Nontuberculous Mycobacteria in Portugal: Trends from the last decade.

Autor:	Santos A; National Reference Laboratory for Mycobacteria, Dept of Infectious Diseases, National Institute of Health, Lisbon, Portugal., Carneiro S; National Reference Laboratory for Mycobacteria, Dept of Infectious Diseases, National Institute of Health, Lisbon, Portugal; Department of Life Sciences, NOVA School of Science and Technology, NOVA University Lisbon, Caparica, Portugal., Silva A; National Reference Laboratory for Mycobacteria, Dept of Infectious Diseases, National Institute of Health, Porto, Portugal., Gomes JP; Bioinformtics Unit, National Institute of Health, Lisbon, Portugal., Macedo R; National Reference Laboratory for Mycobacteria, Dept of Infectious Diseases, National Institute of Health, Lisbon, Portugal. Electronic address: rita.macedo@insa.min-saude.pt.
Jazyk:	angličtina
Zdroj:	Pulmonology [Pulmonology] 2024 Jul-Aug; Vol. 30 (4), pp. 337-343. Date of Electronic Publication: 2022 Feb 24.
DOI:	10.1016/j.pulmoe.2022.01.011
Abstrakt:	Introduction and Objectives: Nontuberculous mycobacteria (NTM) are opportunistic human pathogens found in the environment. The transmission seems to be associated with inhalation of aerosol droplets, ingestion or trauma events. Recent studies indicate that NTM disease is increasing worldwide, however, the true clinical impact of NTM infections is difficult to determine due to challenges in discriminating between disease and colonization as they are ubiquitous in the environment. In addition, understanding the epidemiology of NTM is difficult and has not yet been established. In this work, we used a country NTM representative collection from the National Reference Laboratory for Tuberculosis (NRL-TB) of the National Institute of Health (INSA), to characterize the circulation trends of NTM species in Portugal and the most affected regions, contributing to a better understanding of the NTM epidemiology. Material and Methods: We conducted a nationwide retrospective study where all individuals with positive NTM cultures at the NRL-TB of the INSA from 2014 to December 2020 were included. Positive cultures were identified using GenoType Mycobacterium CM/AS® (Hain Lifescience) according to manufacturer's instructions, or hsp65 DNA sequencing as previously described. Social-demographic data from patients were also analyzed and patients classified into 3 groups according only to microbiological data, "definite NTM disease", "NTM colonization" and, "possible NTM disease". Results: In the period 2014-2020, the NRL-TB performed 50397 cultures. Among these, 1118 cultures were NTM positive retrieved from 944. Most of our cases were in patients whose mean age was 64±15.9 years, and no significant differences between gender was observed, although more frequent in male patients. Overall, from the 944 cases, we were able to identified 93 "definite NTM disease" cases and 79 "possible NTM disease". Mycobacterium avium complex (MAC) (40,8%), Mycobacterium abscessus-chelonae complex (MABC) (9,6%) and Mycobacterium fortuitum (6,3%) were responsible for most of the infections. The geographical distribution of NTM cases varied significantly and was possible to observe that was independent of population density. The region were most cases occurred was Lisbon Metropolitan Area (31,9%), followed by North (25,3%) and Centre (24,4%), however North region has the highest number of "definite NTM disease" cases (n=33). Conclusions: This is the first national wide epidemiological study on this subject, contributing to a better understanding of NTM dynamics in Portugal. MAC was the NTM species responsible for the majority of infections and, LMA the region with the highest number of cases. It was also possible to conclude that the number of NTM isolates is independent of the demography of the region. (Copyright © 2022 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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