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Diagnosis of Pulmonary Tuberculosis and Nontuberculous Mycobacterial Lung Disease in Korea

  • Kwon, Yong Soo (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Koh, Won-Jung (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2014.04.28
  • Accepted : 2014.05.15
  • Published : 2014.07.30

Abstract

The recovery of nontuberculous mycobacteria (NTM) from respiratory specimens and the number of patients with NTM lung disease have been rapidly increasing in Korea. An early differential diagnosis of NTM lung disease from pulmonary tuberculosis (TB) is important, as the therapeutic regimen differs from that of pulmonary TB, and it is not necessary to track the contacts of patients with NTM lung disease. However, differentiating NTM lung disease from pulmonary TB remains difficult, because the clinical presentations of the two diseases are similar and a definite diagnosis of NTM lung disease based on sputum culture takes time. This review focuses on the changing epidemiology, clinical and radiographic manifestation, and laboratory diagnosis of pulmonary TB and NTM lung disease in Korea.

Keywords

References

  1. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007;175:367-416. https://doi.org/10.1164/rccm.200604-571ST
  2. Daley CL, Griffith DE. Pulmonary non-tuberculous mycobacterial infections. Int J Tuberc Lung Dis 2010;14:665-71.
  3. Kendall BA, Winthrop KL. Update on the epidemiology of pulmonary nontuberculous mycobacterial infections. Semin Respir Crit Care Med 2013;34:87-94. https://doi.org/10.1055/s-0033-1333567
  4. Hoefsloot W, van Ingen J, Andrejak C, Angeby K, Bauriaud R, Bemer P, et al. The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples: an NTMNET collaborative study. Eur Respir J 2013;42:1604-13. https://doi.org/10.1183/09031936.00149212
  5. Maiga M, Siddiqui S, Diallo S, Diarra B, Traore B, Shea YR, et al. Failure to recognize nontuberculous mycobacteria leads to misdiagnosis of chronic pulmonary tuberculosis. PLoS One 2012;7:e36902. https://doi.org/10.1371/journal.pone.0036902
  6. Kang BJ, Jo KW, Park TS, Yoo JW, Lee SW, Choi CM, et al. Causes and predictive factors associated with "diagnosis changed" outcomes in patients notified as tuberculosis cases in a private tertiary hospital. Tuberc Respir Dis 2013;75:238-43. https://doi.org/10.4046/trd.2013.75.6.238
  7. Koh WJ, Yu CM, Suh GY, Chung MP, Kim H, Kwon OJ, et al. Pulmonary TB and NTM lung disease: comparison of characteristics in patients with AFB smear-positive sputum. Int J Tuberc Lung Dis 2006;10:1001-7.
  8. Kendall BA, Varley CD, Choi D, Cassidy PM, Hedberg K, Ware MA, et al. Distinguishing tuberculosis from nontuberculous mycobacteria lung disease, Oregon, USA. Emerg Infect Dis 2011;17:506-9. https://doi.org/10.3201/eid1703.101164
  9. Hong YP, Kim SJ, Lew WJ, Lee EK, Han YC. The seventh nationwide tuberculosis prevalence survey in Korea, 1995. Int J Tuberc Lung Dis 1998;2:27-36.
  10. Park YK, Park YS, Na KI, Cho EH, Shin SS, Kim HJ. Increased tuberculosis burden due to demographic transition in Korea from 2001 to 2010. Tuberc Respir Dis 2013;74:104-10. https://doi.org/10.4046/trd.2013.74.3.104
  11. Korea Centers for Disease Control and Prevention. Annual report on the notified tuberculosis in Korea. Cheonju: Korea Centers for Disease Control and Prevention; 2013.
  12. World Health Organization. Definitions and reporting framework for tuberculosis - 2013 revision [Internet]. Geneva: World Health Organization; 2013 [cited 2014 Apr 1]. Available from: http://apps.who.int/iris/bitstre am/10665/79199/1/9789241505345_eng.pdf.
  13. Jeon K, Koh WJ, Kwon OJ, Suh GY, Chung MP, Kim H, et al. Recovery rate of NTM from AFB smear-positive sputum specimens at a medical centre in South Korea. Int J Tuberc Lung Dis 2005;9:1046-51.
  14. Yoo JW, Jo KW, Kim MN, Lee SD, Kim WS, Kim DS, et al. Increasing trend of isolation of non-tuberculous mycobacteria in a tertiary university hospital in South Korea. Tuberc Respir Dis 2012;72:409-15. https://doi.org/10.4046/trd.2012.72.5.409
