Epidemiological characteristics of non-tuberculous mycobacterial disease in Guangzhou

doi:10.19982/j.issn.1000-6621.20240185

Abstract

Abstract:

Objective: The general situation and epidemiological characteristics of non-tuberculous mycobacteria (NTM) disease in Guangzhou were analyzed to provide reference for development and implementation of effective prevention and management policy of NTM disease. Methods: To conduct a retrospective analysis of 2714 newly diagnosed cases of NTM disease in Guangzhou from January 1, 2018, to December 31, 2023. The study examined the annual detection rate trends of NTM disease, as well as the distribution characteristics by gender, age, and bacterial species/groups. We analyzed the impact of age on NTM disease across nine consecutive age groups, with a focus on comparing the detection differences between the youth group (21-40 years) and the middle-aged/elderly group (51-70 years). Additionally, based on the site of infection, we classified the cases into three groups: pulmonary, extrapulmonary, and disseminated, for further analysis. Results: The detection rate of new NTM disease in Guangzhou in 6 years was fluctuating. Male proportion decreased from 41.10% (194 cases) in 2018 to 38.10% (205 cases) in 2023, while female proportion increased from 58.90% (278 cases) to 61.90% (333 cases). The proportion of male decreased year by year, and the proportion of female increased year by year. The main age group was 51-70 years, accounting for 51.62% (1401/2714). The youth group (21-40 years) decreased from 23.09% (109/472) in 2018 to 16.36% (88/538) in 2023, and the middle-aged/elderly group (51-70 years) rose from 48.31% (228/472) to 55.76% (300/538). Among all 2714 patients with new NTM disease in Guangzhou in 6 years, the top 4 strains of NTM isolation from pulmonary group (97.09%, 2635/2714) were: bird-intracellular mycobacterium complex group (M.avium complex, MAC, 43.42%, 1144/2635), Turtle-Mycobacterium abscessus complex (Turtle-M.abscessus complex, MABC, 36.39%, 959/2635), Mycobacterium kansas (8.50%, 224/2635), and M.sp.contingent (4.10%,108/2635); the top 4 strains of NTM isolation from extrapulmonary group (1.69%, 46/2714) were: MABC (34.78%, 16/46), M.contingent (21.74%, 10/46), MAC(19.57%, 9/46), and Mycobacterium salina (15.22%, 7/46); the top 4 strains of NTM isolation from dissemination group (1.22%, 33/2714) were: MAC (42.42%, 14/33), MABC (27.27%, 9/33), Mycobacterium kansas ((15.15%, 5/33), and M.contingent (6.06%, 2/33). MAC induced lung disease composition ratio slightly increased, from 39.19% (185/472) in 2018 to 48.48% (176/363) in 2022 and 44.61% (240/538) in 2023, while MABC induced lung disease composition ratio decreased from 38.98% (184/472) in 2018 to 30.30% (163/538) in 2023. Conclusion: Middle-aged and elderly patients in Guangzhou are more susceptible to NTM, with a higher prevalence in females compared to males. The proportion of cases in the youth group (21-40 years) shows a declining trend, whereas the proportion in the middle-aged/elderly group (51-70 years) shows an increasing trend. The predominant species causing NTM pulmonary disease are MAC and MABC, with the proportion of MABC cases showing a downward trend.

Key words: Mycobacterial infection, Mycobacteria,atypical, Epidemiology, Guangzhou city

CLC Number:

R372
R563

Liang Feng, Liu Deqing, Chen Hua, Chen Pinru, Tan Yaoju, Hu Jinxing, Zhang Danni, Xu Liuqing. Epidemiological characteristics of non-tuberculous mycobacterial disease in Guangzhou[J]. Chinese Journal of Antituberculosis, 2024, 46(11): 1373-1379. doi: 10.19982/j.issn.1000-6621.20240185

Figures/Tables 5

References 35

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年份	患者总例数	结核病例数	构成比(%)	NTM病例数	构成比(%)	结核病并发NTM病例数	构成比(%)
2018	2755	2280	82.76	472	17.13	3	0.11
2019	3390	2889	85.22	493	14.54	8	0.24
2020	2860	2445	85.49	408	14.27	7	0.24
2021	2901	2457	84.69	440	15.17	4	0.14
2022	2408	2042	84.80	363	15.07	3	0.13
2023	3115	2571	82.54	538	17.27	6	0.19
总计	17429	14684	84.25	2714	15.57	31	0.18

年份	男性(例)	构成比(%)	女性(例)	构成比(%)
2018	194	41.10	278	58.90
2019	199	40.37	294	59.63
2020	165	40.44	243	59.56
2021	178	40.45	262	59.55
2022	138	38.02	225	61.98
2023	205	38.10	333	61.90
总计	1079	39.76	1635	60.24

年份	0~10岁	11~20岁	21~30岁	31~40岁	41~50岁	51~60岁	61~70岁	71~80岁	81~93岁	总计
2018	1(0.21)	17(3.60)	55(11.65)	54(11.44)	70(14.83)	110(23.31)	118(25.00)	34(7.20)	13(2.76)	472(100.00)
2019	0(0.00)	10(2.03)	57(11.56)	51(11.44)	75(15.21)	114(23.12)	127(25.76)	49(9.95)	10(2.03)	493(100.00)
2020	1(0.24)	10(2.45)	38(9.32)	39(10.34)	50(12.25)	101(24.75)	108(26.47)	52(12.75)	9(2.21)	408(100.00)
2021	0(0.00)	9(2.05)	39(8.86)	40(9.56)	67(15.23)	110(25.00)	123(27.95)	42(9.54)	10(2.28)	440(100.00)
2022	0(0.00)	4(1.10)	29(7.99)	38(10.47)	49(13.50)	83(22.87)	107(29.48)	45(12.39)	8(2.20)	363(100.00)
2023	0(0.00)	13(2.42)	35(6.51)	53(9.85)	68(12.64)	147(27.32)	153(28.44)	63(11.71)	6(1.11)	538(100.00)
总计	2(0.07)	63(2.32)	253(9.32)	275(10.13)	379(13.96)	665(24.52)	736(27.12)	285(10.50)	56(2.06)	2714(100.00)

年份	MAC 例数	构成比 (%)	MABC 例数	构成比 (%)	堪萨斯例数	构成比 (%)	偶发例数	构成比 (%)	其他例数	构成比 (%)	NTM病总例数
2018	185	39.19	184	38.98	31	6.57	18	3.82	54	11.44	472
2019	198	40.16	196	39.76	33	6.69	23	4.67	43	8.72	493
2020	163	39.95	141	34.56	39	9.56	18	4.41	47	11.52	408
2021	182	41.36	161	36.59	34	7.73	16	3.64	47	10.68	440
2022	176	48.48	114	31.41	33	9.09	7	1.93	33	9.09	363
2023	240	44.61	163	30.3	54	10.04	26	4.83	55	10.22	538
总计	1144	42.15	959	35.34	224	8.25	108	3.98	279	10.28	2714