Pulmonary Department, Meir Medical Center, Kfar Saba, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Respir Med. 2012 Oct;106(10):1472-7. doi: 10.1016/j.rmed.2012.06.023. Epub 2012 Jul 31.
Mycobacterium kansasii infection is one of the most common causes of nontuberculous mycobacterial lung disease in the world. However, it is not possible to differentiate completely between M. kansasii and other nontuberculous mycobacteria (NTM) because of a lack of direct comparative studies. This retrospective study sought to identify their clinical and radiological features systematically.
The sample included 98 consecutive patients with a culture-positive diagnosis of NTM infection, derived from the databases of the Laboratory of Microbiology of a tertiary medical center and two outpatient tuberculosis centers. Sixty-four patients had M. kansasii infection. All patients fulfilled disease criteria for treatment. Data on patient background and clinical features were collected, and chest radiographs were evaluated.
In the M. kansasii group, n = 27 (42%) were native-born Israelis compared to 9.4% (n = 3) of all other NTM groups (p = 0.0001). Similar rates of co-morbid diseases, including diabetes mellitus, heart disease, lung diseases, and malignancy were noted in both groups. Old TB was less common in the M. kansasii group compared to the other NTM (3.1% vs. 23.5%, p = 0.003). Clinical symptoms were significantly more common in patients with M. kansasii infection. On radiological study, M. kansasii infection was associated with more cavitations and unilaterality. Patients with M. kansasii infection had a higher likelihood of right upper lobe disease (p = 0.001). Pleural effusions and lymphadenopathy were found only in a few patients in each group.
Major differences in the epidemiologic and clinical features of M. kansasii infection and other NTM have important diagnostic and clinical implications.
堪萨斯分枝杆菌感染是世界上最常见的非结核分枝杆菌肺部疾病的病因之一。然而，由于缺乏直接的对比研究，完全区分堪萨斯分枝杆菌和其他非结核分枝杆菌（NTM）是不可能的。本回顾性研究旨在系统地确定它们的临床和影像学特征。
该样本包括 98 例连续培养阳性的 NTM 感染患者，来自一家三级医学中心和两家门诊结核病中心的微生物学实验室数据库。64 例患者感染了堪萨斯分枝杆菌。所有患者均符合治疗疾病标准。收集患者背景和临床特征的数据，并评估胸部 X 线片。
在堪萨斯分枝杆菌组中，27 名（42%）患者为以色列本地人，而所有其他 NTM 组中只有 9.4%（n=3）（p=0.0001）。两组患者合并疾病的发生率相似，包括糖尿病、心脏病、肺部疾病和恶性肿瘤。与其他 NTM 相比，堪萨斯分枝杆菌组中陈旧性肺结核的发生率较低（3.1%比 23.5%，p=0.003）。堪萨斯分枝杆菌感染患者的临床症状更为常见。在影像学研究中，堪萨斯分枝杆菌感染与更多的空洞和单侧性有关。堪萨斯分枝杆菌感染患者右上肺疾病的可能性更高（p=0.001）。胸腔积液和淋巴结病仅在每组少数患者中发现。
堪萨斯分枝杆菌感染和其他 NTM 的流行病学和临床特征存在显著差异，这对诊断和临床具有重要意义。
