Yoo Jung-Wan, Jo Kyung-Wook, Kim Mi Na, Lee Sang Do, Kim Woo Sung, Kim Dong Soon, Shim Tae Sun
Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Tuberc Respir Dis (Seoul). 2012 May;72(5):409-15. doi: 10.4046/trd.2012.72.5.409. Epub 2012 May 29.
The isolation of non-tuberculous mycobacteria (NTM) has been increasing in South Korea. To date, however, the cause of this increase has not been determined, and it remains unclear whether the use of liquid media has contributed to this increase. The aim of this study was to evaluate the factors associated with NTM isolation and the impact of liquid media on NTM culture.
Mycobacterial smear/culture results of respiratory specimens (sputum and bronchial aspirates), obtained during the years 2002, 2005, and 2010, were retrieved and analyzed retrospectively.
During the years 2002, 2005, and 2010, 83,096 sputum specimens were collected from 31,104 patients, and were cultured for mycobacteria, using solid media only in the 2002 and 2005 specimens and both solid and liquid media in the 2010. Of these, 3,516 (4.2%) specimens were smear-positive for acid-fast bacilli (AFB). The annual rate of NTM among positive culture specimens increased from 21% in 2002 to 57.8% in 2010 (p<0.001), as did the proportion of NTM, among AFB smear- and culture-positive specimens, from 12.2% in 2002 to 45.2% in 2010 (p<0.001). In 2010, the NTM culture rate was higher in the liquid than in the solid media (13.9% vs. 8.4%, p<0.001). The NTM rate among AFB-positive specimens was higher in patients aged >50 than ≤50 years.
The rate of NTM isolation has steadily been increasing at the hospital in South Korea, likely due in part to the use of liquid media for the culture.
韩国非结核分枝杆菌（NTM）的分离率一直在上升。然而，迄今为止，这种上升的原因尚未确定，液体培养基的使用是否促成了这种上升也仍不清楚。本研究的目的是评估与NTM分离相关的因素以及液体培养基对NTM培养的影响。
回顾性检索并分析了2002年、2005年和2010年期间获得的呼吸道标本（痰液和支气管吸出物）的分枝杆菌涂片/培养结果。
在2002年、2005年和2010年期间，从31104例患者中收集了83096份痰液标本并进行分枝杆菌培养，2002年和2005年的标本仅使用固体培养基，2010年的标本同时使用了固体和液体培养基。其中，3516份（4.2%）标本抗酸杆菌（AFB）涂片阳性。阳性培养标本中NTM的年发生率从2002年的21%上升至2010年的57.8%（p<0.001），AFB涂片和培养均阳性的标本中NTM的比例也从2002年的12.2%上升至2010年的45.2%（p<0.001）。2010年，液体培养基中的NTM培养率高于固体培养基（13.9%对8.4%，p<0.001）。年龄>50岁患者的AFB阳性标本中NTM发生率高于年龄≤50岁的患者。
韩国该医院的NTM分离率一直在稳步上升，这可能部分归因于使用液体培养基进行培养。
