engleski

Geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples in Croatia

Background: The incidence of nontuberculous mycobacteria (NTM) as human pathogens is increasing. It has become clear that the NTM species obtained from clinical specimen differ strongly by region. Aims and objectives:To determine the distribution of NTM species obtained from pulmonary samples of individuals from different geographic regions in Croatia. Methods: Retrospective analysis on all NTM identified at the National Laboratory for Mycobacteria in 2007-2009. For each isolate the person's birth year, sex, specimen collection date, source and geographic region (costal or inland) were recorded. Microbiological criteria of the ATS/IDSA were used for a laboratory- based definition of pulmonary NTM. Results: NTM species were isolated from 712 individuals. 56% of isolates came from male (median age 62 y) and 44% from female (median age 64 years) individuals. More than two thirds of all isolates (525) originated from persons from the inland area. Out of those 525 samples, 80 (15.2%) met the pulmonary NTM criteria, compared to 68 (36.4%) out of the 187 samples identified in the costal area (p<0.0001). More than 90% of isolated species with insignificant clinical relevance originate from the inland area. Incidence of species with relevant clinical burden was significantly higher in the coastal compared to the inland area. Conclusions: The majority of all NTM isolates originated from the inland area. However, isolates which met the ATS pulmonary disease criteria were more frequently isolated from persons living in the costal area. There, more than one third of all isolates likely represented true disease. Geographic region plays an important role for colonization or infection with NTMs in Croatia.

nontuberculous mycobacteria; geographical diversity; pulmonary samples

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