Tropical and Infectious Diseases Department, Andrée Rosemon Hospital, Cayenne, French Guiana.
Pneumology Department, University Hospital of Guadeloupe, Pointe-à-Pitre, France.
PLoS Negl Trop Dis. 2022 Sep 9;16(9):e0010693. doi: 10.1371/journal.pntd.0010693. eCollection 2022 Sep.
Unlike diseases caused by Mycobacterium tuberculosis, M. leprae and M. ulcerans, the epidemiology of pulmonary non-tuberculous mycobacteria (PNTM) has not received due attention in French Guiana. The main objective of the current study was to define the incidence of these PNTM infections: NTM pulmonary diseases (NTM-PD) and casual PNTM isolation (responsible of latent infection or simple colonization). The secondary objectives were to determine species diversity and geographic distribution of these atypical mycobacteria.
A retrospective observational study (2008-2018) of French Guiana patients with at least one PNTM positive respiratory sample in culture was conducted. Patients were then classified into two groups: casual PNTM isolation or pulmonary disease (NTM-PD), according to clinical, radiological and microbiological criteria defined by the American Thoracic Society / Infectious Disease Society of America (ATS / IDSA) in 2007.
178 patients were included, out of which 147 had casual PNTM isolation and 31 had NTM-PD. Estimated annual incidence rate of respiratory isolates was 6.17 / 100,000 inhabitants per year while that of NTM-PD was 1.07 / 100,000 inhabitants per year. Among the 178 patients, M. avium complex (MAC) was the most frequently isolated pathogen (38%), followed by M. fortuitum then M. abscessus (19% and 6% of cases respectively), the latter two mycobacteria being mainly found in the coastal center region. Concerning NTM-PD, two species were mainly involved: MAC (81%) and M. abscessus (16%).
DISCUSSION/CONCLUSION: This is the first study on the epidemiology of PNTM infections in French Guiana. PNTM's incidence looks similar to other contries and metropolitan France and NTM-PD is mostly due to MAC and M.abscessus. Although French Guiana is the French territory with the highest tuberculosis incidence, NTM should not be overlooked.
与由结核分枝杆菌、麻风分枝杆菌和溃疡分枝杆菌引起的疾病不同，法属圭亚那对非结核分枝杆菌（NTM）肺部感染的流行病学尚未给予应有的重视。本研究的主要目的是确定这些 NTM 肺部感染（NTM-PD）和偶然分离的 NTM（导致潜伏感染或单纯定植）的发病率。次要目标是确定这些非典型分枝杆菌的物种多样性和地理分布。
对 2008 年至 2018 年期间至少有一份呼吸道 NTM 阳性培养物的法属圭亚那患者进行了回顾性观察性研究。然后，根据美国胸科学会/传染病学会（ATS/IDSA）2007 年定义的临床、影像学和微生物学标准，将患者分为两组：偶然分离的 NTM 或肺部疾病（NTM-PD）。
共纳入 178 例患者，其中 147 例为偶然分离的 NTM，31 例为 NTM-PD。呼吸道分离物的年估计发病率为 6.17/10 万居民/年，而 NTM-PD 的年发病率为 1.07/10 万居民/年。在 178 例患者中，最常分离到的病原体是鸟分枝杆菌复合群（MAC）（38%），其次是脓肿分枝杆菌，然后是偶然分枝杆菌（分别占病例的 19%和 6%），后两种分枝杆菌主要在沿海中心地区发现。至于 NTM-PD，主要涉及两种物种：MAC（81%）和脓肿分枝杆菌（16%）。
讨论/结论：这是法属圭亚那首次关于 NTM 肺部感染的流行病学研究。NTM 的发病率与其他国家和法国本土相似，NTM-PD 主要由 MAC 和 M.abscessus 引起。尽管法属圭亚那是法国结核病发病率最高的地区，但不应忽视 NTM。
