Changing epidemiology of nontuberculous mycobacterial lung disease in South Korea
Changing epidemiology of nontuberculous mycobacterial lung disease in South Korea
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DOI：
10.3109/00365548.2012.681695
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发表时间：
2012-10-01
影响因子：
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通讯作者：
Kang, Young Ae
中科院分区：
文献类型：
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作者：
Lee, Sang Kook;Lee, Eun Ja;Kang, Young Ae
目的：肺非结核分枝杆菌（NTM）在全球范围内不断增加，但来自中等结核病（TB）负担地区的数据不足，NTM肺病流行病学变化的原因尚不清楚。我们调查了韩国一家三级医院NTM肺病的趋势，并评估了液体培养系统的贡献。研究方法：我们对2006年1月至2010年12月在韩国Severance医院的26，793例患者的呼吸道标本的分枝杆菌培养进行了回顾性观察研究。结果如下：结核分枝杆菌分离株的回收率2006年为5.9%，2010年为7.1%，NTM分离株的回收率2006年为2.0%，2010年为6.3%。NTM分离的年百分比每年都在稳步增加（趋势p < 0.001），NTM分离的患者比例从2006年的21.4%增加到2010年的55.0%（趋势p < 0.001）。2006年NTM肺病患者的发病率（每10万住院患者和门诊患者）为1.82例，2010年增至4.38例（p < 0.001）。虽然仅液体培养基中阳性培养物的比例NTM高于M。结核病（p < 0.001），NTM回收率在固体培养基培养系统中有所增加。结论：2006年至2010年，在结核病负担中等的韩国，从呼吸道标本中分离出的NTM患者和NTM肺病的发病率增加。
Objectives: Pulmonary nontuberculous mycobacteria (NTM) are increasing worldwide, but data from regions with an intermediate tuberculosis (TB) burden are insufficient, and the reason for the changing epidemiology of NTM lung disease is unclear. We investigated the trends of NTM lung disease at a tertiary hospital in Korea and evaluated the contribution of liquid culture systems. Methods: We conducted a retrospective observational study of mycobacterial cultures of respiratory specimens from 26,793 patients at Severance Hospital in South Korea from January 2006 to December 2010. Results: The recovery percent of Mycobacterium tuberculosis isolates was 5.9% in 2006 and 7.1% in 2010, and the recovery percent of NTM isolates was 2.0% in 2006 and 6.3% in 2010. The annual percent of NTM isolation has increased steadily every year (p for trend < 0.001), and the proportion of patients from whom NTM was isolated increased from 21.4% in 2006 to 55.0% in 2010 (p for trend < 0.001). The incidence (per 100,000 inpatients and outpatients) of patients with NTM lung disease was 1.82 in 2006 and increased to 4.38 in 2010 (p < 0.001). Although the proportion of positive cultures in liquid medium only was higher for NTM than for M. tuberculosis (p < 0.001), the NTM recovery rate has increased in solid medium culture systems. Conclusions: The incidence of patients with NTM isolated from respiratory specimens and NTM lung disease increased from 2006 to 2010 in South Korea, a region with an intermediate TB burden.