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Lee, Kwon, Kwon, Lee, Lee, Lee, Yoon, Song, Lee, and Kim: Recovery Rate of Nontuberculous Mycobacteria and the Clinical Course of Nontuberculous Mycobacterial Pulmonary Disease at a Secondary Hospital
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 67(3): 199-204.

Published online: 30 September 2009

DOI: https://doi.org/10.4046/trd.2009.67.3.199

Recovery Rate of Nontuberculous Mycobacteria and the Clinical Course of Nontuberculous Mycobacterial Pulmonary Disease at a Secondary Hospital

Jae Kwang Lee, M.D.1, Hwuck Young Kwon, M.D.1, Jong Kyu Kwon, M.D.1, Hwa Jeong Lee, M.D.1, Dong Wook Lee, M.D.1, Yu Jin Lee, M.D.1, Kyung Hwa Yoon, M.D.1, Do Young Song, M.D.2, Byung Ki Lee, M.D.1, Yeon Jae Kim, M.D.1

1Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.

2Department of Clinical Pathology, Daegu Fatima Hospital, Daegu, Korea.

Address for correspondence: Yeon Jae Kim, M.D. Division of Pulmonary and Critical Care Medicine, Daegu Fatima Hospital, 576-31, Shinam-dong, Dong-gu, Daegu 701-600, Korea. Phone: 82-53-940-7462, Fax: 82-53-954-7417, kimyeonjae@gmail.com

Received 29 May 2009       Accepted 17 July 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

To examine the recovery rate of nontuberculous mycobacteria (NTM) from respiratory specimens and the clinical course of NTM pulmonary disease at a 700-bed secondary hospital.

Methods

This study analyzed the results of 843 acid-fast bacilli (AFB) culture-positive respiratory specimens from 650 subjects collected between May 2003 and April 2008. In addition, the clinical course of NTM pulmonary disease, diagnosed using criteria established by the American Thoracic Society, was examined.

Results

There were 67 (7.9%) NTM isolates recovered from 52 (8.0%) subjects. Among the 535 AFB smear-positive specimens, 34 (6.3%) NTM isolates were recovered. There were 33 (10.7%) NTM isolates were recovered from 308 AFB smear-negative specimens. Of 52 subjects with isolated NTM, M. intracellulare was the most common species at 73.1% (n=33), followed by M. kansassi (n=7), M. abscessus (n=2), M. fortuitum (n=2), and M. avium (n=1). Sixteen (30.8%) patients had NTM pulmonary disease and the most common causative organism was M. intracellulare (n=14, 87.5%). Of these, 6 cases attained negative conversion in culture, 4 cases failed to attain negative conversion because of poor cooperation or expiration from complicated underlying lung disease, and 5 cases were transferred to a higher-grade hospital.

Conclusion

The recovery rate of NTM from respiratory specimens was relatively low and the most common species was M. intracellulare. Patients with NTM pulmonary disease showed variable clinical outcomes.

Keywords: Atypical mycobacteria, Lung diseases, Patient outcomes

Figures and Tables

Figure 1
Recovery rate of NTM from respiratory specimens with positive AFB culture. NTM: nontuberculous mycobacteria; AFB: acid-fast bacilli.
trd-67-199-g001
Table 1
Frequency of isolates of NTM from respiratory specimens, patients and patients with NTM pulmonary disease and the pathogenic potential of isolated NTM
trd-67-199-i001

NTM: nontuberculous mycobacteria.

Table 2
Variables associated with nontuberculous mycobacterial pulmonary disease
trd-67-199-i002

NTM: nontuberculous mycobacteria; MAC: M. avium complex.

*ORs (odds ratios) and corresponding p-values were calculated by logistic regression, adjusted for male sex, prior antituberculous treatment, nodule or cavity on radiograph, and species, †Numbers in parentheses represent percentage.

Table 3
Outcomes of patients with NTM pulmonary disease
trd-67-199-i003

MAC: M. avium complex.

*Treated by etambutol, rifampin and clarithromycin for 20.8±3.13 months, †1 lung cancer, 1 severe pneumonia.

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