Respiratory Treatment and Prevention (Advances in Experimental Medicine and Biology)

NTM pulmonary disease. Clinical implications
of those reductions remain unknown, but they
may have to do with a poor outcome of antibiotic
therapy. Treatment outcomes differ depending
on the bacterial species. The best therapeutic
results have been observed inM. kansasiiand
M. malmoenseinfections. Worse results concern
Mycobacterium aviumcomplex, and very poor
outcomes have been reported in patient with pul-
monary NTM disease caused by M. xenopi,
M. simiae, and, particularly. M. abscessus
subsp.abscessus(van Ingen et al.2012c).

6 Actual Situation in Slovakia

The number of isolated non-tuberculous
mycobacteria strains has significantly increased
as registered by the National Reference Labora-

tory for Mycobacteria during last years (Table2).

The most frequently isolated strains include

M. gordonae,whose cultures grow slowly and

are smooth and yellow pigmented. As they are

frequent isolates in the tap water,M. gordonaeis

often referred to as a tap water bacillus (Lalande

et al. 2001 ) and should rather be interpreted as a

contamination.

In 2014, rapidly growing mycobacteria have

been found in clinical samples from 23 patients;

there were eight cases ofM. fortuitum, six of

M. chelonae, another six ofM. mucogenicum,

and three ofM. abscessus(Table2).Based on

clinical status of patients and their lung X-ray

findings, only six cases were diagnosed as

mycobacteriosis (Table 3). The most serious

clinical issue of 2014 was represented by three

cases of pulmonary mycobacteriosis caused by

M. abscessus. One of the patients died, the other

Table 2 Non-tuberculous mycobacteria strains isolated in Slovakia registered by the National Reference Laboratory in
consecutive years

Mycobacterial species 2010 2011 2012 2013 2014 2015 a
M. gordonae 25 25 28 34 54 48
M. xenopi 6841333
M. avium 44581211
M. intracellulare 010224
M. scrofulaceum 000011
M. chelonae 435467
M. abscesus 031132
M. fortuitum 226788
M. mucogenicum 001663
M. kansasii 302021
M. lentiflavum 101013
aSituation by the end of November 2015

Table 3 Diagnosed lung mycobacterioses in Slovakia in consecutive years

Mycobacterial species 2010 2011 2012 2013 2014 2015 a
M. avium 336786
M. intracellulare 000223
M. xenopi 334222
M. abscesus 021232
M. chelonae 111100
M. srofulaceum 000011
M. kansasii 101121
All 8 9 13151814
aSituation by the end of November 2015

Non-Tuberculous Mycobacteria: Classification, Diagnostics, and Therapy 23