Yoo Jung-Wan, Jo Kyung-Wook, Kim Sung-Han, Lee Sang-Oh, Kim Jae Joong, Park Su-Kil, Lee Je-Hwan, Han Duck Jong, Hwang Shin, Lee SeungGyu, Shim Tae Sun
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Transpl Int. 2016 May;29(5):549-58. doi: 10.1111/tri.12752. Epub 2016 Feb 24.
The incidence, clinical characteristics, and treatment outcomes of tuberculosis (TB) and nontuberculous mycobacterial (NTM) disease developed after transplantation (TPL) in transplant recipients were investigated retrospectively. Between 1996 and 2013, 7342 solid-organ transplantation and 1266 hematopoietic stem cell transplantation were performed at a tertiary referral center in South Korea. Among them, TB and NTM disease developed in 130 and 22 patients, respectively. The overall incidence of TB was 257.4 cases/100 000 patient-years (95% confidence interval [CI], 215.1-305.7) and that of NTM disease was 42.7 cases/100 000 patient-years (95% CI, 26.8-64.7). The median interval from organ TPL to the development of mycobacterial disease was 8.5 months (95% CI, 6.3-11.4) in recipients with TB patients and 24.2 months (95% CI, 13.5-55.7) in those with NTM, respectively. Among NTM patients, Mycobacterium avium-intracellulare complex was the most common causative organism, and nodular bronchiectatic type (77.8%) was the most frequent radiologic feature. Favorable treatment outcome was achieved in 83.7% (95% CI, 76.4-89.1) and 68.8% (95% CI, 44.4-85.8) of TB and NTM patients, respectively (P = 0.166). In conclusion, the overall incidence of TB was higher than that of NTM disease in transplant recipients and treatment outcomes were favorable in both drug-susceptible TB and NTM patients.
对移植受者移植后发生的结核病（TB）和非结核分枝杆菌（NTM）病的发病率、临床特征及治疗结果进行了回顾性研究。1996年至2013年期间，韩国一家三级转诊中心进行了7342例实体器官移植和1266例造血干细胞移植。其中，分别有130例和22例发生了TB和NTM病。TB的总体发病率为257.4例/100 000患者年（95%置信区间[CI]，215.1 - 305.7），NTM病的总体发病率为42.7例/100 000患者年（95% CI，26.8 - 64.7）。TB患者从器官移植到发生分枝杆菌病的中位间隔时间为8.5个月（95% CI，6.3 - 11.4），NTM患者为24.2个月（95% CI，13.5 - 55.7）。在NTM患者中，鸟分枝杆菌复合群是最常见的致病微生物，结节性支气管扩张型（77.8%）是最常见的影像学特征。TB和NTM患者的治疗有效率分别为83.7%（95% CI，76.4 - 89.1）和68.8%（95% CI，44.4 - 85.8）（P = 0.166）。总之，移植受者中TB的总体发病率高于NTM病，药物敏感的TB和NTM患者的治疗结果均良好。
