Division of Pulmonary Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland,
Division of Pulmonary Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.
Respiration. 2022;101(4):367-375. doi: 10.1159/000520033. Epub 2021 Dec 7.
Nontuberculous mycobacteria (NTM) are increasingly identified in industrialized countries, and their role as pathogens is more frequently recognized. The relative prevalence of NTM strains shows an important geographical variability. Thus, establishing the local relative prevalence of NTM strains is relevant and useful for clinicians.
Retrospective analysis (2015-2020) of a comprehensive database was conducted including all results of cultures for mycobacteria in a University Hospital (Geneva, Switzerland), covering a population of approximately 500,000 inhabitants. All NTM culture-positive patients were included in the analyses. Patients' characteristics, NTM strains, and time to culture positivity were reported.
Among 38,065 samples analyzed during the study period, 411 were culture-positive for NTM, representing 236 strains, and 231 episodes of care which occurred in 222 patients. Patients in whom NTM were identified were predominantly female (55%), with a median age of 62 years, and a low BMI (median: 22.6 kg/m2). The Mycobacterium avium complex (MAC) was the most frequently identified group (37% of strains) followed by Mycobacterium gordonae (25%) and Mycobacterium xenopi (12%) among the slowly growing mycobacteria (SGM), while the Mycobacterium chelonae/abscessus group (11%) were the most frequently identified rapidly growing mycobacteria (RGM). Only 19% of all patients were treated, mostly for pulmonary infections: the MAC was the most frequently treated NTM (n = 19, 43% of cases in patients treated) followed by RGM (n = 15, 34%) and M. xenopi (n = 6, 14%). Among those treated, 23% were immunosuppressed, 12% had pulmonary comorbidities, and 5% systemic comorbidities. Cultures became positive after a median of 41 days (IQR: 23; 68) for SGM and 28 days (14; 35) for RGM.
In Western Switzerland, M. avium and M. gordonae were the most prevalent NTM identified. Positive cultures for NTM led to a specific treatment in 19% of subjects. Patients with a positive culture for NTM were mostly female, with a median age of 62 years, a low BMI, and a low prevalence of immunosuppression or associated severe comorbidities.
非结核分枝杆菌（NTM）在工业化国家中的检出率越来越高，其作为病原体的作用也越来越受到重视。NTM 菌株的相对流行率表现出重要的地域差异。因此，确定当地 NTM 菌株的相对流行率对于临床医生来说是相关且有用的。
对一家大学医院（瑞士日内瓦）的分枝杆菌培养综合数据库进行回顾性分析（2015-2020 年），该数据库涵盖了约 50 万居民的人口。所有 NTM 培养阳性的患者均纳入分析。报告患者特征、NTM 菌株和培养阳性时间。
在研究期间分析的 38065 个样本中，411 个样本的 NTM 培养呈阳性，代表 236 株，231 例发生在 222 例患者的护理事件。确定 NTM 的患者主要为女性（55%），中位年龄为 62 岁，BMI 较低（中位数：22.6kg/m2）。在慢生长分枝杆菌（SGM）中，最常鉴定到的菌群是鸟分枝杆菌复合群（MAC）（占菌株的 37%），其次是戈登分枝杆菌（25%）和偶发分枝杆菌（12%），而脓肿分枝杆菌/龟分枝杆菌群（11%）是最常鉴定到的快生长分枝杆菌（RGM）。所有患者中仅有 19%接受了治疗，主要用于肺部感染：MAC 是最常治疗的 NTM（n=19，占治疗患者的 43%），其次是 RGM（n=15，占 34%）和 M. xenopi（n=6，占 14%）。在接受治疗的患者中，23%存在免疫抑制，12%存在肺部合并症，5%存在全身合并症。SGM 的中位培养阳性时间为 41 天（IQR：23；68），RGM 的中位培养阳性时间为 28 天（IQR：14；35）。
在瑞士西部，鸟分枝杆菌和戈登分枝杆菌是最常见的 NTM。NTM 阳性培养导致 19%的患者接受了特定治疗。NTM 阳性培养的患者主要为女性，中位年龄为 62 岁，BMI 较低，免疫抑制或相关严重合并症的患病率较低。
