Research Article
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Solunum yolu kültür örneklerinde tüberküloz dışı mikobakteri (NTM) üreyen hastaların klinik, radyolojik ve mikrobiyolojik özelliklerinin değerlendirilmesi

Year 2025, Volume: 7 Issue: 4, 496 - 500, 28.07.2025
https://doi.org/10.38053/acmj.1730276

Abstract

Aims: This study aimed to look at the clinical, imaging, and microbiological features of patients with non-tuberculosis mycobacteria (NTM) growth in respiratory samples and to identify the factors that might help in distinguishing the difference between infection and colonization.
Methods: This retrospective study included 85 patients with NTM growth in respiratory tract samples (sputum, bronchial lavage/bronchoalveolar lavage) between January 2017 and March 2025. Demographic data, comorbidities, radiological findings, and microbiological results were analyzed. The diagnosis of NTM infection was made based on the ATS/ERS/ESCMID/IDSA clinical practice guidelines, which consider clinical, radiological, and microbiological criteria.
Results: Among the 85 patients, 55.3% were diagnosed with infection and 44.7% with colonization. The most common comorbidities were chronic obstructive pulmonary disease (COPD) (47.1%), bronchiectasis (37.6%), and hypertension (31.8%). Radiological findings included infiltration (51.8%), nodules (50.6%), bronchiectasis (37.6%), and cavitation (20%). Infiltration (p=0.013) and cavitation (p=0.012) were significantly more frequent in the infection group, while bronchiectasis (p=0.010) and asthma (p=0.045) were more prevalent in the colonization group. Inhaled corticosteroid (ICS) use showed no significant difference between groups.
Conclusion: In line with previous literature, this study confirms that NTM infections are commonly associated with structural lung diseases such as COPD and bronchiectasis. Radiological findings, particularly cavitation and infiltration, play an important role in the diagnosis of infection. A comprehensive evaluation of clinical, radiological, and microbiological data is essential for differentiating NTM infection from colonization. Distinguishing colonization from active infection prevents unnecessary treatments. It reduces healthcare costs. It protects patients from the possible side effects of antibiotics.