  15. Koh WJ, Chang B, Jeong BH, Jeon K, Kim SY, Lee NY, et al. Increasing Recovery of nontuberculous mycobacteria from respiratory specimens over a 10-year period in a tertiary referral hospital in South Korea. Tuberc Respir Dis 2013;75:199-204. https://doi.org/10.4046/trd.2013.75.5.199
  16. Koh WJ, Kwon OJ, Lee KS. Diagnosis and treatment of nontuberculous mycobacterial pulmonary diseases: a Korean perspective. J Korean Med Sci 2005;20:913-25. https://doi.org/10.3346/jkms.2005.20.6.913
  17. Park YS, Lee CH, Lee SM, Yang SC, Yoo CG, Kim YW, et al. Rapid increase of non-tuberculous mycobacterial lung diseases at a tertiary referral hospital in South Korea. Int J Tuberc Lung Dis 2010;14:1069-71.
  18. Lee SK, Lee EJ, Kim SK, Chang J, Jeong SH, Kang YA. Changing epidemiology of nontuberculous mycobacterial lung disease in South Korea. Scand J Infect Dis 2012;44:733-8. https://doi.org/10.3109/00365548.2012.681695
  19. Koh WJ, Kwon OJ, Jeon K, Kim TS, Lee KS, Park YK, et al. Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens in Korea. Chest 2006;129:341-8. https://doi.org/10.1378/chest.129.2.341
  20. Ryoo SW, Shin S, Shim MS, Park YS, Lew WJ, Park SN, et al. Spread of nontuberculous mycobacteria from 1993 to 2006 in Koreans. J Clin Lab Anal 2008;22:415-20. https://doi.org/10.1002/jcla.20278
  21. Koh WJ, Jeong BH, Jeon K, Lee NY, Lee KS, Woo SY, et al. Clinical significance of the differentiation between Mycobacterium avium and Mycobacterium intracellulare in M. avium complex lung disease. Chest 2012;142:1482-8. https://doi.org/10.1378/chest.12-0494
  22. Kim HS, Lee Y, Lee S, Kim YA, Sun YK. Recent trends in clinically significant nontuberculous mycobacteria isolates at a Korean general hospital. Ann Lab Med 2014;34:56-9. https://doi.org/10.3343/alm.2014.34.1.56
  23. Jang MA, Koh WJ, Huh HJ, Kim SY, Jeon K, Ki CS, et al. Distribution of nontuberculous mycobacteria by multigene sequence-based typing and clinical significance of isolated strains. J Clin Microbiol 2014;52:1207-12. https://doi.org/10.1128/JCM.03053-13
  24. Jeon K, Kwon OJ, Lee NY, Kim BJ, Kook YH, Lee SH, et al. Antibiotic treatment of Mycobacterium abscessus lung disease: a retrospective analysis of 65 patients. Am J Respir Crit Care Med 2009;180:896-902. https://doi.org/10.1164/rccm.200905-0704OC
  25. Kim HY, Kook Y, Yun YJ, Park CG, Lee NY, Shim TS, et al. Proportions of Mycobacterium massiliense and Mycobacterium bolletii strains among Korean Mycobacterium chelonae- Mycobacterium abscessus group isolates. J Clin Microbiol 2008;46:3384-90. https://doi.org/10.1128/JCM.00319-08
  26. Koh WJ, Jeon K, Lee NY, Kim BJ, Kook YH, Lee SH, et al. Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus. Am J Respir Crit Care Med 2011;183:405-10. https://doi.org/10.1164/rccm.201003-0395OC
  27. Lee SH, Yoo HK, Kim SH, Koh WJ, Kim CK, Park YK, et al. The drug resistance profile of Mycobacterium abscessus group strains from Korea. Ann Lab Med 2014;34:31-7. https://doi.org/10.3343/alm.2014.34.1.31
  28. Yim JJ, Park YK, Lew WJ, Bai GH, Han SK, Shim YS. Mycobacterium kansasii pulmonary diseases in Korea. J Korean Med Sci 2005;20:957-60. https://doi.org/10.3346/jkms.2005.20.6.957
  29. Park HK, Koh WJ, Shim TS, Kwon OJ. Clinical characteristics and treatment outcomes of Mycobacterium kansasii lung disease in Korea. Yonsei Med J 2010;51:552-6. https://doi.org/10.3349/ymj.2010.51.4.552
  30. Zumla A, Raviglione M, Hafner R, von Reyn CF. Tuberculosis. N Engl J Med 2013;368:745-55. https://doi.org/10.1056/NEJMra1200894
  31. Kwon YS, Chi SY, Oh IJ, Kim KS, Kim YI, Lim SC, et al. Clinical characteristics and treatment outcomes of tuberculosis in the elderly: a case control study. BMC Infect Dis 2013;13:121. https://doi.org/10.1186/1471-2334-13-121
  32. Jeong YJ, Lee KS. Pulmonary tuberculosis: up-to-date imaging and management. AJR Am J Roentgenol 2008;191:834-44. https://doi.org/10.2214/AJR.07.3896
  33. Kim RD, Greenberg DE, Ehrmantraut ME, Guide SV, Ding L, Shea Y, et al. Pulmonary nontuberculous mycobacterial disease: prospective study of a distinct preexisting syndrome. Am J Respir Crit Care Med 2008;178:1066-74. https://doi.org/10.1164/rccm.200805-686OC
  34. Kartalija M, Ovrutsky AR, Bryan CL, Pott GB, Fantuzzi G, Thomas J, et al. Patients with nontuberculous mycobacterial lung disease exhibit unique body and immune phenotypes. Am J Respir Crit Care Med 2013;187:197-205. https://doi.org/10.1164/rccm.201206-1035OC
