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Lee, Seo, Jeong, Park, Kim, Ahn, Kim, and Park: Nontuberculous Mycobacteria Isolated from Respiratory Specimens during Recent Two Years: Distribution and Clinical Significance
Original Article
Korean Journal of Clinical Microbiology

Korean Journal of Clinical Microbiology 2012; 15(3): 98-103.

Published online: 20 September 2012

DOI: https://doi.org/10.5145/KJCM.2012.15.3.98

Nontuberculous Mycobacteria Isolated from Respiratory Specimens during Recent Two Years: Distribution and Clinical Significance

Min Kyoung Lee1, Yiel Hea Seo2, Ji Hoon Jeong2, Pil Whan Park2, Kyung Hee Kim2, Jeong Yeal Ahn2, Jin Yong Kim3, Jeong Woong Park3

1School of Medicine, Gachon University School of Medicine, Incheon, Korea.

2Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea.

3Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea.

Correspondence: Yiel Hea Seo, Department of Laboratory Medicine, Gachon University Gil Hospital, 1198, Guwol-dong, Namdong-gu, Incheon 420-709, Korea. (Tel) 82-32-460-3074, (Fax) 82-32-460-3415, seoyh@gilhospital.com

Received 3 March 2012       Revised 30 March 2012       Accepted 17 April 2012

Copyright © 2012 The Korean Society of Clinical Microbiology

Abstract

Background

The isolation of nontuberculous mycobacteria (NTM) has been increasing worldwide as well as its clinical importance. The aim of this study was to investigate the distribution and clinical significance of NTM that has been isolated from respiratory specimens during a recent two-year period at a tertiary hospital.

Methods

We analyzed respiratory samples that were obtained between January 2009 and December 2010 for AFB culture. We retrospectively reviewed the electronic medical records of these patients to obtain both clinical and radiologic information. NTM pulmonary disease was defined by using the guidelines provided by the America Thoracic Society/Infectious Diseases Society of America.

Results

Among the 1,601 specimens that resulted in a positive AFB culture, 310 (19.4%) were NTM. In 189 patients, the most common isolate was M. avium-intracellulare complex (MAC) (127, 67.2%), which was then followed by M. abscessus (31, 16.4%), M. fortuitum (10, 5.3%), M. kansasii (9, 4.8%), and other NTM species. Of these, 93 (49.2%) patients were diagnosed with NTM pulmonary disease. MAC, M. abscessus, and M. kansasii were more virulent than the other species. None of the cases of NTM pulmonary disease were caused by M. fortuitum, M. chelonae, M. peregrinum, M. terrae complex, or M. gordonae.

Conclusion

In Korea, the prevalence of NTM isolates is increasing, as are the cases of pulmonary disease. The pathogenic potential of NTM differs enormously by species and as a result the treatment of NTM lung disease depends on which species has caused the infection. The isolation and identification of NTM isolated from respiratory specimens are mandatory in order for clinical microbiology laboratories to make an accurate diagnosis and suggest the proper treatment of the NTM disease.

Keywords: Mycobacteria, Nontuberculous mycobacteria, Respiratory specimen

Figures and Tables

Table 1
Species distribution and clinical relevance of NTM species isolated from respiratory specimen
kjcm-15-98-i001

*Proportion of NTM disease to NTM isolated patient; †Proportion of NTM disease with treatment to NTM disease.

Abbreviation: Tx, treatment.

Table 2
Clinical characteristics of patients with lung diseases caused by NTM
kjcm-15-98-i002

*P values were obtained by chi-square test, p<0.05; †P value was obtained by two-sample Student's t-test, p<0.05.

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