广州市非结核分枝杆菌病流行病学特征分析  

Epidemiological characteristics of non-tuberculous mycobacterial disease in Guangzhou

作　　者：梁锋 刘德情 陈华 陈品儒[1] 谭耀驹[2] 胡锦兴[1] 张丹妮 许柳清[1] Liang Feng;Liu Deqing;Chen Hua;Chen Pinru;Tan Yaoju;Hu Jinxing;Zhang Danni;Xu Liuqing(Department of Tuberculosis/Non-Tuberculosis Mycobacterial Disease Diagnosis and Treatment Center,Guangzhou Chest Hospital,Guangzhou 510095,China;Department of Laboratory Medicine,Guangzhou Chest Hospital,Guangzhou 510095,China;Department of Tuberculosis Control and Management,Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院结核科/非结核分枝杆菌病诊疗中心,广州510095 [2]广州市胸科医院检验科,广州510095 [3]广州市胸科医院结核病控制管理科,广州510095

出　　处：《中国防痨杂志》2024年第11期1373-1379,共7页Chinese Journal of Antituberculosis

基　　金：广州市科技计划项目(2023A03J0991)。

摘　　要：目的:分析广州市非结核分枝杆菌(non-tuberculous mycobacteria,NTM)病的一般情况及流行病学特点,为制定和实施有效的预防和管理NTM病提供参考信息。方法:回顾性分析2018年1月1日至2023年12月31日广州市新发NTM病患者2714例,并对各年度NTM病的检出率趋势,以及性别、年龄、菌种/群分布特点进行分析。使用9个连续的年龄段分析了年龄对NTM病的影响,并重点对比青年组(21~40岁)和中老年组(51~70岁)的检出差异;根据感染部位的不同,分成肺内组、肺外组、播散组三组进行分析。结果:广州市6年新发NTM病的检出率呈波动趋势,由2018年的男性构成比41.10%(194例)下降至2023年的38.10%(205例),2018年的女性构成比由58.90%(278例)上升至2023年61.90%(333例),男性所占比例逐年降低,女性所占比例逐年升高。好发年龄段为51~70岁,占总病例的51.62%(1401/2714),青年组(21~40岁)构成比呈下降趋势,由2018年的23.09%(109/472)下降至2023年的16.36%(88/538);中老年组(51~70岁)构成比呈上升趋势,由2018年的48.31%(228/472)上升至2023年的55.76%(300/538)。6年广州市新发NTM病患者2714例,其中肺内组(97.09%,2635/2714)NTM分离菌种前4位分别是:鸟-胞内分枝杆菌复合群(M.avium complex,MAC)(43.42%,1144/2635)、龟-脓肿分枝杆菌复合群(Turtle-M.abscessus complex,MABC)(36.39%,959/2635)、堪萨斯分枝杆菌(8.50%,224/2635)、偶发分枝杆菌(4.10%,108/2635);肺外组(1.69%,46/2714)NTM分离菌种前4位分别是:MABC(34.78%,16/46)、偶发分枝杆菌(21.74%,10/46)、MAC(19.57%,9/46)、海分枝杆菌(15.22%,7/46);播散组(1.22%,33/2714)NTM分离菌种前4位分别是:MAC(42.42%,14/33)、MABC(27.27%,9/33)、堪萨斯分枝杆菌(15.15%,5/33)、偶发分枝杆菌(6.06%,2/33);MAC肺病构成比略上升,由2018年的39.19%(185/472)升至2022年的48.48%(176/363)和2023年的44.61%(240/538);MABC肺病构成比呈下降趋势,由2018年的38.98%(184/472)下降至2023年的30.30%(163/538)。结论:广州市�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),an

关 键 词：分枝杆菌感染 分枝杆菌 非典型性 流行病学 广州市 

分 类 号：R372[医药卫生—病原生物学] R563[医药卫生—基础医学]