A clinical-epidemiological characteristic of mycobacteriosis in two subjects of the russian federation

Objective. To study the clinical and epidemiological situation of mycobacteriosis on the territory of two regions of the Russian Federation – the Republic of Mari El (RME) and the Vladimir region (VR). Materials and methods. We analysed the results of identification of 226 NTM cultures and medical records of 105 patients, who provided material, from which nontuberculosis mycobacteria (NTM) were isolated. Results. Mycobacteriosis was diagnosed in 51 patients (48.6%). The incidence rate of mycobactriosis by the end of 2016 was 1.75/100 000 population in RME, 0.28/100 000 in VR, the prevalence was 4.3 and 1.5/100 000 respectively. 76% of cases were associated with Mycobacterium avium-complex. The average age of patients was 56.1 ± 16.6 years. In the clinical structure of disease, lung disease prevailed – 88.2% (n = 42); whereas generalised mycobacteriosis (9.8%; n = 5) occurred exclusively among HIV-infected patients. The most common symptoms were cough (64.3%), dyspnoea (40.5%), signs of intoxication (fever – 23.8%, sweating – 14.3%), weight loss (23.8%). In the structure of lung diseases, fibrocavitary forms were noted in 52.4% of patients, nodular bronchiectatic forms in 47.6%. Conclusion. The prevalence of mycobacteriosis across the studied territories is low (1.75-4.3/100 000). The frequency of development of pulmonary forms is the highest in the age group of 55-65-year-olds, practically with an equal proportion occurring among men and women. The difficulty of an early diagnosis of mycobacteriosis is conditioned by the absence of specific symptoms of disease, similarity of its clinical and x-ray signs with tuberculosis. Immunological diagnosis (Mantoux test with 2ТЕ, recombinant tuberculosis allergen test) does not allow a reliable differentiation between mycobacterial infections due to the likeness of the antigen structure of MBT and certain NTM species. Considering the predicted increase of life expectancy in RF, population ageing, increase of the proportion of immunocompromised individuals along with the increasing incidence of COPD, we should expect the growth of mycobacterial infection diseases. Therefore, the character of disease, its prevalence need further study. Thus the increasing burden of mycobacteriosis creates new tasks for the public healthcare system, requiring solution of organisational and financial issues. © 2020, Dynasty Publishing House. All rights reserved.