Instituto Adolfo Lutz, Santos, SP, Brazil.
Einstein (Sao Paulo). 2022 Feb 14;20:eAO5510. doi: 10.31744/einstein_journal/2022AO5510. eCollection 2022.
To present the frequency and species diversity of non-tuberculous mycobacteria, estimate the prevalence of non-tuberculous mycobacterial pulmonary disease, describe the epidemiological profile, and determine the follow-up of patients with non-tuberculous mycobacterial pulmonary disease living in a region with a high burden of tuberculosis.
This a retrospective cohort observational study using data records obtained from the Instituto Adolfo Lutz - Santos and from the São Paulo Sistema de Vigilância de Tuberculose do Estado de São Paulo in the period between 2000 and 2009. The studied variables were: socio-demographic characteristics, current and past history of tuberculosis, aspects related to diagnosis, and treatment and associated diseases.
We included 319 non-tuberculous mycobacteria isolates in the study, corresponding to 257 patients. The species Mycobacterium kansasii (28.5%) and Mycobacterium fortuitum (16.6%) presented the higher occurrence. In 10.9% (24) of the patients, there was a criterion for confirming a case of pulmonary disease due to non-tuberculous mycobacteria. In relation to gender and age, male and individuals over 50 years old were the most frequent. Considering the confirmed cases, 47.8% had a past history of tuberculosis.
The lack of information about the cases is evident, since pulmonary disease due to non-tuberculous mycobacteria is not mandatory. The therapeutic regimen according to the identified species is fundamental for success in combating the infections caused by non-tuberculous mycobacteria. Besides that, information about the regional epidemiology of pulmonary disease caused by non-tuberculous mycobacteria and the search for associations with other comorbidities are important to establish the correct treatment. In order to improve surveillance of pulmonary diseases by non-tuberculous mycobacteria, we suggest the implantation of a sentinel surveillance and of population-based studies.
介绍非结核分枝杆菌的频率和物种多样性，估计非结核分枝杆菌肺病的患病率，描述流行病学特征，并确定生活在结核病负担高的地区的非结核分枝杆菌肺病患者的随访情况。
这是一项回顾性队列观察研究，使用了 2000 年至 2009 年期间从 Adolfo Lutz-Santos 研究所和圣保罗州结核病监测系统获得的数据记录。研究变量包括：社会人口统计学特征、现病史和既往结核病史、与诊断、治疗和相关疾病相关的方面。
我们纳入了 319 株非结核分枝杆菌分离株，涉及 257 例患者。物种堪萨斯分枝杆菌（28.5%）和偶然分枝杆菌（16.6%）的发生率较高。在 10.9%（24 例）的患者中，有一个标准可以确认非结核分枝杆菌肺病病例。就性别和年龄而言，男性和 50 岁以上的患者最为常见。考虑到确诊病例，47.8%的患者有既往结核病病史。
显然缺乏对病例的信息，因为非结核分枝杆菌肺病不是强制性的。根据鉴定出的物种制定的治疗方案对于成功治疗非结核分枝杆菌感染至关重要。此外，了解非结核分枝杆菌肺病的区域流行病学和寻找与其他合并症的关联对于确定正确的治疗方法很重要。为了改善非结核分枝杆菌肺病的监测，我们建议建立哨点监测和基于人群的研究。
