Golniški simpozij 2011 Zbornik povzetkov

A nation-wide study of nontuberculous
mycobacteria in Slovenia
Manca Æolnir Dovœ 1 , Nataøa Fajfar 1 , Irena Plesec 1 , Æiva Petroviœ 2 , Nada Øorli Peranoviœ 1
1
University Clinic of Respiratory and Allergic Diseases, Golnik
2
Institute of Public Health, Centre for Microbiology, Maribor
Background
Nontuberculous mycobacteria (NTM) are ubiquitous bacteria and are isolated from many environmental
sources, most often from water and soil. They are capable of infecting and causing disease
(mycobacteriosis) in both immunocompetent and immunocompromised hosts. HIV infection,
previous chronic lung disease, cystic fibrosis, work in mining industry, advanced age, and male
sex are the most frequent risk factors for the disease reported in several studies. Human infections
caused by NTM have four major clinical manifestations: pulmonary disease, lymphadenitis, disseminated
disease, and skin or soft tissue infections. The frequency of NTM diseases differs with
regard to different geographical regions of the world. In general, cases of mycobacteriosis are on
the rise in the last years. The aim of this study was to analyze laboratory diagnostics of NTM and
NTM disease in the last eleven years (2000-2010) and to detect any changes in distribution of
NTM in Slovenia.
Methods
Between 2000 and 2010, there were 3-6 laboratories in Slovenia that were performing laboratory diagnostics
of tuberculosis and NTM in humans. In the majority of laboratories, cultures were grown on
solid and in liquid media. All clinical isolates of mycobacteria were sent for identification to the National
Reference Laboratory for Mycobacteria Golnik. GenoType Mycobaterium CM/AS assays (Hain
Lifescience, Nehren, Germany), AccuProbe tests (GenProbe, San Diego, USA), classical biochemical
tests and/or colony morphology of NTM on transparent medium were used for identification of mycobacteria.
Results
A total of 2238 (1.6%) isolates of NTM were isolated from 140,001 clinical specimens in Slovenia
in the period 2000-2010. Mycobacterium (M.) xenopi (27.5%) was the most frequently isolated
species followed by M. avium complex (22.6%), M. gordonae (16.3%), M. kansasii (8.1%) and M.
fortuitum (6.7%). In contrast, M. kansasii and M. avium complex were found to be the most common
disease-causing mycobacteria in our country in the last 11 years. Mycobacteriosis has been
observed in at least 115 persons in the same period. Eight of them were children aged between
1.5 and 4 years, all had lymphadenitis caused by M. avium complex and all were detected in the
period 2006-2010.
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