Institute of Microbiology and Laboratory Medicine, Department IML red GmbH, WHO - Supranational Tuberculosis Reference Laboratory, Munich-Gauting, Germany.
Department of Pneumology & Infectious Diseases, Asklepios Lung Clinic Munich-Gauting, member of the German Centre for Lung Research; Gauting, Germany.
Emerg Microbes Infect. 2023 Dec;12(2):2276342. doi: 10.1080/22221751.2023.2276342. Epub 2023 Dec 6.
Numbers of non-tuberculous mycobacteria (NTM) pulmonary diseases (PD) have been repeatedly reported as increasing over the last decades, particularly in Europe. Sound epidemiological data are however missing for most European regions. This study calculated prevalence and incidence of NTM recovered from patients' lungs in Germany, the largest Central European country, over a five-year period. It furthermore determined regional particularities of NTM species and results from susceptibility testing. 22 German NTM laboratories provided their mycobacteriological diagnostic data of 11,430 NTM isolates recovered from 5998 pulmonary patients representing 30% of all notified NTM-PD cases of Germany from 2016 to 2020. NTM incidence and prevalence were calculated for every study year. The presented epidemiological indicators are particularly reliant as TB surveillance data were used as a reference and TB notification reaches almost 100% in Germany. Laboratory incidence and prevalence of NTM recovered from respiratory samples ranged from 4.5-4.9 and from 5.3-5.8/100,000 for the population of Germany, respectively, and did not change over the five-year study period. Prevalence and incidence were stable also when stratifying for facultative pathogenic NTM, complex (MAIC), and complex (MABSC). The proportion of NTM with drug susceptibility testing (DST) increased from 27.3% (2016) to 43.8% (2020). The unchanging laboratory NTM prevalence/incidence in Germany represents a "ceiling" of possible NTM-PD notification when diagnostic strategies do not change in the coming years. A notable increase in NTM-DST may indicate better notification of NTM-PD and/or awareness of new clinical guidelines but still remains below clinical needs.
过去几十年,非结核分枝杆菌(NTM)肺病(PD)的病例数不断增加,这一情况在欧洲尤为明显。然而,大多数欧洲地区缺乏健全的流行病学数据。本研究计算了德国(中欧最大的国家)五年来从患者肺部分离出的 NTM 的患病率和发病率。此外,本研究还确定了 NTM 种属的区域特点和药敏试验结果。22 家德国 NTM 实验室提供了其从 5998 例肺部患者中分离出的 11430 株 NTM 分离株的分枝杆菌学诊断数据,这些患者代表了 2016 年至 2020 年德国报告的所有 NTM-PD 病例的 30%。研究年计算了 NTM 的发病率和患病率。本研究中提出的流行病学指标特别可靠,因为 TB 监测数据被用作参考,德国的 TB 报告几乎达到 100%。从呼吸道样本中分离出的 NTM 的实验室发病率和患病率分别为德国人群的 4.5-4.9/100,000 和 5.3-5.8/100,000,在五年的研究期间没有变化。当按兼性致病 NTM、复杂(MAIC)和复杂(MABSC)进行分层时,患病率和发病率也是稳定的。具有药敏试验(DST)的 NTM 的比例从 27.3%(2016 年)增加到 43.8%(2020 年)。德国实验室 NTM 患病率/发病率保持不变,代表如果未来几年诊断策略不变,可能的 NTM-PD 报告率达到了“上限”。具有药敏试验的 NTM 显著增加可能表明 NTM-PD 的报告率提高和/或对新临床指南的认识提高,但仍低于临床需求。