Abstract
Increase in risk groups on mycobacteriosis (AIDS and other immunosupressed patients), difficulties in differential diagnostics with TB, differences in mycobacteriosis incidence in different countries demand studying regional features of nontuberculous mycobacteria (NTM) occurrence and improving mycobacteriosis diagnostics.
The aim of the study was definition of occurrence and clinical value of NTM and improving mycobacteriosis diagnostics.
In 2009, 45 NTM cultures were isolated from 23 patients with TB or TB suspicion in centre using solid media and BACTEC MGIT 960. The proportion of NTM among all mycobacterial cultures was 0.9%. NTM identification was carried out using biochemical and cultural tests and molecular method Genotype Mycobacterium CM (Hain Lifescience, Germany).
60.9% NTM strains isolated from 14 patients were fast-growing (M. abscessus, M. fortuitum, M. chelonae, M. peregrinum, M. smegmatis, M. phlei) and 39.1% strains isolated from 9 patients were slowly growing (M. avium complex, M. kansasii, M. gordonae, M. terrae). 73.9% NTM strains isolated from 17 patients were clinically relevant; NTM strains isolated from 6 patients hadn't clinical relevance. NTM cultures were isolated many times from 10 patients, once from 13 patients. Mixed cultures (M. tuberculosis and NTM) were isolated from 5 patients. This fact can be evidence of TB superinfection in patients with mycobacteriosis during hospital stay.
Mycobacteriosis can be diagnosed in patients with pulmonary inflammatory process progressing in spite of antituberculous therapy in case of NTM culture isolation in 3 samples and more. Laboratory diagnostics of pulmonary mycobacteriosis should include a complex of microbiological and molecular methods.
- © 2011 ERS
