Abstract
BackgroundIn Italy, the prevalence of non-tuberculous mycobacteria (NTM) in human infections is largely unknown. Herein, we report the epidemiology of NTM infections in a region of central Italy, Tuscany, over the last 11 years, and provide a review of the recent literature on NTM isolation rates in different geographic regions.MethodsThe complete collection of NTM strains isolated from a total of 42,055 clinical specimens at the Laboratory of Clinical Mycobacteriology of Pisa University Hospital, Italy, from 1 January 2004 to 31 December 2014 was included.ResultsIn our setting, in the period 2004–2014 a total of 147 patients had cultures positive for NTM. The number of NTM isolates increased considerably from five isolates in 2004 to 29 in 2014; a sharp increase occurred in the last 3 years. Overall, 16 NTM species were isolated; the most common were M. avium, M. intracellulare and M. gordonae detected in respectively in 41.5, 14.3 and 11.6 % of NTM patients. In general, NTM isolates were largely prevalent in people older than 60 (57.8 %); patients aged 1–10 year-old almost exclusively yielded M. avium and M. intracellulare. Of the 147 NTM clinical isolates, 76.2 % were from respiratory specimens, 10.9 % from lymph nodes, 2.7 % from blood (yielding exclusively M. avium), and the remaining 10.2 % from other clinical specimens.ConclusionsThe observed increase in NTM isolation rate in our setting is in keeping with the general increase in NTM infections reported worldwide in the past two decades, although the distribution of the NTM prevalent species differs by geographic region.
Highlights
In Italy, the prevalence of non-tuberculous mycobacteria (NTM) in human infections is largely unknown
Between January 2004 and December 2014, a total of 42,055 clinical specimens collected from approximately 15,000 patients with suspected mycobacterial infection were tested; a total of 595 patients had cultures positive for mycobacteria; M. tuberculosis complex and NTM species were isolated from 448 (75.3 %) and 147 (24.7 %) patients, respectively
A total of 16 NTM species were isolated (Table 1), the most common belonging to the Mycobacterium avium complex (MAC) (n = 82, 55.8 %); in particular, M. avium subsp. hominissuis was detected in 61 (41.5 %) and M. intracellulare in 21 (14.3 %) patients
Summary
In Italy, the prevalence of non-tuberculous mycobacteria (NTM) in human infections is largely unknown. We report the epidemiology of NTM infections in a region of central Italy, Tuscany, over the last 11 years, and provide a review of the recent literature on NTM isolation rates in different geographic regions. Non-tuberculous mycobacteria (NTM) include all Mycobacterium species other than Mycobacterium tuberculosis complex and Mycobacterium leprae. NTM are generally endowed with low pathogenicity to humans [2], some species are associated with a variety of human diseases, especially concomitantly to particular risk factors [3]; respiratory tract infections are the most frequent, followed by lymphadenitis in children, disseminated infections in severely immunocompromised patients and NTM species No of.
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