Nontuberculous mycobacteria in China: incidence and antimicrobial resistance spectrum from a nationwide survey.

IF 4.8 1区医学 Q1 INFECTIOUS DISEASES Infectious Diseases of Poverty Pub Date : 2021-04-29 DOI:10.1186/s40249-021-00844-1

Chun-Fa Liu, Yi-Meng Song, Wen-Cong He, Dong-Xin Liu, Ping He, Jing-Jing Bao, Xin-Yang Wang, Yan-Ming Li, Yan-Lin Zhao

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Abstract

Background: Information on the prevalence and resistance spectrum of nontuberculous mycobacteria (NTM) in China is mainly based on regional or local data. To estimate the proportion of NTM cases in China, a national survey of NTM pulmonary disease was carried out based on acid-fast positive sputum samples collected in 2013.

Methods: Sputum samples collected from enrolled presumptive cases in 72 nationwide tuberculosis surveillance sites from the 31 provinces in the mainland of China were cultured using L-J medium at the National tuberculosis reference laboratory (NTRL). MALDI-TOF MS identified the species of re-cultured strains, and minimal inhibitory concentrations (MICs) were determined to evaluate the drug susceptibility of NTM isolates. Data analysis used statistical software SPSS version 22.0 for Windows statistical package.

Results: Of 4917 mycobacterial isolates cultured, 6.4% [317/4917, 95% confidence interval (CI) 5.8%-7.2%] were confirmed as NTM, among which 7.7% (287/3709, 95% CI 6.9%-8.6%) were from the southern region. In inland and coastal China, 87.7% (95% CI 78.7%-93.2%) and 50.0% (95% CI 43.7%-56.3%) of isolates, respectively, were slow-growing mycobacteria (SGM), with the remaining rapid growing mycobacteria (RGM). A total of 29 species were detected, Mycobacterium abscessus had higher clarithromycin-inducible resistance rates than M. massiliense (65.67% vs 2.22%). M. kansasii presented lower resistance rates in linezolid and moxifloxacin than M. avium-intracellulare complex (3.23% vs 66.67%, 0 vs 47.22%) and other SGM (3.23% vs 38%, 0 vs 26%).

Conclusions: More NTM pulmonary disease was observed in the south and coastal China (P < 0.01). SGM was widely distributed, and more RGM are present in southern and coastal China (P < 0.01). The antimicrobial resistance spectrum of different NTM species was significantly different and accurate species identification would be facilitated to NTM pulmonary disease treatment.

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中国的非结核分枝杆菌：全国性调查得出的发病率和抗菌药耐药性谱。

背景：有关中国非结核分枝杆菌（NTM）流行率和耐药谱的信息主要基于地区或地方数据。为了估算中国非结核分枝杆菌病例的比例，我们根据2013年采集的酸性耐药阳性痰标本开展了一项全国非结核分枝杆菌肺病调查：方法：在国家结核病参考实验室（NTRL）使用 L-J 培养基对来自中国大陆 31 个省 72 个全国结核病监测点的入组推定病例采集的痰标本进行培养。MALDI-TOF MS 鉴定了再培养菌株的种类，并测定了最低抑菌浓度（MICs），以评估 NTM 分离物的药敏性。数据分析采用 SPSS 22.0 版 Windows 统计软件包：在培养出的 4917 株分枝杆菌中，6.4%[317/4917，95% 置信区间（CI）5.8%-7.2%]被确诊为 NTM，其中 7.7%（287/3709，95% CI 6.9%-8.6%）来自南方地区。在中国内陆和沿海地区，分别有87.7%（95% CI 78.7%-93.2%）和50.0%（95% CI 43.7%-56.3%）的分离株为慢速生长分枝杆菌（SGM），其余为快速生长分枝杆菌（RGM）。脓肿分枝杆菌的克拉霉素诱导耐药率（65.67% vs 2.22%）高于M. massiliense分枝杆菌。堪萨斯分枝杆菌对利奈唑胺和莫西沙星的耐药率（3.23% vs 66.67%，0 vs 47.22%）低于阿维菌素-肠杆菌属复合分枝杆菌（3.23% vs 38%，0 vs 26%）和其他SGM（3.23% vs 38%，0 vs 26%）：结论：在中国南方和沿海地区观察到更多的NTM肺部疾病（P

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来源期刊

Infectious Diseases of Poverty Medicine-Public Health, Environmental and Occupational Health

CiteScore

16.70

自引率

1.20%

发文量

368

审稿时长

13 weeks

期刊介绍： Infectious Diseases of Poverty is a peer-reviewed, open access journal that focuses on essential public health questions related to infectious diseases of poverty. It covers a wide range of topics and methods, including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies, and their application. The journal also explores the impact of transdisciplinary or multisectoral approaches on health systems, ecohealth, environmental management, and innovative technologies. It aims to provide a platform for the exchange of research and ideas that can contribute to the improvement of public health in resource-limited settings. In summary, Infectious Diseases of Poverty aims to address the urgent challenges posed by infectious diseases in impoverished populations. By publishing high-quality research in various areas, the journal seeks to advance our understanding of these diseases and contribute to the development of effective strategies for prevention, diagnosis, and treatment.