MYCOBACTERIOSIS OF THE RESPIRATORY SYSTEM: EPIDEMIOLOGY, MICROBIOLOGY AND CLINICAL ASPECTS OF DIAGNOSIS

Abstract

Scientific and Clinical Antituberculosis Center, Department of Health Care of the city of Moscow, ul. Stromynka 10, Sokol'Niki, Moskva 107014. In 40 patients (with no clinically significant immunosuppression) according to the criteria of the American Thoracic Society, pulmonary mycobacterioses (MAC - 35%, M. kansasii - 25%, M. xenopi - 20%, M. fortuitum - 12,5% и M. chelonae - 7,5%) have been diagnosed. In 95% of patients acute clinical symptomatology with polymorphic radiographic findings has been noted. The constant and massive non-tuberculosis mycobacteria (NTMB) excretion was noted. With fluorescent microscopy acid-fast mycobacteria (AFM) were identified from sputum in 62.5% patients, in 22.5% of patients AFM were found in bronchoalveolar lavage fluid. Cultural analysis of sputum processed by broth dilution method permitted to isolate NTMB in 65%, including in 50% - two times or more. In a solid medium sputum cultures with growth of NTMB were isolated in 45%, including 20% - two times or more. In 10.0% NTMB were isolated when plated on solid media operating material. M. fortuitum, M. chelonae and MAC are the most resistant to anti-TB drugs: M. fortuitum - to all major drugs series, M.chelonae - to all major drugs and a number of reserve drugs, including fluoroquinolones) and MAC (resistant to both isoniazid and rifampicin in 92.9% of cases including, in combination with fluoroquinolones and kanamycin, or capreomycin - in 64.3%)

Keywords

Non-tuberculosis mycobacteria / diagnosis / identification / drug resistance

References

[1] Вейсфейлер Д. Биология и изменчивость микобактерий туберкулеза и атипичные микобактерии: экспериментальные и теоретические исследования. - Будапешт, 1975.

[2] Литвинов В. И., Макарова Н. В., Краснова М. А. Нетуберкулезные микобактерии. - М., 2008.

[3] Литвинов В. И., Дорожкова И. Р., Макарова М. В. и др. Выделение и идентификация нетуберкулезных микобактерий // Вестн. РАМН. - 2010. - № 3. - С. 7-11.

[4] Макарова М. В. Выделение и идентификация нетуберкулезных микобактерий у пациентов фтизиатрических учреждений: Автореф. дис.. д-ра мед. наук. - М., 2010.

[5] Определитель бактерий Берджи. - 9-е изд. / Под ред. Дж. Хоулта, Н. Крига, П. Снита и др.; пер. с англ. - М., 1997. -Т. 1-2.

[6] Оттен Т. Ф., Васильев А. В. Микобактериоз. - СПб., 2005.

[7] Andrejak C., Thomsen V. O., Johansen I. S. et al. Nontuberculous pulmonary mycobacteriosis in Denmark: incidence and prognostic factors // Аш. J. Respir. Git. Сare rned. - 2010. - Vol. 181. - P. 514-521.

[8] Billinger M. E., Olivier K. N., Viboud C. et al. Nontuberculous mycobacteria-associated lung disease in hospitalized persons, United States, 1998-2005 // Emerg. Infect. Dis. - 2009. - Vol. 15. - P 1562-1569.

[9] Cassidy P. M., Hedberg K., Saulson A. et al. Nontuberculous mycobacterial disease prevalence and risk factors: a changing epidemiology // Сііп. Infect. Dis. - 2009. - Vol. 49. - P. 124-129.

[10] Daley C. L., Griffith D. E. Pulmonary non-tuberculous mycobacterial infections // Int. J. Tuberc. Lung Dis. - 2010. - Vol. 14, N 6. - P. 665-671.

[11] Evans A. J., Crisp A. J., Hubbard R. B. et al. Pulmonary rnycobacterium kansasii infection: comparison of radiological appearances with pulmonary tuberculosis // Thorax. - 1996. - Vol. 51. - P. 1243-1247.

[12] Falkinham J. O. Nontuberculous mycobacteria in the environment // Сlіn. Chest Мed. - 2002. - Vol. 23. - P. 529-551.

