Identification and Distribution of Nontuberculous Mycobacteria from 2005 to 2011 in Cheonan, Korea

Background Nontuberculous mycobacteria (NTM) are considered opportunistic pathogens, and several species of NTM are associated with human diseases that typically involve the pulmonary, skin/soft tissue, or lymphatic systems; such infection may also cause disseminated diseases. Recent studies have reported increasing rates of NTM-induced disease worldwide. Methods Respiratory samples are being analyzed for acid-fast bacilli (AFB) culture and NTM identification at Dankook University Hospital in Cheonan, Korea, from September 2005 to September 2011. Identification is performed by using polymerase chain reaction-restriction fragment length polymorphism analysis targeting a novel region of the rpoB gene. Results A total of 25,133 specimens were received for AFB culture, of which 1,014 (4.0%) were NTM-positive. A total of 267 samples from 186 patients were tested for NTM identifications, and 232 samples from 157 patients were positive for NTM species. Among the patients who tested positive for NTM, 65.6% were men and the average age was 63.3 years. Mycobacterium avium complex, the most commonly detected NTM pathogen, was found in 65.9% of the 232 samples. The annual average percentage of NTM isolates from AFB culture-positive specimens was 31.3%: the highest rate was seen in 2011 (44.3%), followed by 2009 (37.4%) and 2010 (37.2%). An upward trend in NTM incidence was found during the study period. Conclusion The prevalence of pulmonary NTM isolates continues to increase in Cheonan, suggesting that pulmonary NTM disease is becoming increasingly common.

[1]  G. Bai,et al.  Novel Polymorphic Region of the rpoB Gene Containing Mycobacterium Species-Specific Sequences and Its Use in Identification of Mycobacteria , 2003, Journal of Clinical Microbiology.

[2]  R. Thomson Changing Epidemiology of Pulmonary Nontuberculous Mycobacteria Infections , 2010, Emerging infectious diseases.

[3]  H. I. Bang,et al.  Comparison of Ogawa Media, BACTEC MGIT 960 System and TB/NTM Real-Time PCR for Detecting Mycobacterium Species , 2011 .

[4]  Pan‐Chyr Yang,et al.  Increasing Incidence of Nontuberculous Mycobacteria , 2010 .

[5]  D. Lie,et al.  Changing Epidemiology of Pulmonary Nontuberculous Mycobacteria Infections Rachel M. Thomson, on behalf of the NTM working group at the Queensland TB Control Centre and Queensland Mycobacterial Reference Laboratory , 2010 .

[6]  Jae Seung Lee,et al.  Clinical Utility of Polymerase Chain Reaction for the Differentiation of Nontuberculous Mycobacteria in Patients with Acid-fast Bacilli Smear-positive Specimens , 2005 .

[7]  V. Katoch Infections due to non-tuberculous mycobacteria (NTM). , 2004, The Indian journal of medical research.

[8]  F. Portaels Epidemiology of mycobacterial diseases. , 1995, Clinics in dermatology.

[9]  G. Bai,et al.  Species Identification of Mycobacteria by PCR-Restriction Fragment Length Polymorphism of therpoB Gene , 2000, Journal of Clinical Microbiology.

[10]  V. Nomellini,et al.  Murray and Nadel’s Textbook of Respiratory Medicine , 2012 .

[11]  J. Choi,et al.  Clinical Utility of Bronchial Washing PCR for IS6110 and Amplicor for the Rapid Diagnosis of Active Pulmonary Tuberculosis in Smear Negative Patients , 2001 .

[12]  S. Jeong,et al.  Isolation of Nontuberculous Mycobacteria by DNA Probe and Clinical Characteristics of Patients with NTM Pulmonary Disease , 2005 .

[13]  J. Yim,et al.  Mycobacterium kansasii Pulmonary Diseases in Korea , 2005, Journal of Korean medical science.

[14]  Margaret M. Johnson,et al.  Nontuberculous mycobacterial pulmonary disease , 2008, Current opinion in pulmonary medicine.

[15]  Pan‐Chyr Yang,et al.  Increasing Incidence of Nontuberculous Mycobacteria, Taiwan, 2000–2008 , 2010, Emerging infectious diseases.

[16]  Young Kil Park,et al.  Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens in Korea. , 2006, Chest.

[17]  Y. Seo,et al.  Nontuberculous Mycobacteria Isolated from Respiratory Specimens during Recent Two Years: Distribution and Clinical Significance , 2012 .

[18]  R. Wallace,,et al.  Newly described or emerging human species of nontuberculous mycobacteria. , 2002, Infectious disease clinics of North America.

[19]  D. Song,et al.  Recovery Rate of Nontuberculous Mycobacteria and the Clinical Course of Nontuberculous Mycobacterial Pulmonary Disease at a Secondary Hospital , 2009 .

[20]  Mary Ann Blosky,et al.  Nontuberculous mycobacterial lung disease prevalence at four integrated health care delivery systems. , 2010, American journal of respiratory and critical care medicine.

[21]  Todd P. Primm,et al.  Health Impacts of Environmental Mycobacteria , 2004, Clinical Microbiology Reviews.

[22]  T. Marras,et al.  Isolation prevalence of pulmonary non-tuberculous mycobacteria in Ontario, 1997–2003 , 2007, Thorax.

[23]  D. van Soolingen,et al.  Nontuberculous Mycobacteria in Respiratory Tract Infections, Eastern Asia , 2011, Emerging infectious diseases.

[24]  H. Sørensen,et al.  Nontuberculous pulmonary mycobacteriosis in Denmark: incidence and prognostic factors. , 2010, American journal of respiratory and critical care medicine.

[25]  G. Bai,et al.  Recovery rate of NTM from AFB smear-positive sputum specimens at a medical centre in South Korea. , 2005, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[26]  J. Yim,et al.  Rapid increase of non-tuberculous mycobacterial lung diseases at a tertiary referral hospital in South Korea. , 2010, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[27]  H. Lee,et al.  Nontuberculous Mycobacterial Pulmonary Infection in Immunocompetent Patients , 2002 .

[28]  Chulhun L. Chang,et al.  Identification of Mycobacteria using High Performance Liquid Chromatography in Clinical Specimens. , 2004 .

[29]  J. R. Mason,et al.  Murray and Nadel's Textbook of Respiratory Medicine , 2015 .

[30]  Hee Jin Choi,et al.  Recovery Rate and Characteristics of Nontuberculous Mycobacterial Isolates in a University Hospital in Korea , 2005 .

[31]  M. Young,et al.  Nontuberculous mycobacterial infections. , 2008, Archives of pathology & laboratory medicine.

[32]  E. Kim,et al.  [Identification of Nontuberculous Mycobacteria by Sequence Analysis of the 16S Ribosomal RNA, the Heat-shock Protein 65 and the RNA Polymerase beta-Subunit Genes.]. , 2006, The Korean journal of laboratory medicine.

[33]  Jae Myung Lee,et al.  How Reliable is Sputum PCR Test in the Diagnosis of Pulmonary Tuberculosis When Sputum Smear is Negative , 2001 .

[34]  Bong Keun Lee,et al.  Pathogenic Classification and Clinical Characteristics of Nontuberculous Mycobacterial Pulmonary Disease in a National Tuberculosis Hospital , 2005 .

[35]  J. Douglas,et al.  Mycobacterium gordonae: a new pathogen? , 1986, Thorax.

[36]  A. Asija,et al.  Disseminated Mycobacterium gordonae Infection in an Immunocompetent Host , 2011, American journal of therapeutics.