Non - tuberculous mycobacteriosis of the lungs - diagnostic possibilities in the practice of the pulmonologist

Abstract

Aim of the study. Show the possibilities of diagnosing non - tuberculous mycobacteriosis of the lungs (NTML) in the practice of the pulmonologist. Materials and methods. A survey of 90 patients with a confirmed diagnosis of non - tuberculous mycobacteriosis of the lungs (NTML) was presented. The diagnosis of pulmonary mycobacteriosis was established in accordance with the criteria proposed in 2007 by the American Thoracic Society and the American Society of Infectious Diseases (ATS/IDRS). Among the patients, 55 (61.1%) women prevailed, the average age was 51.2±15.3 years. Patients were evaluated complaints, the presence of concomitant diseases of the lungs, was carried out computed tomography of the chest high - resolution (HRCT), a culture study of sputum, in the absence of sputum or a single determination of the NTM culture in it, a study was conducted on materials of bronchoalveolar washout (ALS/BAL), or lung biopsies. Statistical processing of the research results was performed using descriptive statistics using Microsoft® Excel for Windows xp® on a personal computer. Results and conclusion. As a result of the study, it was revealed that before the diagnosis of NTML was established, 66.7% of patients were long observed for chronic lung diseases (chronic obstructive pulmonary disease, chronic bronchitis), and in 55.6% of cases (50 people) were registered with a phthisiologist about pulmonary tuberculosis. According to the CT scan of OGK, dissemination was determined in 66.7% of cases, in 48.9% - bronchiectasis, single or multiple destruction cavities - 46.7% of cases. In 72.2% of cases, non - tuberculous mycobacteria (NTM) were found in sputum, in 33.3% - in ALS and in 22.2% of NTMs were found in the surgical material. In 14.4% of cases, only surgery allowed to establish the diagnosis of mycobacteriosis.

About the authors

E B Vladimirova

Central TB Research Institute

Email: velebor@mail.ru
к.м.н., н.с. отд. дифференциальной диагностики туберкулеза легких и экстракорпоральных методов лечения ФГБНУ «ЦНИИТ»; ORCID: 0000-0002-5050-5360 Moscow, Russia

E I Shmelev

Central TB Research Institute

д.м.н., проф., заслуженный деятель науки Российской Федерации, зав. отд. дифференциальной диагностики туберкулеза легких и экстракорпоральных методов лечения ФГБНУ «ЦНИИТ» Moscow, Russia

A S Zaytseva

Central TB Research Institute

к.м.н., с.н.с. отд. дифференциальной диагностики туберкулеза легких и экстракорпоральных методов лечения ФГБНУ «ЦНИИТ» Moscow, Russia

M N Kovalevskaya

Central TB Research Institute

к.м.н., н.с. отд. дифференциальной диагностики туберкулеза легких и экстракорпоральных методов лечения ФГБНУ «ЦНИИТ» Moscow, Russia

S A Kasimtseva

Central TB Research Institute

к.м.н., н.с. отдела дифференциальной диагностики туберкулеза легких и экстракорпоральных методов лечения ФГБНУ «ЦНИИТ» Moscow, Russia

R B Amansakhedov

Central TB Research Institute

к.м.н., врач-рентгенолог ФГБНУ «ЦНИИТ» Moscow, Russia

L N Chernousova

Central TB Research Institute

д.б.н., проф., руководитель отд. микробиологии ФГБНУ «ЦНИИТ» Moscow, Russia

A E Ergeshov

Central TB Research Institute

д.м.н., проф., директор ФГБНУ «ЦНИИТ» Moscow, Russia

N M Shmeleva

Central TB Research Institute

к.м.н., с.н.с. отд. дифференциальной диагностики туберкулеза легких и экстракорпоральных методов лечения ФГБНУ «ЦНИИТ» Moscow, Russia

References

  1. Griffith D.E, Aksamit T, Brown-Elliott B.A, et al. An official ATS/ IDSA statement: Diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175(4):367-416. doi.org/10.1164/rccm.200604-571st
  2. Sniadack D.H, Ostroff S.M, Karlix M.A, et al. A nosocomial pseudooutbreak of Mycobacterium xenopi due to a contaminated potable water supply: lessons in prevention. Infect Control Hosp Epidemiol. 1993;14(11):636-41. doi.org/10.2307/30149746
  3. Эргешов А.Э., Шмелев Е.И., Ковалевская М.Н., Ларионова Е.Е., Черноусова Л.Н. Нетуберкулезные микобактерии у пациентов с заболеваниями органов дыхания (клинико - лабораторное исследование). Пульмонология. 2016;26(3):303-8. doi.org/10.18093/0869-0189-2016-26-3-303-308
  4. Winthrop K.L, Mc Nelley E, Kendall B, et al. Pulmonary nontuberculous mycobacterial disease prevalence and clinical features: an emerging public health disease. Am J Respir Crit Care Med. 2010 Oct1;182(7):977-82. doi: 10.1164/rccm.201003-0503OC
  5. Андреевская С.Н., Ларионова Е.Е., Смирнова Т.Г., Андриевская И.Ю., Киселева Е.А., Черноусова Л.Н. Лекарственная чувствительность медленнорастущих нетуберкулезных микобактерий. Туберкулез и болезни легких. 2016;94(4):43-50. https://doi.org/10.21292/2075-1230-2016-94-4-43-50
  6. Haworth C.S, Banks J, Capstick T, Fisher A.J, et al. British Thoracic Society guidelines for the management of non - tuberculous mycobacterial pulmonary disease (NTM-PD). Thorax. 2017 Nov;72(Suppl 2):ii1-ii64. doi: 10.1136/thoraxjnl-2017-210927
  7. Hwang J.A, Kim S, Jo K.W, Shim T.S. Natural history of Mycobacterium avium complex lung disease in untreated patients with stable course. Eur Respir J. 2017 Mar 8;49(3):pii:1600537. doi: 10.1183/13993003.00537-2016

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