Caracterización clínica y microbiológica de pacientes no VIH con micobacteriosis atípica pulmonar: experiencia de un centro público

Abstract

Introduction: Atypical mycobacteria encompass over a hundred species that have gained promi­nence for their pulmonary and systemic involvement in patients with chronic pulmonary diseases. Their incidence has risen in recent years. They are distributed worldwide, are ubiquitous in the environment, and can be isolated from water, soil, animals, and even medical equipment. Our aim is to clinically and microbiologically characterize patients with pulmonary involvement by atypical mycobacteria. Method: A retrospective, observational, and descriptive study was conducted, analyzing clinical records of pa­tients without HIV infection, with pulmonary involvement by atypical mycobacteria, microbiologically confirmed at the Instituto Nacional del Tórax (Chile), between 2018 and 2022. Clinical and microbiolo­gical data were collected. Results: Thirty-four cases were analyzed. The average age was 68 years-old, and 70.6% were women. The most common comorbidities were smoking (47.1%) and bronchiectasis (38.2%). The predominant symptoms were cough (70.6%), dyspnea (29.4%), and weight loss (17.6%). The most frequent samples for isolation were sputum (47.1%) and bronchoalveolar lavage (26.5%). The most frequently identified mycobacteria were Mycobacterium intracellulare (38.2%), Mycobacterium avium (29.4%), and co-isolation of both (11.8%). In 21 cases, observation was chosen, with over 90% of cases showing a favorable outcome.Conclusions: The analyzed cases of atypical mycobacteriosis presented with nonspecific respiratory and systemic clinical features. The most frequent species were M. avium and M. intracellulare. Observation was decided in the majority of cases, not being associated with unfavorable outcomes.