References

  • Falkinham Iii JO. The biology of environmental mycobacteria. Environ Microbiol Rep. 2009;1(6):477-487. doi:10.1111/j.1758-2229.2009.00054.x
  • Jamal F, Hammer MM. Nontuberculous mycobacterial infections. Radiol Clin North Am. 2022;60(3):399-408. doi:10.1016/j.rcl.2022.01.012
  • Daley CL, Iaccarino JM, Lange C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Eur Respir J. 2020;56(1):2000535. doi:10.1183/ 13993003.00535-2020
  • Johnson MM, Odell JA. Nontuberculous mycobacterial pulmonary infections. J Thorac Dis. 2014;6(3):210-220. doi:10.3978/j.issn.2072-1439. 2013.12.24
  • Koh WJ, Kwon OJ, Jeon K, et al. Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens in Korea. Chest. 2006;129(2):341-348. doi:10.1378/chest.129.2.341
  • Marras TK, Daley CL. Epidemiology of human pulmonary infection with nontuberculous mycobacteria. Clin Chest Med. 2002;23(3):553-567. doi:10.1016/s0272-5231(02)00019-9
  • Jeon D. Infection source and epidemiology of nontuberculous mycobacterial lung disease. Tuberc Respir Dis (Seoul). 2019;82(2):94-101. doi:10.4046/trd.2018.0026
  • Adzic-Vukicevic T, Barac A, Blanka-Protic A, et al. Clinical features of infection caused by non-tuberculous mycobacteria: 7 years' experience. Infection. 2018;46(3):357-363. doi:10.1007/s15010-018-1128-2
  • Strollo SE, Adjemian J, Adjemian MK, Prevots DR. The burden of pulmonary nontuberculous mycobacterial disease in the United States. Ann Am Thorac Soc. 2015;12(10):1458-64. doi:10.1513/AnnalsATS. 201503-173OC
  • Bents SJ, Mercaldo RA, Powell C, Henkle E, Marras TK, Prevots DR. Nontuberculous mycobacterial pulmonary disease (NTM PD) incidence trends in the United States, 2010-2019. BMC Infect Dis. 2024;24(1):1094. doi:10.1186/s12879-024-09965-y
  • Veziris N, Andréjak C, Bouée S, Emery C, Obradovic M, Chiron R. Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study. BMC Infect Dis. 2021;21(1):1165. doi:10.1186/s12879-021-06825-x
  • Jones MM, Winthrop KL, Nelson SD, et al. Epidemiology of nontuberculous mycobacterial infections in the U.S. Veterans Health Administration. PLoS One. 2018;13(6):e0197976. doi:10.1371/journal.pone.0197976
  • Kim RD, Greenberg DE, Ehrmantraut ME, et al. Pulmonary nontuberculous mycobacterial disease: prospective study of a distinct preexisting syndrome. Am J Respir Crit Care Med. 2008;178(10):1066-1074. doi:10.1164/rccm.200805-686OC
  • Jeong YJ, Lee KS, Koh WJ, et al. Nontuberculous mycobacterial pulmonary infections: CT scan findings, with pathologic correlations. Radiographics. 2004;24(5):1237-1256. doi:10.1148/radiol.2313030833
  • Erasmus JJ, McAdams HP, Farrell MA, Patz EF Jr. Pulmonary nontuberculous mycobacterial infection: radiologic manifestations. Radiographics. 1999;19(6):1487-1505. doi:10.1148/radiographics.19.6. g99no101487
  • Koh WJ, Kwon OJ, Lee KS. Nontuberculous mycobacterial pulmonary diseases in immunocompetent patients. Korean J Radiol. 2002;3(3):145-157. doi:10.3348/kjr.2002.3.3.145
  • Koh WJ, Lee KS, Kwon OJ, Jeong YJ, Kwak SH, Kim TS. Bilateral bronchiectasis and bronchiolitis at thin-section CT: diagnostic implications in nontuberculous mycobacterial pulmonary infection. Radiology. 2005;235(1):282-288. doi:10.1148/radiol.2351040371
  • Dailloux M, Abalain ML, Laurain C, et al. Respiratory infections associated with nontuberculous mycobacteria in non-HIV patients. Eur Respir J. 2006;28(6):1211-1215. doi:10.1183/09031936.00063806
  • Chien JY, Lai CC, Sheng WH, Yu CJ, Hsueh PR. Pulmonary infection and colonization with nontuberculous mycobacteria, Taiwan, 2000-2012. Emerg Infect Dis. 2014;20(8):1382-1385. doi:10.3201/eid2008.131673
  • Hernández-Garduño E, Elwood RK. Demographic risk factors of pulmonary colonization by non-tuberculous mycobacteria. Int J Tuberc Lung Dis. 2010;14(1):106-112.
  • Szturmowicz M, Oniszh K, Wyrostkiewicz D, Radwan-Rohrenschef P, Filipczak D, Zabost A. Non-tuberculous mycobacteria in respiratory specimens of patients with obstructive lung diseases-colonization or disease? Antibiotics (Basel). 202020;9(7):424. doi:10.3390/antibiotics 9070424
  • Mencarini J, Cresci C, Simonetti MT, et al. Non-tuberculous mycobacteria: epidemiological pattern in a reference laboratory and risk factors associated with pulmonary disease. Epidemiol Infect. 2017; 145(3):515-522. doi:10.1017/S0950268816002521
  • Chen S, Zhong J, Yang Q, et al. Comparative analysis of non-tuberculous mycobacterial lung disease and lung colonization: a case-control study. BMC Infect Dis. 2024;24(1):1159. doi:10.1186/s12879-024-10067-y
  • Garcia B, Wilmskoetter J, Grady A, Mingora C, Dorman S, Flume P. Chest computed tomography features of nontuberculous mycobacterial pulmonary disease versus asymptomatic colonization: a cross-sectional cohort study. J Thorac Imaging. 2022;37(3):140-145. doi:10.1097/RTI. 0000000000000610
  • Andréjak C, Thomsen VØ, Johansen IS, et al. Nontuberculous pulmonary mycobacteriosis in Denmark: incidence and prognostic factors. Am J Respir Crit Care Med. 2010;181(5):514-521. doi:10.1164/rccm.200905-0778OC

Evaluation of the clinical, radiological, and microbiological characteristics of the patients with non-tuberculosis mycobacteria (NTM) growth in respiratory tract samples culture

Year 2025, Volume: 7 Issue: 4, 496 - 500, 28.07.2025
https://doi.org/10.38053/acmj.1730276

