Rindi Laura, Garzelli Carlo
Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Via San Zeno, 35/39, 56127, Pisa, Italy.
BMC Infect Dis. 2016 Feb 1;16:44. doi: 10.1186/s12879-016-1380-y.
In Italy, the prevalence of non-tuberculous mycobacteria (NTM) in human infections is largely unknown. Herein, we report the epidemiology of NTM infections in a region of central Italy, Tuscany, over the last 11 years, and provide a review of the recent literature on NTM isolation rates in different geographic regions.
The complete collection of NTM strains isolated from a total of 42,055 clinical specimens at the Laboratory of Clinical Mycobacteriology of Pisa University Hospital, Italy, from 1 January 2004 to 31 December 2014 was included.
In our setting, in the period 2004-2014 a total of 147 patients had cultures positive for NTM. The number of NTM isolates increased considerably from five isolates in 2004 to 29 in 2014; a sharp increase occurred in the last 3 years. Overall, 16 NTM species were isolated; the most common were M. avium, M. intracellulare and M. gordonae detected in respectively in 41.5, 14.3 and 11.6% of NTM patients. In general, NTM isolates were largely prevalent in people older than 60 (57.8%); patients aged 1-10 year-old almost exclusively yielded M. avium and M. intracellulare. Of the 147 NTM clinical isolates, 76.2% were from respiratory specimens, 10.9% from lymph nodes, 2.7% from blood (yielding exclusively M. avium), and the remaining 10.2% from other clinical specimens.
The observed increase in NTM isolation rate in our setting is in keeping with the general increase in NTM infections reported worldwide in the past two decades, although the distribution of the NTM prevalent species differs by geographic region.
在意大利，非结核分枝杆菌（NTM）在人类感染中的流行情况很大程度上未知。在此，我们报告了意大利中部托斯卡纳地区过去11年中NTM感染的流行病学情况，并对不同地理区域NTM分离率的近期文献进行了综述。
纳入了2004年1月1日至2014年12月31日期间从意大利比萨大学医院临床分枝杆菌实验室共42,055份临床标本中分离出的NTM菌株的完整收集。
在我们的研究中，2004 - 2014年期间共有147例患者的NTM培养呈阳性。NTM分离株的数量从2004年的5株显著增加到2014年的29株；在过去3年中出现了急剧增加。总体而言，分离出了16种NTM；最常见的是鸟分枝杆菌、胞内分枝杆菌和戈登分枝杆菌，分别在41.5%、14.3%和11.6%的NTM患者中检测到。一般来说，NTM分离株在60岁以上人群中占主导（57.8%）；1 - 10岁的患者几乎仅分离出鸟分枝杆菌和胞内分枝杆菌。在147株NTM临床分离株中，76.2%来自呼吸道标本，10.9%来自淋巴结，2.7%来自血液（仅分离出鸟分枝杆菌），其余10.2%来自其他临床标本。
在我们的研究环境中观察到的NTM分离率增加与过去二十年全球报告的NTM感染总体增加一致，尽管NTM流行菌种的分布因地理区域而异。
