Igari H, Kikuchi N, Kawashima T, Onozaki I, Kuriyama T
Department of Internal Medicine, Chiba Kaihin Municipal Hospital, Japan.
Kekkaku. 1994 Jul;69(7):483-90.
In the past eight years, we experienced 94 cases of nontuberculous mycobacteria (NTM) isolation from the specimens of sputum, gastric juice, pleural fluid and fiberoptic bronchoscopic procedure at Chiba Kaihin Municipal Hospital. The species of NTM were M. avium complex (MAC) in 23, M. gordonae in 15, M. kansasii in 12, M. fortuitum in 8, M. chelonae in 7, etc.. The number of isolation of NTM has increased, and it is worthwhile to mention that it had exceeded the number of isolation of M. tuberculosis since 1991. We experienced 28 cases of pulmonary infections caused by NTM during the same period. Thirteen cases were by M. avium complex, 11 cases by M. kansasii, one case by MAC and M. kansasii, one case by M. chelonae and two cases by unidentified NTM. Pulmonary infections by NTM also gradually increased. Thirteen cases (46.4%) had underlying diseases in the respiratory system. Most of them were progressive diseases with cavities and were easily diagnosed by mycobacterial examinations of the specimens such as sputum or gastric juice. We were unable to diagnose 12 cases (42.9%) by mycobacterial examinations. Most of them had no underlying diseases and showed small lesions without cavitation on the chest X-ray. Eight cases were diagnosed by the histopathological examination of TBLB (transbronchial lung biopsy) specimens. In such cases, these procedures were also useful for the early diagnosis. This study indicated the increase of the isolation of NTM and the pulmonary infections by NTM. Once the infections are established, they are progressive, and the early diagnosis of these infections are thought to be important.
在过去八年中，我们在千叶海滨市立医院从痰液、胃液、胸水和纤维支气管镜检查标本中分离出94例非结核分枝杆菌（NTM）。NTM的种类有鸟分枝杆菌复合群（MAC）23例、戈登分枝杆菌15例、堪萨斯分枝杆菌12例、偶然分枝杆菌8例、龟分枝杆菌7例等。NTM的分离数量有所增加，值得一提的是，自1991年以来其分离数量已超过结核分枝杆菌。同期我们还遇到28例由NTM引起的肺部感染。其中13例由鸟分枝杆菌复合群引起，11例由堪萨斯分枝杆菌引起，1例由MAC和堪萨斯分枝杆菌共同引起，1例由龟分枝杆菌引起，2例由未鉴定的NTM引起。NTM引起的肺部感染也逐渐增多。13例（46.4%）有呼吸系统基础疾病。其中大多数是有空洞的进展性疾病，通过痰液或胃液等标本的分枝杆菌检查很容易诊断。通过分枝杆菌检查我们无法诊断12例（42.9%）。其中大多数没有基础疾病，胸部X线显示小病灶且无空洞。8例通过经支气管肺活检（TBLB）标本的组织病理学检查得以诊断。在这些病例中，这些检查方法对早期诊断也很有用。本研究表明NTM的分离及NTM引起的肺部感染有所增加。一旦感染确立，病情会进展，因此这些感染的早期诊断被认为很重要。