Abstract

Aims: This study aimed to look at the clinical, imaging, and microbiological features of patients with non-tuberculosis mycobacteria (NTM) growth in respiratory samples and to identify the factors that might help in distinguishing the difference between infection and colonization.
Methods: This retrospective study included 85 patients with NTM growth in respiratory tract samples (sputum, bronchial lavage/bronchoalveolar lavage) between January 2017 and March 2025. Demographic data, comorbidities, radiological findings, and microbiological results were analyzed. The diagnosis of NTM infection was made based on the ATS/ERS/ESCMID/IDSA clinical practice guidelines, which consider clinical, radiological, and microbiological criteria.
Results: Among the 85 patients, 55.3% were diagnosed with infection and 44.7% with colonization. The most common comorbidities were chronic obstructive pulmonary disease (COPD) (47.1%), bronchiectasis (37.6%), and hypertension (31.8%). Radiological findings included infiltration (51.8%), nodules (50.6%), bronchiectasis (37.6%), and cavitation (20%). Infiltration (p=0.013) and cavitation (p=0.012) were significantly more frequent in the infection group, while bronchiectasis (p=0.010) and asthma (p=0.045) were more prevalent in the colonization group. Inhaled corticosteroid (ICS) use showed no significant difference between groups.
Conclusion: In line with previous literature, this study confirms that NTM infections are commonly associated with structural lung diseases such as COPD and bronchiectasis. Radiological findings, particularly cavitation and infiltration, play an important role in the diagnosis of infection. A comprehensive evaluation of clinical, radiological, and microbiological data is essential for differentiating NTM infection from colonization. Distinguishing colonization from active infection prevents unnecessary treatments. It reduces healthcare costs. It protects patients from the possible side effects of antibiotics.

Ethical Statement

This study was conducted in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines, and ethical approval was obtained from the Non-Interventional Clinical Research Ethics Committee of XXXX University with the decision dated 19/02/2025 and numbered 2025/4/1

