Epidemiological status and clinical characteristics of 225 cases of non-tuberculous mycobacterial pulmonary disease in Hainan Province
Objective To explore the epidemiological and clinical characteristics of non-tuberculous mycobacterial(NTM)pulmonary disease in Hainan in recent years,and to provide data support for the prevention and treatment of NTM pulmonary disease.Methods Medical records of patients diagnosed with NTM pulmonary disease who treated at the Second Affiliated Hospital of Hainan Medical University(Hainan Provincial Tuberculosis Hospital)from January 2018 to December 2022 were collected.The demographics,regional distribution,temporal distribution,distribution of mycobacterial species,clinical symptoms,and radiological imaging changes of these patients were analyzed.Results A total of 225 confirmed cases of NMT pulmonary disease were collected in this study,with 133(59.1％)female patients outnumbering 92(40.9％)male patients.The disease predominantly affected people over 50 years old,with 192 cases(85.3％),and the major onset age range was 61-＜81 years old,with a median age of 63 and an average age of 62.Farmers comprised the majority of the patients,with 112 cases(49.8％).More patients were from the western region(90 cases,40.0％)than from the central region(76 cases,33.8％),followed by the eastern region(59 cases,26.2％).A total of 10 strains were detected from 225 samples,with the most common strains being Mycobacterium intracellulare(92 cases,40.9％),Mycobacterium chelonae/abscessus(80 cases,35.6％),and Mycobacterium avium(15 cases,6.7％),followed by Mycobacterium kansasii(5 cases,2.2％),Mycobacterium fortuitum(4 cases,1.8％),and Mycobacterium parascrofulaceum(3 cases,1.3％).There were 10 cases(4.5％)of mixed infections,including Mycobacterium avium and Mycobacterium intracellulare(8 cases,3.6％),Mycobacterium intracellulare and Mycobacterium chelonae/abscessus(1 case,0.4％),and Mycobacterium fortuitum and Mycobacterium chelonaelabscessus(1 case,0.4％).The primary clinical manifestations of NTM pulmonary disease included cough and sputum(219 cases,97.3％),hemoptysis(92 cases,40.9％),fever(61 cases,27.1％),dyspnea(57 cases,25.3％),night sweats(52 cases,23.1％),weight loss(50 cases,22.2％),and thoracodynia(35 cases,15.6％).There was no significant difference in symptoms between male and female patients.Pleural thickening(188 cases,83.6％)and bronchiectasis(151 cases,67.1％)were the most common imaging changes in NTM pulmonary disease,followed by cavities(93 cases,41.3％),emphysema(41 cases,18.2％),and lung damage(28 cases,12.4％).Male patients were more likely to have lung damage and emphysema,while female patients were more likely to have bronchiectasis.Conclusions The distribution of NTM species is diverse in Hainan area,with Mycobacterium intracellulare,Mycobacterium chelonae/abscessus,and Mycobacterium avium are dominant species.NTM pulmonary disease and pulmonary tuberculosis have similar clinical features,which requires attention for differentiation in clinical practice.
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