Prevalence and clinical outcomes of nontuberculous mycobacteria in a Brazilian cystic fibrosis reference center
Prevalence and clinical outcomes of nontuberculous mycobacteria in a Brazilian cystic fibrosis reference center
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DOI：
10.1093/femspd/fty051
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发表时间：
2018-07-01
影响因子：
3.3
通讯作者：
Mauch, Renan M.
中科院分区：
文献类型：
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作者：
Aiello, Talita B.;Levy, Carlos E.;Mauch, Renan M.
非结核分枝杆菌（NTM）已被公认为囊性纤维化（CF）患者的机会致病菌群，全球患病率为3%至23%。各种因素可能会影响不同CF中心的患病率，特别是误诊，因为许多中心仍然缺乏NTM的系统筛查。在这里，我们评估了NTM分离的存在和临床结果的微生物呼吸道培养CF患者参加巴西参考中心后，建立了系统的诊断协议。在117例进行NTM研究的呼吸道样本培养的患者中，我们发现7例患者（6%）至少有一个NTM阳性结果[4例男性（57.1%），中位年龄= 21岁（9-58）]。这些案件逐一报告。中位FEV 1为40%，所有患者均显示肺部恶化体征，肺部急性加重的中位次数为3次/患者/年。然而，NTM隔离的影响在我们中心仍不清楚，因为所有患者都合并感染了其他CF呼吸道病原体。我们的NTM患病率接近文献报道的最低水平，这可能是受常规应用的卡介苗的影响。
Nontuberculous mycobacteria (NTM) have been well established as an opportunistic pathogenic bacterial group for cystic fibrosis (CF) patients, with a prevalence ranging from 3% to 23% worldwide. A myriad of factors can bias the prevalence rate in different CF centers, especially misdiagnosis as systematic screening for NTM are still lacking in a number of centers. Here, we evaluated the presence and clinical outcomes of NTM isolation in microbiological respiratory cultures from CF patients attending a Brazilian reference center after setting up a systematic diagnostic protocol. Of 117 patients with respiratory samples cultured for NTM research, we found seven patients (6%) with at least one positive result for NTM [four males (57.1%), median age = 21 years (9-58)]. These cases are reported one-by-one. Median FEV1 was 40%, all patients showed signs of lung deterioration, with a median number of pulmonary exacerbations of three per patient/year. However, the impact of NTM isolation remains unclear in our center as all patients were coinfected with other CF respiratory pathogens. Our NTM prevalence assimilates to the lowest levels reported in literature, which is possibly influenced by the routinely applied Bacille Calmette-Guerin vaccine.