| Objectives:To describe and analyze the antibiotic resistance and clinical significance of nontuberculous mycobacteria(NTM) and provide reference to the diagnosis, prophylaxis and therapy of NTM disease.Methods:NTM identification was performed by commercially available molecular assays, among the specimen isolated and cultured from patients in The First Affiliated Hospital of Zhejiang University School of Medicine between June2012and December2013. All the NTM strains were tested against10antibiotics through broth dilution method to measure the minimal inhibitory concentration. Cilinical data and treatment outcomes were collected for analysis.Results:(1) During the study period,89positive samples for NTM were isolated and40of them were considered as causing NTM diseases, including33of which were identified as slowly growing NTM(SGM) and7as rapid growing NTM(RGM).67.5%were Mycobacterium avium and Mycobacterium intracellulare(MAC) complex.(2) among the40NTM disease cases, more males were infected (1.83:1);35.0%(14/40) were with age over65.57.5%(23/40) were immunocompromised or had pulmonary structure related diseases like COPD;60%(24/40) had received>6months of irregular antibiotic therapy;34(85%) had been misdiagnosed, including25as Tuberculosis, with median error diagnosis period of9.5months.(3) According to the susceptibility test, azithromycin(100%,100%), clarithromycin(87.9%,85.7%), levofloxacin(87.9%,100%), rifabutin(90.9%,100%) and amikacin(90.9%,100%) were active drugs for both SGM and RGM. Moxiflocacin was also active against SGM with97%susceptibility.18isolated NTM strains were resisted against more than2drugs simultaneously.Conclusions:With a high probability to be diagnosed falsely, the contribution of the molecular biotechnology is important in order to provide proper identification. As regular anti-tuberculosis drugs are not active against NTM, further study for antibiotic therapy including macrolides will be of significant value. |
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