Chongwe Gershom, Michelo Charles, Kelly Paul
Department of Public Health, School of Medicine, University of Zambia, Box 50110, Lusaka, Zambia.
Tropical Gastroenterology Unit, School of Medicine, Department of Internal Medicine, University of Zambia, Box 50110, Lusaka, Zambia.
BMC Res Notes. 2017 Jan 7;10(1):27. doi: 10.1186/s13104-016-2329-3.
The intestinal carriage of nontuberculous mycobacteria (NTM) is associated with disease, especially in severely immunocompromised individuals. These organisms, although often considered contaminants, have been known to cause various types of illnesses. We aimed to determine the prevalence of and associated factors for NTM among patients booked for colonoscopy at the University Teaching Hospital (UTH) in Lusaka.
We randomly recruited 97 patients attending routine endoscopy procedures between November 2012 and October 2013 and after consent, administered a structured questionnaire. We collected stool and intestinal lavage samples, as well as biopsy samples from the descending colon and the caecal area during the endoscopy procedure. Samples were cultured using the mycobacteria growth indicator tube (MGIT) method followed by the GenoType Mycobacterium CM/AS assay for identification of NTM. Results were expressed as means and standard deviations; proportions were expressed as percentages with corresponding 95% confidence intervals. We used Fisher's exact Chi square test for cross-tabulations where appropriate. All statistical tests were two-sided, with a significance level set at p < 0.05.
Out of the 97 patients, 45 (46.4%) were female and 52 (53.6%) were males with mean ages 49.1 (±16.7, range 24-85) and 44.4 (±15.0, range 18-80) years respectively. The prevalence of NTM was 7.2% (95% CI 1.9-12.4), while that of Mycobacterium tuberculosis (MTB) was 6.2% (95% CI 2.3-13.0). Carriage of NTM was not significantly associated with age, sex or presenting symptoms such as diarrhoea, abdominal pain, weight loss as well as HIV status. There were no identifiable predictors of NTM carriage.
The results have shown that NTM and MTB are present in the intestines of the patients booked for colonoscopy at the University Teaching Hospital in Lusaka, but their presence is not related to presenting symptoms. Given that this may be an indicator of a bigger burden of NTM in this population, there is a need to explore this burden and the contribution it could have on abdominal disease in general as well as examine potential factors that might be important predictors.
非结核分枝杆菌（NTM）在肠道内的携带与疾病相关，尤其是在严重免疫功能低下的个体中。这些微生物虽然常被视为污染物，但已知会引起各种类型的疾病。我们旨在确定卢萨卡大学教学医院（UTH）预约结肠镜检查的患者中NTM的患病率及相关因素。
我们随机招募了97例在2012年11月至2013年10月期间接受常规内镜检查的患者，在获得同意后，发放一份结构化问卷。我们在内镜检查过程中收集粪便和肠道灌洗样本，以及降结肠和盲肠区域的活检样本。样本采用分枝杆菌生长指示管（MGIT）法培养，随后进行GenoType分枝杆菌CM/AS检测以鉴定NTM。结果以均值和标准差表示；比例以百分比及相应的95%置信区间表示。在适当情况下，我们使用Fisher精确卡方检验进行交叉表分析。所有统计检验均为双侧检验，显著性水平设定为p < 0.05。
97例患者中，45例（46.4%）为女性，52例（53.6%）为男性，平均年龄分别为49.1（±16.7，范围24 - 85）岁和44.4（±15.0，范围18 - 80）岁。NTM的患病率为7.2%（95% CI 1.9 - 12.4），而结核分枝杆菌（MTB）的患病率为6.2%（95% CI 2.3 - 13.0）。NTM的携带与年龄、性别或腹泻、腹痛、体重减轻等症状以及HIV状态均无显著关联。没有可识别的NTM携带预测因素。
结果表明，在卢萨卡大学教学医院预约结肠镜检查的患者肠道中存在NTM和MTB，但它们的存在与所呈现的症状无关。鉴于这可能表明该人群中NTM负担更大，有必要探讨这一负担及其对一般腹部疾病可能产生的影响，并研究可能是重要预测因素的潜在因素。
