Non-tuberculous mycobacteria: epidemiological pattern in a reference laboratory and risk factors associated with pulmonary disease.
The diseases caused by non-tuberculous mycobacteria (NTM), in both AIDS and non-AIDS populations, are increasingly recognized worldwide. Although the American Thoracic Society published the guidelines for diagnosis of NTM pulmonary disease (NTM-PD), the diagnosis is still difficult. In the first part of the study, we collected data on NTM isolates in the Mycobacteriology Laboratory of Careggi Hospital (Florence, Italy) and analysed the epidemiological data of NTM isolates. Then, to analyse the risk factors associated to NTM-PD, we studied the presence of ATS/IDSA criteria for NTM-PD in patients who had at least one positive respiratory sample for NTM and were admitted to the Infectious Disease Unit and the Section of Respiratory Medicine. We selected 88 patients with available full clinical data and, according to ATS/IDSA criteria, classified 15 patients (17%) as NTM-PD cases and 73 as colonized patients (83%). When comparing colonized and NTM-PD patients we did not find significant differences of age, gender and comorbidity. We observed that Mycobacterium avium and M. intracellulare were statistically associated with NTM-PD (P = 0·001) whereas M. xenopi was statistically associated with colonization. Although the number of studied patients is limited, our study did not identify risk factors for NTM-PD that could help clinicians to discriminate between colonization and disease. We underline the need of close monitoring of NTM-infected patients until the diagnosis is reasonably excluded. Further larger prospective studies and new biological markers are needed to identify new useful tools for the diagnosis of NTM-PD.
Infectious Diseases Unit,Department of Experimental and Clinical Medicine,University of Florence,Florence,Italy.
J
J
Mencarini
Pneumology Unit,Careggi Hospital,Florence,Italy.
C
C
Cresci
Tuscany Regional Reference Centre for Mycobacteria,Microbiology and Virology Unit,Careggi Hospital,Florence,Italy.
M T
MT
Simonetti
Infectious Diseases Unit,Department of Experimental and Clinical Medicine,University of Florence,Florence,Italy.
C
C
Truppa
Pneumology Unit,Careggi Hospital,Florence,Italy.
G
G
Camiciottoli
Section of Respiratory Medicine,Department of Experimental and Clinical Medicine,University of Florence,Florence,Italy.
M L
ML
Frilli
Unit of Infectious and Tropical Diseases,Careggi Hospital,Florence,Italy.
P G
PG
Rogasi
Infectious Diseases Unit,Department of Experimental and Clinical Medicine,University of Florence,Florence,Italy.
S
S
Veloci
Pneumology Unit,Careggi Hospital,Florence,Italy.
M
M
Pistolesi
Tuscany Regional Reference Centre for Mycobacteria,Microbiology and Virology Unit,Careggi Hospital,Florence,Italy.
G M
GM
Rossolini
Infectious Diseases Unit,Department of Experimental and Clinical Medicine,University of Florence,Florence,Italy.
A
A
Bartoloni
Unit of Infectious and Tropical Diseases,Careggi Hospital,Florence,Italy.
F
F
Bartalesi
D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008171:Lung Diseases / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000302:isolation & purification*; D012189:Retrospective Studies; D012307:Risk Factors
Mycobacteria; respiratory infections