Central Laboratory, Chongqing Public Health Medical Centre, Chongqing400036, China.
School of Nursing, Southwest Medical University, Sichuan646000, China.
Epidemiol Infect. 2020 Dec 28;149:e7. doi: 10.1017/S0950268820003088.
With the rapid rise in the prevalence of non-tuberculous mycobacteria (NTM) diseases across the world, the microbiological diagnosis of NTM isolates is becoming increasingly important for the diagnosis and treatment of NTM disease. In this study, the clinical presentation, species distribution and drug susceptibility of patients with NTM disease visiting the Chongqing Public Health Medical Centre during March 2016-April 2019 were retrospectively analysed. Among the 146 patients with NTM disease, eight NTM species (complex) were identified. The predominant NTM species in these patients were identified to be Mycobacterium abscessus complex (53, 36.3%), M. intracellulare (38, 26%) and M. fortuitum (17, 11.7%). In addition, two or more species were isolated from 7.5% of the patients. Pulmonary NTM disease (142, 97.3%) showed the highest prevalence among the patients. It was observed that 40.1% of the patients with pulmonary NTM disease had chronic pulmonary obstructive disease and bronchiectasis, while 22.5% had prior tuberculosis. Male patients showed more association with the conditions of cough and haemoptysis than the female patients. In an in vitro antimicrobial susceptibility testing, most of the species showed susceptibility to linezolid, amikacin and clarithromycin, while M. fortuitum exhibited low susceptibility to tobramycin. In conclusion, the prevalence of NTM disease, especially that of the pulmonary NTM disease, is common in Southwest China. Species identification and drug susceptibility testing are thus extremely important to ensure appropriate treatment regimens for patient care and management.
随着非结核分枝杆菌(NTM)疾病在全球的患病率迅速上升,NTM 分离株的微生物学诊断对于 NTM 疾病的诊断和治疗变得越来越重要。本研究回顾性分析了 2016 年 3 月至 2019 年 4 月期间重庆公共卫生医疗救治中心就诊的 NTM 病患者的临床表现、菌种分布和药敏情况。在 146 例 NTM 病患者中,鉴定出 8 种 NTM (复合)种。这些患者中主要的 NTM 种被鉴定为脓肿分枝杆菌复合群(53 例,36.3%)、胞内分枝杆菌(38 例,26%)和偶发分枝杆菌(17 例,11.7%)。此外,7.5%的患者分离出两种或两种以上的菌种。在这些患者中,肺部 NTM 病(142 例,97.3%)的患病率最高。观察到,40.1%的肺部 NTM 病患者患有慢性阻塞性肺疾病和支气管扩张症,而 22.5%的患者有既往肺结核病史。男性患者比女性患者更容易出现咳嗽和咯血等症状。在体外抗菌药物敏感性试验中,大多数菌种对利奈唑胺、阿米卡星和克拉霉素敏感,而偶发分枝杆菌对妥布霉素的敏感性较低。总之,NTM 病,尤其是肺部 NTM 病的患病率在中国西南地区较为常见。因此,菌种鉴定和药敏试验对于确保为患者提供适当的治疗方案和管理非常重要。