Inventory study of non-tuberculous mycobacteria in the European Union

BMC Infectious Diseases

Vibeke Østergaard Thomsen¹  Manca Žolnir-Dovč⁵  Dick van Soolingen⁶  Monique Perrin⁹  Enrico Tortoli^1,11  Dimitrios Papaventsis^1,10  Elvira Richter²  Hanna Soini⁷  Tiina Kummik³  Vera Katalinić-Janković⁸  Csaba Ködmön⁴  Marieke J van der Werf⁴ 

[1] International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark;National Reference Laboratory for Mycobacteria, Forschungszentrum Borstel, Borstel, Germany;Department of Mycobacteriology, Tartu University Hospital, Tartu, Estonia;European Centre for Disease Prevention and Control, Stockholm, Sweden;National Reference Laboratory for Mycobacteria, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia;National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands;National Institute for Health and Welfare, Turku, Finland;National Mycobacterium Reference Laboratory, Croatian National Institute of Public Health, Zagreb, Croatia;Division de Bactériologie – Parasitologie, Laboratoire National de Santé, Luxembourg, Luxembourg;National Reference Laboratory for Mycobacteria, “Sotiria” Chest Diseases Hospital, Athens, Greece;Emerging Bacterial Pathogens Unit, San Raffaele Scientific Institute, Milan, Italy

关键词: European Union;    Epidemiology;    Mycobacterioses;    Non-tuberculous mycobacteria;   

Others  :  1134755
DOI  :  10.1186/1471-2334-14-62

 received in 2013-08-28, accepted in 2013-11-22,  发布年份 2014

【 摘 要 】

Background

Since non-tuberculous mycobacteria (NTM) disease is not notifiable in most European Union (EU) and European Economic Area (EEA) countries, the epidemiological situation of the >150 NTM species is largely unknown. We aimed to collect data on the frequency of NTM detection and NTM species types in EU/EEA countries.

Methods

Officially nominated national tuberculosis reference laboratories of all EU/EEA countries were asked to provide information on: laboratory routines for detection and identification of NTM, including drug sensitivity testing (DST) methods; data on the number and type of NTM species identified; coverage and completeness of the provided data on NTM; type and number of human specimens tested for NTM; and number of specimens tested for Mycobacterium tuberculosis complex and NTM. This information was summarized and the main results are described.

Results

In total, 99 different NTM species were identified with M. avium, M. gordonae, M. xenopi , M. intracellulare, and M. fortuitum identified most frequently. Seven percent of the NTM species could not be identified. NTM was cultured from between 0.4-2.0% of the specimens (data from four countries). The laboratories use culturing methods optimised for M. tuberculosis complex. Identification is mainly carried out by a commercial line probe assay supplemented with sequencing. Most laboratories carried out DST for rapid growers and only at the explicit clinical request for slow growers.

Conclusion

It is likely that the prevalence of NTM is underestimated because diagnostic procedures are not optimized specifically for NTM and isolates may not be referred to the national reference laboratory for identification. Due to the diagnostic challenges and the need to establish the clinical relevance of NTM, we recommend that countries should concentrate detection and identification in only few laboratories.

