Fig. 1a)
Summary
Infectious diseases caused by nontuberculous mycobacteria (NTM) are increasingly becoming a major global problem. We collected 418 specimens from Bio Medical Laboratories (BML), Inc., and 114 specimens from 45 hospitals in Japan Their epidemiological differences were examined according to the specimen type, region, and climate. The proportion of M. abscessus group (MAG) strains was significantly lower in NLRS than in LRS (35.9% vs 68.4%). A recent large-scale questionnaire survey in Japan revealed an increased prevalence of NTM infections, with a fivefold increase in pulmonary infections caused by the Mycobacteroides abscessus group (MAG), a type of rapidly growing mycobacteria (RGM), over the past 15 y ears[2]. Epidemiological analysis of NTM isolated from lower respiratory tract specimens (LRS) from three major commercial laboratories in Japan showed that the frequency of M. abscessus isolation was highest in the Kyushu-Okinawa area located in southern J apan[6]. NTM epidemiological studies suggested that climate conditions, such as temperature, precipitation, and water vapor pressure, affect NTM a ctivity[7,8]
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