Microbiological criteria in non-tuberculous mycobacteria pulmonary disease: a tool for diagnosis and epidemiology.
The value of microbiological criteria in diagnosing non-tuberculous mycobacteria pulmonary disease (NTM-PD) and monitoring its epidemiology is unknown.



To correlate the rate of NTM-PD based on microbiological criteria (American Thoracic Society/Infectious Diseases Society of America [ATS/IDSA] or stricter microbiological criteria) compared with the full ATS/IDSA criteria, to assess the positive predictive value (PPV) of different microbiological criteria in predicting NTM-PD, and to evaluate the clinical relevance of different NTM species.



Retrospective study of all patients with pulmonary NTM isolates in Croatia during an 8-year period. NTM species were divided into low, intermediate and high clinical relevance groups for additional analyses.



Good correlation between both microbiological and full ATS/IDSA criteria was observed. The PPV of stricter and ATS/IDSA microbiological criteria was respectively 93.3% and 59.8%. The usefulness of microbiological criteria varied between groups. ATS/IDSA microbiological criteria had a PPV of 89.8% in the high relevance group, while in the intermediate relevance group, the PPV of stricter and ATS/IDSA microbiological criteria was respectively 94.3% and 63.4%.



Microbiological criteria are useful in detecting NTM-PD, allowing laboratory-based monitoring. Stricter criteria should be used for species of low clinical relevance, and less stringent criteria for species of high relevance in the local setting.
Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia.
M
M
Jankovic
Division of Molecular Medicine, Laboratory of Molecular Virology and Bacteriology, Ruder Boskovic Institute, Zagreb, Croatia.
I
I
Sabol
National Mycobacteria Reference Laboratory, Croatian National Institute of Public Health, Zagreb, Croatia.
L
L
Zmak
National Mycobacteria Reference Laboratory, Croatian National Institute of Public Health, Zagreb, Croatia.
V Katalinic
VK
Jankovic
Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia.
M
M
Jakopovic
National Mycobacteria Reference Laboratory, Croatian National Institute of Public Health, Zagreb, Croatia.
M
M
Obrovac
Mycobacteria Laboratory, Institute of Public Health, Rijeka, Croatia.
B
B
Ticac
Department for Respiratory Diseases, Clinical Hospital Centre, Rijeka, Croatia.
L Kardum
LK
Bulat
Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia.
S Popovic
SP
Grle
Department of Clinical and Molecular Microbiology, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia.
I
I
Marekovic
Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia.
M
M
Samarzija
Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
J
J
van Ingen
D000293:Adolescent; D000328:Adult; D000368:Aged; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D012189:Retrospective Studies; D055815:Young Adult