【 授权许可】

   
2014 van der Werf et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Piersimoni C, Scarparo C: Pulmonary infections associated with non-tuberculous mycobacteria in immunocompetent patients. Lancet Infect Dis 2008, 8(5):323-334.
• [2]Daley CL, Griffith DE: Pulmonary non-tuberculous mycobacterial infections. Int J Tuberc Lung Dis 2010, 14(6):665-671.
• [3]List of prokaryotic names with standing in nomenclature - genus Mycobacteriumhttp://www.bacterio.net/index.html webcite
• [4]van Ingen J, Bendien SA, de Lange WC, Hoefsloot W, Dekhuijzen PN, Boeree MJ, van Soolingen D: Clinical relevance of non-tuberculous mycobacteria isolated in the Nijmegen-Arnhem region, The Netherlands. Thorax 2009, 64(6):502-506.
• [5]Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, Holland SM, Horsburgh R, Huitt G, Iademarco MF, 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.
• [6]Bryant JM, Grogono DM, Greaves D, Foweraker J, Roddick I, Inns T, Reacher M, Haworth CS, Curran MD, Harris SR, et al.: Whole-genome sequencing to identify transmission of mycobacterium abscessus between patients with cystic fibrosis: a retrospective cohort study. Lancet 2013, 381(9877):1551-1560.
• [7]Aitken ML, Limaye A, Pottinger P, Whimbey E, Goss CH, Tonelli MR, Cangelosi GA, Dirac MA, Olivier KN, Brown-Elliott BA, et al.: Respiratory outbreak of mycobacterium abscessus subspecies massiliense in a lung transplant and cystic fibrosis center. Am J Respir Crit Care Med 2012, 185(2):231-232.
• [8]Padoveze MC, Fortaleza CM, Freire MP, Brandao de Assis D, Madalosso G, Pellini AC, Cesar ML, Pisani Neto V, Beltramelli MM, Chimara E, et al.: Outbreak of surgical infection caused by non-tuberculous mycobacteria in breast implants in Brazil. J Hosp Infect 2007, 67(2):161-167.
• [9]Lowry PW, Beck-Sague CM, Bland LA, Aguero SM, Arduino MJ, Minuth AN, Murray RA, Swenson JM, Jarvis WR: Mycobacterium chelonae infection among patients receiving high-flux dialysis in a hemodialysis clinic in California. J Infect Dis 1990, 161(1):85-90.
• [10]Kotilainen H, Valtonen V, Tukiainen P, Poussa T, Eskola J, Jarvinen A: Clinical symptoms and survival in non-smoking and smoking HIV-negative patients with non-tuberculous mycobacterial isolation. Scand J Infect Dis 2011, 43(3):188-196.
• [11]Hoefsloot W, van Ingen J, Peters EJ, Magis-Escurra C, Dekhuijzen PN, Boeree MJ, van Soolingen D: Mycobacterium genavense in the Netherlands: an opportunistic pathogen in HIV and non-HIV immunocompromised patients. An observational study in 14 cases. Clin Microbiol Infect 2012, 19(5):432-437.
• [12]Ding LW, Lai CC, Lee LN, Huang LM, Hsueh PR: Lymphadenitis caused by non-tuberculous mycobacteria in a university hospital in Taiwan: predominance of rapidly growing mycobacteria and high recurrence rate. J Formos Med Assoc 2005, 104(12):897-904.
• [13]Andrejak C, Nielsen R, Thomsen VO, Duhaut P, Sorensen HT, Thomsen RW: Chronic respiratory disease, inhaled corticosteroids and risk of non-tuberculous mycobacteriosis. Thorax 2012, 68(3):256-262.
• [14]Kluger N, Cohen P, Fallet-Bianco C, Guillevin L: Mycobacterium chelonae infection under adalimumab therapy for spondylarthritis. Clin Exp Rheumatol 2010, 28(1):101-102.
• [15]Maimon N, Brunton J, Chan AK, Marras TK: Fatal pulmonary mycobacterium xenopi in a patient with rheumatoid arthritis receiving etanercept. Thorax 2007, 62(8):739-740.
• [16]van de Vosse E, Hoeve MA, Ottenhoff TH: Human genetics of intracellular infectious diseases: molecular and cellular immunity against mycobacteria and salmonellae. Lancet Infect Dis 2004, 4(12):739-749.
