Bonnet Maryline, San Kim Chamroeun, Pho Yati, Sok Chandara, Dousset Jean-Philippe, Brant William, Hurtado Northan, Eam Khun Kim, Ardizzoni Elisa, Heng Seiha, Godreuil Sylvain, Yew Wing-Wai, Hewison Cathy
Emerg Infect Dis. 2017 Jul;23(7):1139-1147. doi: 10.3201/eid2307.170060.
Prevalence of nontuberculous mycobacteria (NTM) disease is poorly documented in countries with high prevalence of tuberculosis (TB). We describe prevalence, risk factors, and TB program implications for NTM isolates and disease in Cambodia. A prospective cohort of 1,183 patients with presumptive TB underwent epidemiologic, clinical, radiologic, and microbiologic evaluation, including >12-months of follow-up for patients with NTM isolates. Prevalence of NTM isolates was 10.8% and of disease was 0.9%; 217 (18.3%) patients had TB. Of 197 smear-positive patients, 171 (86.8%) had TB confirmed (167 by culture and 4 by Xpert MTB/RIF assay only) and 11 (5.6%) had NTM isolates. HIV infection and past TB were independently associated with having NTM isolates. Improved detection of NTM isolates in Cambodia might require more systematic use of mycobacterial culture and the use of Xpert MTB/RIF to confirm smear-positive TB cases, especially in patients with HIV infection or a history of TB.
在结核病（TB）高流行率的国家，非结核分枝杆菌（NTM）病的流行情况记录不足。我们描述了柬埔寨NTM分离株和疾病的流行情况、危险因素以及对结核病防治规划的影响。对1183例疑似结核病患者进行了前瞻性队列研究，进行了流行病学、临床、放射学和微生物学评估，包括对NTM分离株患者进行超过12个月的随访。NTM分离株的流行率为10.8%，疾病流行率为0.9%；217例（18.3%）患者患有结核病。在197例涂片阳性患者中，171例（86.8%）结核病得到确诊（167例通过培养确诊，4例仅通过Xpert MTB/RIF检测确诊），11例（5.6%）有NTM分离株。HIV感染和既往结核病与NTM分离株独立相关。在柬埔寨，提高NTM分离株的检测率可能需要更系统地使用分枝杆菌培养，并使用Xpert MTB/RIF来确诊涂片阳性的结核病病例，尤其是在HIV感染患者或有结核病病史的患者中。
