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Nontuberculous Mycobacteria in Portugal

2022-02-24Artigo científico Acesso aberto
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dc.contributor.authorSantos, A.
dc.contributor.authorCarneiro, S.
dc.contributor.authorSilva, A.
dc.contributor.authorGomes, J. P.
dc.contributor.authorMacedo, R.
dc.contributor.institutionDCV - Departamento de Ciências da Vida
dc.contributor.pblElsevier Espana S.L.U
dc.date.accessioned2023-03-15T22:32:46Z
dc.date.available2023-03-15T22:32:46Z
dc.date.issued2022-02-24
dc.descriptionPublisher Copyright: © 2022 Sociedade Portuguesa de Pneumologia
dc.description.abstractIntroduction 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.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent7
dc.format.extent687417
dc.identifier.doi10.1016/j.pulmoe.2022.01.011
dc.identifier.issn2531-0429
dc.identifier.otherPURE: 55817789
dc.identifier.otherPURE UUID: 51b249be-1a3a-402c-8e16-817dee217218
dc.identifier.otherScopus: 85125537190
dc.identifier.otherPubMed: 35219623
dc.identifier.urihttp://hdl.handle.net/10362/150636
dc.identifier.urlhttps://www.scopus.com/pages/publications/85125537190
dc.language.isoeng
dc.peerreviewedyes
dc.subjectNontuberculous mycobacteria
dc.subjectNTM
dc.subjectNTM disease
dc.subjectNTM epidemiology
dc.subjectPulmonary and Respiratory Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleNontuberculous Mycobacteria in Portugalen
dc.title.subtitleTrends from the last decadeen
dc.typejournal article
degois.publication.titlePulmonology
dspace.entity.typePublication
rcaap.rightsopenAccess

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