Elwood R Kevin, Opazo Saez Anabelle M, Lentini Vittorio, Shadmani Ramak
British Columbia Centre for Disease Control, Division of Tuberculosis Control, Vancouver, Canada.
Can Respir J. 2002 Sep-Oct;9(5):319-23. doi: 10.1155/2002/202870.
The incidence of pulmonary disease due to mycobacteria other than tuberculosis (TB) in Canada has not been documented.
To determine the incidence of pulmonary disease due to mycobacteria in the nonimmunocompromised population of British Columbia.
A retrospective cohort study of 110 cases of mycobacteria infection other than TB identified from 1991 to 1995.
British Columbia Centre for Disease Control, Division of TB Control.
The overall incidence rate of infection with mycobacteria other than TB was 0.63 10-5/year. This incidence rate was significantly higher among women (relative risk [RR]=2, P=0.0006) and in those aged 55 years or older (RR=8, P<0.00001). In contrast with TB, patients were more frequently born in Canada (P<0.00001) or in industrialized countries other than Canada (P<0.00001), and were less likely to be Aboriginal (P=0.0007) or foreign born from Asia (P<0.0001). The most common organism isolated in British Columbia was Mycobacterium avium-intracellulare (82.7%). Overall, 78 (71%) cases had underlying lung disease. Drug intolerance was very common (42%). After treatment, 55% and 41% of the patients were rendered smear negative or culture negative, respectively. Radiological improvement was noted in 55% of patients, and 60% of patients responded symptomatically to treatment.
The overall incidence of pulmonary disease is low. It is a disease predominantly of women 55 years and older, and targets completely different ethnic groups than TB, suggesting a protective effect of infection with Mycobacterium tuberculosis. M avium-intracellulare was the most common pathogen isolated. Further investigation is required into the natural history of so-called 'colonizers'. Considerable morbidity may be prevented with earlier intervention.
加拿大非结核分枝杆菌所致肺部疾病的发病率尚无记录。
确定不列颠哥伦比亚省非免疫功能低下人群中分枝杆菌所致肺部疾病的发病率。
对1991年至1995年间确诊的110例非结核分枝杆菌感染病例进行回顾性队列研究。
不列颠哥伦比亚省疾病控制中心结核病控制部。
非结核分枝杆菌感染的总体发病率为0.63×10⁻⁵/年。女性（相对危险度[RR]=2，P=0.0006）和55岁及以上人群（RR=8，P<0.00001）的发病率显著更高。与结核病患者相比，这些患者更多在加拿大出生（P<0.00001）或在加拿大以外的工业化国家出生（P<0.00001），且不太可能是原住民（P=0.0007）或出生于亚洲的外国移民（P<0.0001）。在不列颠哥伦比亚省分离出的最常见病原体是鸟分枝杆菌复合群（82.7%）。总体而言，78例（71%）病例有潜在肺部疾病。药物不耐受非常常见（42%）。治疗后，分别有55%和41%的患者痰涂片转阴或培养转阴。55%的患者影像学有改善，60%的患者治疗后症状有改善。
肺部疾病的总体发病率较低。这是一种主要发生在55岁及以上女性中的疾病，且与结核病的目标人群完全不同，提示结核分枝杆菌感染有保护作用。鸟分枝杆菌复合群是分离出的最常见病原体。需要对所谓“定植菌”的自然史进行进一步研究。早期干预可预防相当一部分发病情况。
