Abstract
Background and Objectives: Knowledge about species diversity of non-tuberculous mycobacteria (NTM) and the frequency of tuberculosis (TB) is an important issue in rural-urban regions such as Piauí (northeast of Brazil), of low incidence rate of TB , can help to improve diagnosis and prevention strategies. The aim of this study is to examine some epidemiological aspects and the frequency of Mycobacterium tuberculosis (Mtb) and NTM isolated at the central public health reference laboratory, Dr. Costa Alvarenga, Piauí (LACEN-PI). Methods: Data records of all mycobacterosis and tuberculosis cases from January 2014 to March 2015 were analyzed. Results : Of the 20% (142/706) positive growths, 70% (99) were Mtb and 10% NTM. The remainde was of inadequate clinical samples, not allowing the identification of even the suspected NTM. The most frequent clinical form was pulmonary with TB patients younger than those infected with NTM (p = 0.001), the majority living in Teresina (52%). NTMs identified were M. abscessus (36%), M. avium, M. intracellulare, Mycobacterium sp. (14% each) and M. asiaticum, M. szulgai, M. kansasii 7% (each). Mtb drug resistance (7.8%) and TB co-infection with the human immunodeficiency virus (HIV-TB) found to be high (49%, 19/39) . Conclusion: The frequencies of Mtb infection, drug resistance and HIV-TB co-infection are still underestimated and failures in the identification of NTM may decrease the actual frequency of these infections. Therefore, there is a need for improvements in TB control and in the diagnosis of NTMs in Piauí.
Highlights
The importance and usefulness of identifying mycobacterium species, including criteria that may be shared between microbiologists and physicians, have a positive impact on treatment approaches
The aim of this study is to examine some epidemiological aspects and the frequency of Mycobacterium tuberculosis (Mtb) and non-tuberculous mycobacteria (NTM) isolated at the central public health reference laboratory, Dr Costa Alvarenga, Piauí (LACEN-PI)
Most of them were adults, but those diagnosed with M. tuberculosis infection were younger than that NTM infected (p=0.001) and of male sex (p=0.039)
Summary
The importance and usefulness of identifying mycobacterium species, including criteria that may be shared between microbiologists and physicians, have a positive impact on treatment approaches. A notable improvement in treating and controlling mycobacterial infections in recent years, tuberculosis, caused by Mycobacterium tuberculosis bacilli (Mtb), remains among the highest mortality infectious disease.[1] On the other hand, the species of non-tuberculous mycobacteria (NTM), which can be an environmental opportunistic pathogen, or nonpathogenic in some cases, are increasing as the causal agent of pulmonary mycobacteriosis.[2] Roughly of the 180 NTM species already described one third can be pathogenic Their frequency and etiopathogenesis still not well described in many geographic regions mainly in developing countries.[3] the notification conditions of NTM vary, while in countries of low tuberculosis incidence rate as Australia (5.7–7.7/100.000 inh) this is compulsory based on electronic and laboratory reports for NTM lung disease,[4] in the United States (2.6–3.5/100.000 inh) notification is extra pulmonary NTM.[5,6] In countries of higher tuberculosis incidence rate (34.8/100.000 inh) and treatment discontinuation (10.8%), such as Brazil,[7] NTM notification is not compulsory and available data associated with sporadic and occasional studies.
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