  35. Lee AR, Lee J, Choi SM, Seong MW, Kim SA, Kim M, et al. Phenotypic, immunologic, and clinical characteristics of patients with nontuberculous mycobacterial lung disease in Korea. BMC Infect Dis 2013;13:558. https://doi.org/10.1186/1471-2334-13-558
  36. 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;235:282-8. https://doi.org/10.1148/radiol.2351040371
  37. Centers for Disease Control and Prevention (CDC). Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR Morb Mortal Wkly Rep 2009;58:7-10.
  38. Koh WJ, Ko Y, Kim CK, Park KS, Lee NY. Rapid diagnosis of tuberculosis and multidrug resistance using a MGIT 960 system. Ann Lab Med 2012;32:264-9. https://doi.org/10.3343/alm.2012.32.4.264
  39. Chihota VN, Grant AD, Fielding K, Ndibongo B, van Zyl A, Muirhead D, et al. Liquid vs. solid culture for tuberculosis: performance and cost in a resource-constrained setting. Int J Tuberc Lung Dis 2010;14:1024-31.
  40. Park MY, Kim YJ, Hwang SH, Kim HH, Lee EY, Jeong SH, et al. Evaluation of an immunochromatographic assay kit for rapid identification of Mycobacterium tuberculosis complex in clinical isolates. J Clin Microbiol 2009;47:481-4. https://doi.org/10.1128/JCM.01253-08
  41. Park KS, Kim JY, Lee JW, Hwang YY, Jeon K, Koh WJ, et al. Comparison of the Xpert MTB/RIF and Cobas TaqMan MTB assays for detection of Mycobacterium tuberculosis in respiratory specimens. J Clin Microbiol 2013;51:3225-7. https://doi.org/10.1128/JCM.01335-13
  42. van Ingen J. Diagnosis of nontuberculous mycobacterial infections. Semin Respir Crit Care Med 2013;34:103-9. https://doi.org/10.1055/s-0033-1333569
  43. Chihota VN, van Halsema CL, Grant AD, Fielding KL, van Helden PD, Churchyard GJ, et al. Spectrum of non-tuberculous mycobacteria identified using standard biochemical testing vs. 16S sequencing. Int J Tuberc Lung Dis 2013;17:267-9. https://doi.org/10.5588/ijtld.12.0425
  44. Lee H, Bang HE, Bai GH, Cho SN. Novel polymorphic region of the rpoB gene containing Mycobacterium species-specific sequences and its use in identification of mycobacteria. J Clin Microbiol 2003;41:2213-8. https://doi.org/10.1128/JCM.41.5.2213-2218.2003
  45. Kim S, Park EM, Kwon OJ, Lee JH, Ki CS, Lee NY, et al. Direct application of the PCR restriction analysis method for identifying NTM species in AFB smear-positive respiratory specimens. Int J Tuberc Lung Dis 2008;12:1344-6.
  46. Choi GE, Chang CL, Whang J, Kim HJ, Kwon OJ, Koh WJ, et al. Efficient differentiation of Mycobacterium abscessus complex isolates to the species level by a novel PCR-based variable- number tandem-repeat assay. J Clin Microbiol 2011;49: 1107-9. https://doi.org/10.1128/JCM.02318-10
  47. Shin SJ, Choi GE, Cho SN, Woo SY, Jeong BH, Jeon K, et al. Mycobacterial genotypes are associated with clinical manifestation and progression of lung disease caused by Mycobacterium abscessus and Mycobacterium massiliense. Clin Infect Dis 2013;57:32-9. https://doi.org/10.1093/cid/cit172
  48. Jeong BH, Song JU, Kim W, Han SG, Ko Y, Song J, et al. Nontuberculous mycobacterial lung disease caused by Mycobacterium lentiflavum in a patient with bronchiectasis. Tuberc Respir Dis 2013;74:187-90. https://doi.org/10.4046/trd.2013.74.4.187
  49. Jeong BH, Kim SY, Jeon K, Huh HJ, Ki CS, Lee NY, et al. The first Korean case of nontuberculous mycobacterial lung disease caused by Mycobacterium abscessus subspecies bolletii in a patient with bronchiectasis. Tuberc Respir Dis 2014;76: 30-3. https://doi.org/10.4046/trd.2014.76.1.30
  50. Kim SY, Shin SJ, Lee NY, Koh WJ. First case of pulmonary disease caused by a Mycobacterium avium complex strain of presumed veterinary origin in an adult human patient. J Clin Microbiol 2013;51:1993-5. https://doi.org/10.1128/JCM.00462-13
  51. Kim SY, Yoo H, Jeong BH, Jeon K, Ha YE, Huh HJ, et al. First case of nontuberculous mycobacterial lung disease caused by Mycobacterium marseillense in a patient with systemic lupus erythematosus. Diagn Microbiol Infect Dis 2014;79:355-7. https://doi.org/10.1016/j.diagmicrobio.2014.03.019

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