Abstract
Background. The epidemiology of pulmonary nontuberculous mycobacteria (NTM) in Greece is largely unknown. Objectives. To determine the incidence and the demographic, microbiological, and clinical characteristics of patients with pulmonary NTM infection and pulmonary NTM disease. Methods. A retrospective review of the demographic, microbiological, and clinical characteristics of patients with NTM culture-positive respiratory specimens from January 2007 to May 2013. Results. A total of 120 patients were identified with at least one respiratory NTM isolate and 56 patients (46%) fulfilled the microbiological ATS/IDSA criteria for NTM disease. Of patients with adequate data, 16% fulfilled the complete ATS/IDSA criteria for NTM disease. The incidence of pulmonary NTM infection and disease was 18.9 and 8.8 per 100.000 inpatients and outpatients, respectively. The spectrum of NTM species was high (13 species) and predominated by M. avium-intracellulare complex (M. avium (13%), M. intracellulare (10%)), M. gordonae (14%), and M. fortuitum (12%). The ratio of isolation of NTM to M. tuberculosis in all hospitalized patients was 0.59. Conclusions. The first data on the epidemiology of pulmonary NTM in Athens, Greece, are presented. NTM infection is common in patients with chronic respiratory disease. However, only a significantly smaller proportion of patients fulfill the criteria for NTM disease.
Highlights
Nontuberculous mycobacterial (NTM) species are mycobacterial species other than those classified to the Mycobacterium tuberculosis complex (e.g., M. tuberculosis (Mtb), M. bovis, M. africanum, and M. microti) and M. leprae [1]
A spectrum of virulence has been identified ranging from primary pathogens such as M. kansasii that can cause disease in presumably healthy individuals and M. avium that is associated with preexisting lung disease or defects of cellular immunity to species such as M. gordonae that are rarely associated with disease [3]
Pulmonary diseases have been reported to account for up to 94% of cases of nontuberculous mycobacteria (NTM) disease [4] and pulmonary NTM disease commonly occurs in the context of chronic lung disease, such as chronic obstructive pulmonary disease (COPD), bronchiectasis, cystic fibrosis (CF), pneumoconiosis, prior TB, and esophageal motility
Summary
Nontuberculous mycobacterial (NTM) species are mycobacterial species other than those classified to the Mycobacterium tuberculosis complex (e.g., M. tuberculosis (Mtb), M. bovis, M. africanum, and M. microti) and M. leprae [1]. To determine the incidence and the demographic, microbiological, and clinical characteristics of patients with pulmonary NTM infection and pulmonary NTM disease. A retrospective review of the demographic, microbiological, and clinical characteristics of patients with NTM culture-positive respiratory specimens from January 2007 to May 2013. A total of 120 patients were identified with at least one respiratory NTM isolate and 56 patients (46%) fulfilled the microbiological ATS/IDSA criteria for NTM disease. Of patients with adequate data, 16% fulfilled the complete ATS/IDSA criteria for NTM disease. The incidence of pulmonary NTM infection and disease was 18.9 and 8.8 per 100.000 inpatients and outpatients, respectively. NTM infection is common in patients with chronic respiratory disease. Only a significantly smaller proportion of patients fulfill the criteria for NTM disease
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