Del Giudice Ginevra, Iadevaia Carlo, Santoro Giulia, Moscariello Emilio, Smeraglia Riccardo, Marzo Carlo
Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Monaldi Hospital, Naples, Italy.
Clin Respir J. 2011 Oct;5(4):203-10. doi: 10.1111/j.1752-699X.2010.00220.x. Epub 2010 Aug 16.
Nontuberculous mycobacterial lung infections are relatively common in immunocompromised patients but are now increasingly being diagnosed in immunocompetent individuals. These organisms are not always pathogenic bacteria when isolated from human samples. The identification of which isolates are contaminants or colonizers is based on internationally accepted criteria. The clinical significance of the isolation of nontuberculous mycobacteria (NTM) from respiratory specimens in Italy is unknown.
study was performed to evaluate the local epidemiology of NTM pulmonary infection in Naples in patients with positive respiratory specimens, and also to describe the clinical and radiological features of NTM pulmonary disease in immunocompetent patients with or without pre-existing lung disease.
Between December 2006 and September 2009, the clinical records and radiological examinations of 39 patients with 55 positive cultures for NTM species by sputum or bronchial wash or lavage were reviewed.
According to microbiological, clinical and radiological criteria, our study identified 16 patients with NTM lung infection as a 'disease' group and 23 patients in a 'contamination' group but without disease. M. intracellulare (n = 7, 41.2%), followed by M. kansasii (n = 5, 29.4%) were the most common NTM found in the 'disease' group. We detected a high number of M. gordonae isolates in respiratory samples obtained by fibrobronchoscopy.
We evaluated the clinical significance of isolations in our reference centre in Naples. Forty-one of all patients have 'disease', M. intracellulare and M. kansasii are mainly responsible. NTM species were analyzed in relation to their frequency. Assumptions were made about low pathogenic NTM isolations.
非结核分枝杆菌肺部感染在免疫功能低下患者中相对常见，但现在越来越多地在免疫功能正常个体中被诊断出来。从人体样本中分离出的这些微生物并不总是致病菌。根据国际公认的标准来确定哪些分离株是污染物或定植菌。在意大利，从呼吸道标本中分离出非结核分枝杆菌（NTM）的临床意义尚不清楚。
本研究旨在评估那不勒斯NTM肺部感染在呼吸道标本阳性患者中的当地流行病学情况，并描述有或无既往肺部疾病的免疫功能正常患者中NTM肺部疾病的临床和放射学特征。
回顾了2006年12月至2009年9月期间39例患者的临床记录和放射学检查结果，这些患者通过痰液、支气管冲洗液或灌洗液培养出55株NTM阳性菌株。
根据微生物学、临床和放射学标准，我们的研究将16例NTM肺部感染患者确定为“疾病”组，23例患者为“污染”组但无疾病。在“疾病”组中，胞内分枝杆菌（n = 7，41.2%）最为常见，其次是堪萨斯分枝杆菌（n = 5，29.4%）。我们在经纤维支气管镜获取的呼吸道样本中检测到大量戈登分枝杆菌分离株。
我们在那不勒斯的参考中心评估了分离株的临床意义。所有患者中有41例患有“疾病”，主要由胞内分枝杆菌和堪萨斯分枝杆菌引起。对NTM菌种按其出现频率进行了分析。对低致病性NTM分离株进行了推测。
