title: Comparison of the incidence between tuberculosis and nontuberculous mycobacterial disease after gastrectomy.
abstract: OBJECTIVE
  Gastrectomy is a well-known risk factor for tuberculosis (TB). However, little data are available regarding the relationship between gastrectomy and the risk of nontuberculous mycobacterial (NTM) disease. Here, we investigated the incidence of TB and NTM lung disease in gastrectomized patients.
  
  
  METHODS
  New cases of TB and NTM lung infection or disease were examined among patients who had undergone gastrectomy due to gastric cancer from 2003 to 2009 at a tertiary referral hospital in South Korea. Annualized incidence rates for cases were compared with those of the general population.
  
  
  RESULTS
  This study included a total of 2,684 patients. New mycobacterial cases were found in 41 patients. Cases of TB and NTM lung infection were 35 (85 %) and 6 (15 %) including 2 NTM lung disease cases, respectively. Annualized crude incidence rates for TB, NTM lung infection, and NTM lung disease were 327/100,000, 56/100,000, and 19/100,000, respectively. The age-standardized incidence rate of TB was significantly higher in gastrectomized patients than in the general population. However, the standardized incidences of NTM lung infection and disease were not significantly different from those of non-gastrectomized patients. Patients with NTM lung infection frequently exhibited comorbid chronic lung disease, while those with TB were more frequently found to have fibronodular lesions on preoperative chest radiography.
  
  
  CONCLUSIONS
  Gastrectomy does not appear to increase the risk of NTM lung disease. However, NTM lung infection or disease should be considered as a differential diagnosis of pulmonary TB in gastrectomized patients accompanying chronic lung disease.
authors.affiliation: Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
authors.forename: C H
authors.initials: CH
authors.lastname: Kim
authors.forename: K H
authors.initials: KH
authors.lastname: Im
authors.forename: S S
authors.initials: SS
authors.lastname: Yoo
authors.forename: S Y
authors.initials: SY
authors.lastname: Lee
authors.forename: S I
authors.initials: SI
authors.lastname: Cha
authors.forename: H Y
authors.initials: HY
authors.lastname: Jung
authors.forename: J Y
authors.initials: JY
authors.lastname: Park
authors.forename: W
authors.initials: W
authors.lastname: Yu
authors.forename: J
authors.initials: J
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology*; D056910:Republic of Korea / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000601:surgery; D062606:Tertiary Care Centers; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*