Actual diagnostic methods used in nontuberculous mycobacteria infections

Abstract

Introduction. Nontuberculous mycobateria, also called atypical mycobacteria, for a long period of time, were considered to be inoffensive for humans. Nowadays they are considered to be very wide spread and responsible for many atypical clinical manifestations such as localized lymphadenitis, tuberculosis like extrapulmonar lesions, disseminated form and so on. There a known more species today than 30 years ago, and all of them are classified in Ernest Runyon classification which dates from 1959.It includes four groups of atypical mycobacteria in dependence of coloration and rapidity of growth: group I-photochromogens; group II-cotochromogens; group III-nonchromogens; group IV-rapid growing. These mycobacteria live in water, air and soil, that’s why they can contaminate organisms throughout airflow, via parenteral and enteral way. The diagnosis is not so hard, but in many cases irrelevant because of the possibility of atypical mycobacteria to contaminate containers for sputum collection. Aim of the study. To analyse the actual situation of atypical mycobacteria diagnosis in our country, the diagnostic methods used for confirmation here and abroad. Materials and methods. The diagnosis of nontuberculuos mycobacteria is based on 3 criteria: 1) Clinical criterion: cough, fever, dyspnea and fatigue; 2) Radiologic criterion: persistent nodular infiltration; 3) Microbiologic criterion: positive culture and positive microscopic view. Each positive culture is the confirmed via GenoType® Mycobacterium CM test. 201 cases of nontuberculous mycobacteria infections were confirmed in 2015-2017 in Republic of Moldova. All of them were confirmed from sputum. Results. Most of the cases could be found in presenile patiens, mostly in women and high incidence of species m. fortuitum followed by m. kansasii is revealed Conclusions. The only method of diagnosis available at this moment in our country and abroad ,to confirm the atypical mycobacteria infection was GenoType® Mycobacterium CM test. Most of the cases could be found in presenile patiens, almost in women. A high incidence of species m.fortuitum followed by m.kansasii was found in our country which leads to the most common transmition way of non-tuberculous mycbacteria.