• [17]Thomsen VO, Andersen AB, Miorner H: Incidence and clinical significance of non-tuberculous mycobacteria isolated from clinical specimens during a 2-y nationwide survey. Scand J Infect Dis 2002, 34(9):648-653.
• [18]Ringshausen FC, Apel RM, Bange FC, de Roux A, Pletz MW, Rademacher J, Suhling H, Wagner D, Welte T: Burden and trends of hospitalisations associated with pulmonary non-tuberculous mycobacterial infections in Germany, 2005-2011. BMC Infect Dis 2013, 13:231.
• [19]Moore JE, Kruijshaar ME, Ormerod LP, Drobniewski F, Abubakar I: Increasing reports of non-tuberculous mycobacteria in England, Wales and Northern Ireland, 1995-2006. BMC Public Health 2010, 10:612.
• [20]Amorim A, Macedo R, Lopes A, Rodrigues I, Pereira E: Non-tuberculous mycobacteria in HIV-negative patients with pulmonary disease in Lisbon, Portugal. Scand J Infect Dis 2010, 42(8):626-628.
• [21]Martin-Casabona N, Bahrmand AR, Bennedsen J, Thomsen VO, Curcio M, Fauville-Dufaux M, Feldman K, Havelkova M, Katila ML, Koksalan K, et al.: Non-tuberculous mycobacteria: patterns of isolation. A multi-country retrospective survey. Int J Tuberc Lung Dis 2004, 8(10):1186-1193.
• [22]Hoefsloot W, van Ingen J, Andrejak C, Angeby K, Bauriaud R, Bemer P, Beylis N, Boeree MJ, Cacho J, Chihota V, et al.: The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples: a NTM-NET collaborative study. Eur Respir J 2013. Epub ahead of print, doi: 10.1183/09031936.00149212
• [23]van Ingen J, van der Laan T, Dekhuijzen R, Boeree M, van Soolingen D: In vitro drug susceptibility of 2275 clinical non-tuberculous mycobacterium isolates of 49 species in The Netherlands. Int J Antimicrob Agents 2010, 35(2):169-173.
• [24]Levy-Frebault VV, Portaels F: Proposed minimal standards for the genus mycobacterium and for description of new slowly growing mycobacterium species. Int J Syst Bacteriol 1992, 42(2):315-323.
• [25]Ferroni A, Vu-Thien H, Lanotte P, Le Bourgeois M, Sermet-Gaudelus I, Fauroux B, Marchand S, Varaigne F, Berche P, Gaillard JL, et al.: Value of the chlorhexidine decontamination method for recovery of nontuberculous mycobacteria from sputum samples of patients with cystic fibrosis. J Clin Microbiol 2006, 44(6):2237-2239.
• [26]Tortoli E, Pecorari M, Fabio G, Messino M, Fabio A: Commercial DNA probes for mycobacteria incorrectly identify a number of less frequently encountered species. J Clin Microbiol 2010, 48(1):307-310.
• [27]van Ingen J, Boeree MJ, de Lange WC, de Haas PE, van der Zanden AG, Mijs W, Rigouts L, Dekhuijzen PN, van Soolingen D: Mycobacterium noviomagense sp. nov.; clinical relevance evaluated in 17 patients. Int J Syst Evol Microbiol 2009, 59(Pt 4):845-849.
• [28]Petrini B: Mycobacterium abscessus: an emerging rapid-growing potential pathogen. APMIS 2006, 114(5):319-328.
• [29]Van Ingen J: Nontuberculosis Mycobacteria; from gene sequence to clinical relevance. Thesis. Nijmegen: Univerity of Nijmegen; 2009.
• [30]Tortoli E: Impact of genotypic studies on mycobacterial taxonomy: the new mycobacteria of the 1990s. Clin Microbiol Rev 2003, 16(2):319-354.
• [31]Koh WJ, Kwon OJ, Jeon K, Kim TS, Lee KS, Park YK, Bai GH: Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens in Korea. Chest 2006, 129(2):341-348.
• [32]Andrejak C, Thomsen VO, Johansen IS, Riis A, Benfield TL, Duhaut P, Sorensen HT, Lescure FX, Thomsen RW: Nontuberculous pulmonary mycobacteriosis in Denmark: incidence and prognostic factors. Am J Respir Crit Care Med 2010, 181(5):514-521.
• [33]Clinical and Laboratory Standards Institute: Susceptibility testing of mycobacteria, Nocardia, and other aerobic actinomycetes. Second edition. Wayne, PA: Clinical and Laboratory Standards Institute; 2011. CLSI document M24-A2