[논문]Identification and Distribution of Nontuberculous Mycobacteria from 2005 to 2011 in Cheonan, Korea

Kim, Jae Kyung; Rheem, Insoo

doi:10.4046/trd.2013.74.5.215

Identification and Distribution of Nontuberculous Mycobacteria from 2005 to 2011 in Cheonan, Korea 원문보기

Tuberculosis and respiratory diseases : TRD = 결핵 및 호흡기 질환, v.74 no.5, 2013년, pp.215 - 221

Kim, Jae Kyung (Department of Laboratory Medicine, Dankook University Hospital, Dankook University College of Medicine) , Rheem, Insoo (Department of Laboratory Medicine, Dankook University College of Medicine)

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Background: Nontuberculous mycobacteria (NTM) are considered opportunistic pathogens, and several species of NTM are associated with human diseases that typically involve the pulmonary, skin/soft tissue, or lymphatic systems; such infection may also cause disseminated diseases. Recent studies have reported increasing rates of NTM-induced disease worldwide. Methods: Respiratory samples are being analyzed for acid-fast bacilli (AFB) culture and NTM identification at Dankook University Hospital in Cheonan, Korea, from September 2005 to September 2011. Identification is performed by using polymerase chain reaction-restriction fragment length polymorphism analysis targeting a novel region of the rpoB gene. Results: A total of 25,133 specimens were received for AFB culture, of which 1,014 (4.0%) were NTM-positive. A total of 267 samples from 186 patients were tested for NTM identifications, and 232 samples from 157 patients were positive for NTM species. Among the patients who tested positive for NTM, 65.6% were men and the average age was 63.3 years. Mycobacterium avium complex, the most commonly detected NTM pathogen, was found in 65.9% of the 232 samples. The annual average percentage of NTM isolates from AFB culture-positive specimens was 31.3%: the highest rate was seen in 2011 (44.3%), followed by 2009 (37.4%) and 2010 (37.2%). An upward trend in NTM incidence was found during the study period. Conclusion: The prevalence of pulmonary NTM isolates continues to increase in Cheonan, suggesting that pulmonary NTM disease is becoming increasingly common.

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문제 정의

Given these clinical challenges, further knowledge of the epidemiology of NTM in Korea is needed. The purpose of this study was to identify NTM and investigate their distribution in clinical specimens isolated from a tertiary teaching hospital in Cheonan, Korea.

제안 방법

Patients for whom NTM identification tests were requested provided samples of sputum and bronchial washing fluid. For this study, we retrospectively analyzed the results of these samples. Data were analyzed and categorized according to gender, age, and year of analysis.

대상 데이터

This study included the isolation of NTM species from all clinical specimens referred to Dankook University Hospital Laboratory in Cheonan, Korea, from September 2005 to September 2011 (Table 1). Patients for whom NTM identification tests were requested provided samples of sputum and bronchial washing fluid.

이론/모형

There are numerous species of NTM, and recently developed molecular methods have enabled the recognition of many of these species⁷ . In this study, NTM were identified using a polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) method, based on the rpoB gene, at the Korean Institute of Tuberculosis^8,9.

성능/효과

A total of 25,133 specimens were received for AFB culture, of which 3,236 (12.9%) were AFB positive and 1,014 (4.0%) were NTM positive. A total of 267 samples from 186 patients were collected for NTM identification, and 232 samples from 157 patients were positive for NTM species (Table 1).
8%). In a study performed in Seoul¹⁷, MAC was found in 138 of the 328 samples (42.1%), while other identified species included M. fortuitum (64, 15.2%), M. abscessus (37, 11.3%), and M. gordonae (33, 10.1%). However, in a study conducted in the Masan²⁰area, MAC was found in 55 of 100 samples (55%), while other species included M.
In this study, NTM species were more commonly isolated from men than from women; however, NTM was not strongly associated with gender, but rather depended more on region and timing. The average age of patients with NTM has been increasing since the late 1990s.
avium in 34 samples. M. kansasii was the next most prevalent species (18 isolates, 7.8%), followed by M. abscessus complex (M. abscessus and M. massiliense; 15 isolates, 6.5%) and M. gordonae (12 isolates, 5.2%) (Table 2). The annual distributions of NTM species are detailed in Table 3.

참고문헌 (34)

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Identification and Distribution of Nontuberculous Mycobacteria from 2005 to 2011 in Cheonan, Korea 원문보기

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Identification and Distribution of Nontuberculous Mycobacteria from 2005 to 2011 in Cheonan, Korea 원문보기

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