Supporting Institution

None

Thanks

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References

  • Falkinham Iii JO. The biology of environmental mycobacteria. Environ Microbiol Rep. 2009;1(6):477-487. doi:10.1111/j.1758-2229.2009.00054.x
  • Jamal F, Hammer MM. Nontuberculous mycobacterial infections. Radiol Clin North Am. 2022;60(3):399-408. doi:10.1016/j.rcl.2022.01.012
  • Daley CL, Iaccarino JM, Lange C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Eur Respir J. 2020;56(1):2000535. doi:10.1183/ 13993003.00535-2020
  • Johnson MM, Odell JA. Nontuberculous mycobacterial pulmonary infections. J Thorac Dis. 2014;6(3):210-220. doi:10.3978/j.issn.2072-1439. 2013.12.24
  • Koh WJ, Kwon OJ, Jeon K, et al. Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens in Korea. Chest. 2006;129(2):341-348. doi:10.1378/chest.129.2.341
  • Marras TK, Daley CL. Epidemiology of human pulmonary infection with nontuberculous mycobacteria. Clin Chest Med. 2002;23(3):553-567. doi:10.1016/s0272-5231(02)00019-9
  • Jeon D. Infection source and epidemiology of nontuberculous mycobacterial lung disease. Tuberc Respir Dis (Seoul). 2019;82(2):94-101. doi:10.4046/trd.2018.0026
  • Adzic-Vukicevic T, Barac A, Blanka-Protic A, et al. Clinical features of infection caused by non-tuberculous mycobacteria: 7 years' experience. Infection. 2018;46(3):357-363. doi:10.1007/s15010-018-1128-2
  • Strollo SE, Adjemian J, Adjemian MK, Prevots DR. The burden of pulmonary nontuberculous mycobacterial disease in the United States. Ann Am Thorac Soc. 2015;12(10):1458-64. doi:10.1513/AnnalsATS. 201503-173OC
  • Bents SJ, Mercaldo RA, Powell C, Henkle E, Marras TK, Prevots DR. Nontuberculous mycobacterial pulmonary disease (NTM PD) incidence trends in the United States, 2010-2019. BMC Infect Dis. 2024;24(1):1094. doi:10.1186/s12879-024-09965-y
  • Veziris N, Andréjak C, Bouée S, Emery C, Obradovic M, Chiron R. Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study. BMC Infect Dis. 2021;21(1):1165. doi:10.1186/s12879-021-06825-x
  • Jones MM, Winthrop KL, Nelson SD, et al. Epidemiology of nontuberculous mycobacterial infections in the U.S. Veterans Health Administration. PLoS One. 2018;13(6):e0197976. doi:10.1371/journal.pone.0197976
  • Kim RD, Greenberg DE, Ehrmantraut ME, et al. Pulmonary nontuberculous mycobacterial disease: prospective study of a distinct preexisting syndrome. Am J Respir Crit Care Med. 2008;178(10):1066-1074. doi:10.1164/rccm.200805-686OC
  • Jeong YJ, Lee KS, Koh WJ, et al. Nontuberculous mycobacterial pulmonary infections: CT scan findings, with pathologic correlations. Radiographics. 2004;24(5):1237-1256. doi:10.1148/radiol.2313030833
  • Erasmus JJ, McAdams HP, Farrell MA, Patz EF Jr. Pulmonary nontuberculous mycobacterial infection: radiologic manifestations. Radiographics. 1999;19(6):1487-1505. doi:10.1148/radiographics.19.6. g99no101487
  • Koh WJ, Kwon OJ, Lee KS. Nontuberculous mycobacterial pulmonary diseases in immunocompetent patients. Korean J Radiol. 2002;3(3):145-157. doi:10.3348/kjr.2002.3.3.145
  • Koh WJ, Lee KS, Kwon OJ, Jeong YJ, Kwak SH, Kim TS. Bilateral bronchiectasis and bronchiolitis at thin-section CT: diagnostic implications in nontuberculous mycobacterial pulmonary infection. Radiology. 2005;235(1):282-288. doi:10.1148/radiol.2351040371
  • Dailloux M, Abalain ML, Laurain C, et al. Respiratory infections associated with nontuberculous mycobacteria in non-HIV patients. Eur Respir J. 2006;28(6):1211-1215. doi:10.1183/09031936.00063806
  • Chien JY, Lai CC, Sheng WH, Yu CJ, Hsueh PR. Pulmonary infection and colonization with nontuberculous mycobacteria, Taiwan, 2000-2012. Emerg Infect Dis. 2014;20(8):1382-1385. doi:10.3201/eid2008.131673
  • Hernández-Garduño E, Elwood RK. Demographic risk factors of pulmonary colonization by non-tuberculous mycobacteria. Int J Tuberc Lung Dis. 2010;14(1):106-112.
  • Szturmowicz M, Oniszh K, Wyrostkiewicz D, Radwan-Rohrenschef P, Filipczak D, Zabost A. Non-tuberculous mycobacteria in respiratory specimens of patients with obstructive lung diseases-colonization or disease? Antibiotics (Basel). 202020;9(7):424. doi:10.3390/antibiotics 9070424
  • Mencarini J, Cresci C, Simonetti MT, et al. Non-tuberculous mycobacteria: epidemiological pattern in a reference laboratory and risk factors associated with pulmonary disease. Epidemiol Infect. 2017; 145(3):515-522. doi:10.1017/S0950268816002521
  • Chen S, Zhong J, Yang Q, et al. Comparative analysis of non-tuberculous mycobacterial lung disease and lung colonization: a case-control study. BMC Infect Dis. 2024;24(1):1159. doi:10.1186/s12879-024-10067-y
  • Garcia B, Wilmskoetter J, Grady A, Mingora C, Dorman S, Flume P. Chest computed tomography features of nontuberculous mycobacterial pulmonary disease versus asymptomatic colonization: a cross-sectional cohort study. J Thorac Imaging. 2022;37(3):140-145. doi:10.1097/RTI. 0000000000000610
  • Andréjak C, Thomsen VØ, Johansen IS, et al. Nontuberculous pulmonary mycobacteriosis in Denmark: incidence and prognostic factors. Am J Respir Crit Care Med. 2010;181(5):514-521. doi:10.1164/rccm.200905-0778OC
There are 25 citations in total.

Details

Primary Language English
Subjects Chest Diseases
Journal Section Research Article
Authors

Savaş Gegin 0000-0001-7362-8710

Özlem Aydoğdu 0000-0002-2030-5202

Levent Özdemir 0000-0002-3478-5454

Burcu Özdemir 0000-0003-4678-7729

Esra Arslan Aksu 0000-0003-0448-1801

Deniz Çelik 0000-0003-4634-205X

Submission Date June 30, 2025
Acceptance Date July 18, 2025
Publication Date July 28, 2025
Published in Issue Year 2025 Volume: 7 Issue: 4

Cite

AMA Gegin S, Aydoğdu Ö, Özdemir L, Özdemir B, Arslan Aksu E, Çelik D. Evaluation of the clinical, radiological, and microbiological characteristics of the patients with non-tuberculosis mycobacteria (NTM) growth in respiratory tract samples culture. Anatolian Curr Med J / ACMJ / acmj. July 2025;7(4):496-500. doi:10.38053/acmj.1730276

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