engleski

Non-tuberculous Mycobacteria Isolated from Clinical Specimens in Croatia 2000-2008

The genus Mycobacterium currently has more than 140 species, including M. tuberculosis complex, M. leprae and other organisms referred to as nontuberculous mycobacteria (NTM). In recent years, there has been a marked increase in the number of cases of human disease due NTM that seem to be related to the geographic distribution of these species in the environment. A wide range of diseases is caused by NTM, including lung disease, lymphadenitis, skin and soft tissue infections, osteoarticular disease and disseminated disease. In Croatia, TB diagnostics is conducted in 14 laboratories that use Löwenstein-Jensen and MGIT media for the recovery of mycobacteria from clinical specimens. Full-grown AFB cultures, negative for M. tuberculosis, are sent to Croatian National Institute of Public Health where the identification is performed by means of GenoType Mycobacterium CM/AS kits (Hain Lifescience) and/or by phenotypical methods. Of total of 39, 580 clinical isolates isolated in Croatia from 2000 to 2008, 37, 426 (94.55%) were identified as belonging to M. tuberculosis complex and 2, 154 (5.45%) as NTM. During that period, NTM prevalence increased steadily, starting with 4.2% in 2000 and rising to 9.9% in 2008. Total of 95 patients with NTM isolates met microbiologic criteria for mycobacteriosis. After M. xenopi (n=36 ; 37.89%) and MAC (n=31 ; 32.63%), most patients had M. kansasii (n=15 ; 15.79%) isolated. M. fortuitum was isolated in 5 patients (5.26%), M. abscessus in 3 (3.16%), while M. chelonae, M. celatum, M. scrofulaceum, M. gordonae, M. peregrinum and M. marinum were isolated in one patient each (1.05%). With TB notification rate of 19/100.000, Croatia is a middle-incidence country and TB is still a public health problem. Nevertheless, the incidence of NTM, as well as number of mycobacteriosis patients, is steadily rising and the key role of the laboratory is increasing the awareness of NTM as potential pathogens. The correct and rapid identification of NTM is at the basis of the proper therapeutic modality.

NTM; clinical specimens; Croatia

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