Centro Médico de Campinas, Ramos de Souza Laboratory, Microbiology Sector.
Department of Clinical Pathology, School of Medical Sciences, University of Campinas.
Pathog Dis. 2018 Jul 1;76(5). doi: 10.1093/femspd/fty051.
Nontuberculous mycobacteria (NTM) have been well established as an opportunistic pathogenic bacterial group for cystic fibrosis (CF) patients, with a prevalence ranging from 3% to 23% worldwide. A myriad of factors can bias the prevalence rate in different CF centers, especially misdiagnosis as systematic screening for NTM are still lacking in a number of centers. Here, we evaluated the presence and clinical outcomes of NTM isolation in microbiological respiratory cultures from CF patients attending a Brazilian reference center after setting up a systematic diagnostic protocol. Of 117 patients with respiratory samples cultured for NTM research, we found seven patients (6%) with at least one positive result for NTM [four males (57.1%), median age = 21 years (9-58)]. These cases are reported one-by-one. Median FEV1 was 40%, all patients showed signs of lung deterioration, with a median number of pulmonary exacerbations of three per patient/year. However, the impact of NTM isolation remains unclear in our center as all patients were coinfected with other CF respiratory pathogens. Our NTM prevalence assimilates to the lowest levels reported in literature, which is possibly influenced by the routinely applied Bacille Calmette-Guérin vaccine.
非结核分枝杆菌（NTM）已被证实是囊性纤维化（CF）患者的一种机会致病菌，全球患病率为 3%至 23%。许多因素会影响不同 CF 中心的患病率，特别是在一些中心，系统筛查 NTM 的误诊率仍然很高。在这里，我们评估了在巴西参考中心建立系统诊断方案后，从 CF 患者的微生物呼吸培养物中分离出 NTM 的存在和临床结果。在对 117 名进行 NTM 研究的呼吸道样本患者中，我们发现了 7 名（6%）至少有一次 NTM 阳性结果的患者[4 名男性（57.1%），中位年龄为 21 岁（9-58 岁）]。逐个报告这些病例。中位 FEV1 为 40%，所有患者均出现肺部恶化迹象，每位患者每年的肺部恶化次数中位数为 3 次。然而，在我们中心，NTM 分离的影响尚不清楚，因为所有患者均合并有其他 CF 呼吸道病原体感染。我们的 NTM 患病率与文献报道的最低水平相当，这可能与常规应用卡介苗有关。
