北德克萨斯非结核分枝杆菌的患病率及菌种多样性
Prevalence and species diversity of non-tuberculous mycobacteria in North Texas.
作者信息
Sah Manoj K, Mahimainathan Lenin, Mesfin Muluye, Clark Andrew E, SoRelle Jeffrey A
机构信息
Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Health Sciences, University of Texas Health Science Center, San Antonio, USA.
Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
J Infect Public Health. 2025 Oct;18(10):102890. doi: 10.1016/j.jiph.2025.102890. Epub 2025 Jul 5.
BACKGROUND
Non-tuberculous mycobacterial (NTM) infections are an emerging group of related opportunistic pathogens resembling tuberculosis (TB) infections with a wide virulence spectrum. The diversity of the causative agents of NTM disease underscores the need for swift identification, as it differs by geographic regions, and treatment approaches vary. This study aimed to determine the prevalence of Non-tuberculous Mycobacteria recovered in North Texas.
METHODS
A retrospective study was conducted between January 1, 2022, to December 31, 2023. We included 15,724 pulmonary and extra-pulmonary specimens submitted to Acid Fast Bacilli (AFB) culture. A total of 820 specimens growing with the Mycobacterial species were counted for the final analysis. Species prevalence, site of growth, and seasonal trends were evaluated at our site.
RESULTS
In a total of 15,724 AFB cultures (5.21 %, n = 820), specimens were positive for twenty-four different species/subspecies of mycobacteria. Overall, the prevalence of NTM was (5.05 %, n = 795). Out of 820, the incidence of NTM was (97 %, n = 795) and M. tuberculosis complex (3 %, n = 25). 15.4 % (704/4574) of NTM were isolated from pulmonary and 0.82 % (91/11,150) from extra-pulmonary specimens. (63 %, n = 514) were slow-growing mycobacteria. The major NTM species were M. avium complex (MAC) (46 %, n = 375), followed by M. abscessus complex (23.78 %, n = 195), M. chelonae (4.9 %, n = 40), M. mucogenicum phocaicum (3.9 %, n = 32), and M. arupense (2.1 %, n = 17). Notably, MAC had cyclical low points in July and February but peaked in October. There was no seasonal pattern for M. abscessus complex.
CONCLUSIONS
Our findings revealed that the frequency of NTM was much higher than TB. Remarkably, the prevalence of M. avium complex and M. abscessus complex occupies the top rank, with the emerging M. chelonae and M. mucogenicum phocaicum. This warrants a precise analytical approach to identify the NTM as the diverse geographical distribution and the needed species-specific treatment regimen to adopt control measures.
背景
非结核分枝杆菌（NTM）感染是一组新出现的相关机会性病原体，类似于结核病（TB）感染，毒力谱广泛。NTM病病原体的多样性突出了快速鉴定的必要性，因为其因地理区域而异，治疗方法也有所不同。本研究旨在确定在北德克萨斯州分离出的非结核分枝杆菌的患病率。
方法
在2022年1月1日至2023年12月31日期间进行了一项回顾性研究。我们纳入了15724份提交给抗酸杆菌（AFB）培养的肺和肺外标本。最终分析统计了共820份培养出分枝杆菌属菌种的标本。在我们的研究地点评估了菌种患病率、生长部位和季节趋势。
结果
在总共15724份AFB培养物中（5.21%，n = 820），标本对24种不同的分枝杆菌菌种/亚种呈阳性。总体而言，NTM的患病率为（5.05%，n = 795）。在820份标本中，NTM的发生率为（97%，n = 795），结核分枝杆菌复合群为（3%，n = 25）。15.4%（704/4574）的NTM分离自肺部标本，0.82%（91/11150）分离自肺外标本。（63%，n = 514）为生长缓慢的分枝杆菌。主要的NTM菌种是鸟分枝杆菌复合群（MAC）（46%，n = 375），其次是脓肿分枝杆菌复合群（23.78%，n = 195）、龟分枝杆菌（4.9%，n = 40）、黏液产孢分枝杆菌（3.9%，n = 32）和阿鲁普分枝杆菌（2.1%，n = 17）。值得注意的是，MAC在7月和2月有周期性低点，但在10月达到峰值。脓肿分枝杆菌复合群没有季节性模式。
结论
我们的研究结果表明，NTM的发生率远高于TB。值得注意的是，鸟分枝杆菌复合群和脓肿分枝杆菌复合群的患病率位居前列，还有新出现的龟分枝杆菌和黏液产孢分枝杆菌。这需要一种精确的分析方法来鉴定NTM，因为其地理分布多样，且需要采取针对特定菌种的治疗方案来采取控制措施。
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