Streit Elisabeth, Millet Julie, Rastogi Nalin
WHO Supranational TB Reference Laboratory, Tuberculosis & Mycobacteria Unit, Institut Pasteur de la Guadeloupe, Morne Jolivière, BP 484, 97183 Les Abymes, France.
Tuberc Res Treat. 2013;2013:472041. doi: 10.1155/2013/472041. Epub 2013 Dec 18.
Nontuberculous mycobacteria (NTM) are ubiquitous environmental organisms able to cause severe opportunistic human infections. Their distribution patterns are subject to geographical variations. This study describes their isolation frequencies from clinical specimen in the three French overseas departments of the Americas, namely, Guadeloupe, Martinique, and French Guiana during 1994-2012. A total of 651 strains from as many patients (one isolate per species per patient) were analysed regarding regional isolation patterns and potential pattern changes over time. The Mycobacterium avium complex was the most common group of NTM in Guadeloupe and French Guiana. In Martinique it was the second most common after the rapidly growing mycobacteria. M. fortuitum was the most commonly isolated species in all three departments. Some species (M. kansasii, M. xenopi, and M. terrae complex) displayed a clear regional preference. Furthermore a change in isolation frequency was observed for M. intracellulare (increase) and M. kansasii (decrease) in Guadeloupe. In conclusion, marked regional differences in isolation frequencies of NTM species were observed in the study area. Results are discussed in context of variables such as study populations, risk factors, methodology employed, isolation from pulmonary versus sterile isolation sites (blood, urine, and CSF), and in vitro drug-susceptibility patterns.
非结核分枝杆菌（NTM）是普遍存在于环境中的微生物，能够引起严重的人类机会性感染。它们的分布模式存在地理差异。本研究描述了1994年至2012年期间在美洲的三个法国海外省，即瓜德罗普岛、马提尼克岛和法属圭亚那，从临床标本中分离出NTM的频率。对来自651名患者（每位患者每种菌株分离出一株）的总共651株菌株进行了分析，以了解区域分离模式以及随时间可能发生的模式变化。鸟分枝杆菌复合群是瓜德罗普岛和法属圭亚那最常见的NTM菌群。在马提尼克岛，它是继快速生长分枝杆菌之后第二常见的菌群。偶然分枝杆菌是所有三个省份最常分离出的菌种。一些菌种（堪萨斯分枝杆菌、蟾蜍分枝杆菌和土地分枝杆菌复合群）表现出明显的区域偏好。此外，在瓜德罗普岛观察到细胞内分枝杆菌的分离频率有所增加，而堪萨斯分枝杆菌的分离频率有所下降。总之，在研究区域观察到NTM菌种分离频率存在明显的区域差异。结合研究人群、危险因素、采用的方法、从肺部与无菌隔离部位（血液、尿液和脑脊液）分离以及体外药敏模式等变量对结果进行了讨论。