[13] Griffith D. E., Aksamit T., Brown-Elliott B. A. et al. Ап official АTS/IDSА statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases // Аm. J. Respir. Сrit. Сare Med. - 2007. - Vol. 175. - P. 367-416.

[14] Hazelton T. R., Newell J. D., Cook J. L. et al. СТ finding in 14 patients with Мycobacterium chelonae pulmonary infection // Аm. J. Roentgenol. - 2000. - Vol. 175, N 2. - P. 413-416.

[15] Iseman M. D., Marras T. K. The importance of nontuberculous mycobacterial lung disease // Аm. J. Respir. Сrit. Сare Med. - 2008. - Vol. 178. - P. 999-1000.

[16] Lai C. C., Tan C. K., Chou C. H. et al. Increasing incidence of nontuberculous mycobacteria, Taiwan, 2000-2008 // Emerg. Infect. Dis. - 2010. - Vol. 16. - P. 294-296.

[17] Linares M. J., Pelaez M. J., Casal M. Isolation of atypical mycobacteria from mycobacteria reference center in Spain // Int. J. Tuberc. Lung Dis. - 1999. - Vol. 3, N 9. - Suppl. - P. 181-182.

[18] Malouf M. A., Glanville A. R. The spectrum of mycobacterial infection after lung transplantation // Am. J. Respir. Crit. Care Med. - 1999. - Vol. 160. - P. 1611-1616.

[19] Marras T. K., Daley C. L. Epidemiology of human pulmonary infection with nontuberculous mycobacteria // Clin. Chest Med. -2002. - Vol. 23. - P. 553-567.

[20] Marras T. K. The importance of nontuberculous mycobacterial lung disease // Am. J. Respir. Crit. Care Med. - 2008. - Vol. 178. - P. 999-1000.

[21] Matos E. D., Santana M. A., de Santana M. C. et al. Nontuberculosis mycobacteria at a multiresistant tuberculosis reference center in Bahia // Braz. J. Infect. Dis. - 2004. - Vol. 8. - P. 296-304.

[22] Mazza-Stalder J., Jaton-Ogay K., Nicod L. Nontuberculous mycobacteria pulmonary disease: what’s new? // Rev. Med. Suisse. -2009. - Vol. 226, N 5. - P. 2344-2346, 2348-2350.

[23] Moore J., Kruijshaar M. E., Ormerod L. P. et al. Increasing number of non-tuberculous mycobacteria in England, Wales and Northern Ireland, 1995-2006 // BMC Publ. Hlth. - 2010. - Vol. 10. - P. 612.

[24] Raviglione M. Diseases due to other mycobacteria // Control of Communicable Diseases Manual. - 18th Ed. / Ed. L. David, M. Heymann. - Washington, 2004. - P. 572-573.

[25] Sakatani M. Nontuberculosis mycobacteriosis: the present status of epidemiology and clinical studies // Kekkaku. - 1999. - Vol. 74, N 4. - P. 377-384.

[26] Sakatani M., Nakajima Y. Treatment of non-tuberculous pulmonary mycobacteriosis // Kekkaku. - 2006. - Vol. 81, N 1. - P. 35-50.

[27] Schinsky M. F., McNeil M. M., Whithey A. M. et al. Mycobacterium septicum sp. Nov., a new rapidly growing species associated with catheter-related bacteraemia // Int. J. Syst. Evol. Microbiol. - 2000. - Vol. 50, N 2. - P. 575-581.

[28] Timpe A., Runyon E. H. The relationship of «atypical» acid-fast bacteria to human disease // J. Lab. Clin. Med. - 1954. - Vol. 44. - P. 202-209.

[29] Tortoli E. Impact of genotypic studies on mycobacterial taxonomy: the new mycobacteria of the 1990s // Clin. Microbiol. Rev. - 2003. -Vol. 16. - P. 319-354.

[30] van Ingen J., de Zwaan R., Dekhuijzen R. P. et al. Clinical relevance of Mycobacterium chelonae-abscessus group isolation in 95 patients // J. Infect. - 2009. - Vol. 59. - P. 324-331.

[31] von Rhein C. F., Arbeit R. D., Horsburgh R. et al. Sources of disseminated Mycobacterium avium infection in AIDS // J. Infect. -2002. - Vol. 44. - P. 166-170.

RIGHTS & PERMISSIONS

Eco-vector