Marinho A, Fernandes G, Carvalho T, Pinheiro D, Gomes I
Pulmonology Unit, Hospital São João, Oporto, Portugal.
Rev Port Pneumol. 2008 May-Jun;14(3):323-37.
Nontuberculous mycobacteria (NTM) play an increasingly significant pathogenic role in HIV -positive patients, in patients with chronic lung disease, in other chronic conditions and in the elderly.
Evaluate the importance of NTM isolation in respiratory samples in patients without HIV-infection.
Retrospective evaluation of our hospital patients with no known AIDS, with at least one NTM positive respiratory sample, from 1997 -2004.
We found 102 patients, with a median age of 63 years; 67% male. Sixty -three (62%) had underlying lung disease, mainly tuberculosis sequelae (n=19). The majority (47%) of the isolations were Mycobacterium avium complex (MAC). A diagnosis of Mycobacterium pulmonary disease was made in 16 patients (15.7%), 14 of which met the American Thoracic Society diagnostic criteria. Ten male and 6 female; median age 65 years. Twelve had underlying lung disease. All of them had respiratory infection complaints. Chest X -rays showed mainly pulmonary infiltrates, linear opacities and cavitation. MAC was the cause of mycobacterium respiratory disease in 12 patients (75%).
NTM isolation did not equal pulmonary NTM disease in the majority of cases, even in patients with underlying lung disease. MAC was the most commonly isolated agent and its relative importance was higher in the presence of NTM disease.
非结核分枝杆菌（NTM）在HIV阳性患者、慢性肺病患者、其他慢性病患者及老年人中发挥着越来越重要的致病作用。
评估在未感染HIV的患者中，呼吸道样本中分离出NTM的重要性。
对我院1997年至2004年至少有一份NTM阳性呼吸道样本且无已知艾滋病的患者进行回顾性评估。
我们发现了102例患者，中位年龄为63岁；67%为男性。63例（62%）有潜在肺部疾病，主要是结核后遗症（n = 19）。大多数（47%）分离出的是鸟分枝杆菌复合群（MAC）。16例患者（15.7%）被诊断为非结核分枝杆菌肺病，其中14例符合美国胸科学会的诊断标准。男性10例，女性6例；中位年龄65岁。12例有潜在肺部疾病。他们都有呼吸道感染症状。胸部X光主要显示肺部浸润、线状阴影和空洞。MAC是12例患者（75%）非结核分枝杆菌呼吸道疾病的病因。
在大多数情况下，即使是有潜在肺部疾病的患者，NTM的分离并不等同于肺部NTM病。MAC是最常分离出的病原体，在NTM病中其相对重要性更高。
