최근 7년 동안 비결핵항산균 배양 건수 및 비결핵항산균 폐질환 진단 건수의 변화

Abstract

Background: The incidence of nontuberculous mycobacteria (NTM) isolates and lung disease caused by NTM is increasing worldwide. In this study, we report recent trends in NTM isolation rate, and the trends in the incidence of NTM lung disease compared to that of pulmonary tuberculosis (caused by Mycobacterium tuberculosis [MTB]) at a referral hospital in South Korea.

Methods: We collected the data for mycobacterial isolates cultured from respiratory specimens between January 1, 2009 and December 31, 2015 at Seoul National University Hospital, a tertiary referral hospital in South Korea. The species of mycobacteria identified in cultures, as well as clinical information of the patients from whom NTM was cultured were obtained. The annual number of NTM isolates, the number of patients in whom NTM was isolated, and cases of newly diagnosed NTM were calculated and compared with those for MTB.

Results: During the study period, a total of 12,670 NTM isolates were cultured from respiratory specimens. The annual number of new NTM cases increased from 1,530 in 2009 to 2,169 in 2015, while the number of MTB cases decreased from 1,141 to 839 (p for trend <0.001). The rate at which the species was identified from the NTM isolates increased from 25.75% in 2009 to 52.19% in 2015 (p for trend <0.001). Among NTM isolates, the most common species of isolated NTM was M. avium complex (MAC) (n=3,041, 61.19%), followed by M. abscessus complex (MABC) (n=1,103, 22.19%). The isolation rate of MAC increased, while that of MABC remained stable throughout the study period (p for trend <0.001). Patients with newly diagnosed NTM lung disease also increased, from 128 patients in 2009 to 162 patients in 2015 (p for trend < 0.001). The majority of patients diagnosed with NTM lung disease throughout the study period were female (62.3%, p<0.001).

Conclusions: The NTM isolation rate and the incidence of NTM lung disease has increased since 2009 in a tertiary referral center in South Korea.