The nontuberculous mycobacteria are present in environment and has been isolated
from natural waters, soil, animals and water distribution systems. It’s characterized by the
presence of mycolic acid in the cell wall. In general, the disease is acquired through inhalation
of droplets containing mycobacteria. This disease can manifest itself in many ways as
lymphadenitis, pulmonary, cutaneous and disseminated. They are opportunistic pathogens of
variable pathogenicity. Immunity defects, local or systemic, are required to cause disease in
humans. We evaluated epidemiological, clinical and radiological features of 44 cases with
pulmonary nontuberculous mycobacteriosis at Hospital Universitário João de Barros Barreto.
In addition, we treated and followed 21/44 (47,7%) patients during a period of six to
seventeen months in a prospective cohort study. There was an increase more than 100% in the
number of cases in 2010 when compared to previous years. The most frequently isolated
mycobacterias were M. intracellulare (22.7%) and M. massiliense (20.5%). The conditions
associated included previous treatment for tuberculosis (93.2%), bronchiectasis (59%), HIV
(11.4%), asthma (9.1%) and chronic obstructive pulmonary disease (9.1%). In general, there
were no differences between NTM groups in radiological aspects, but when we analyzed
chest radiographs, we found atelectasis more frequently in M. massiliense group vs. M.
abscessus group. When we considered mycobacterial cultures, there was a good treatment
outcome. Negative, persistent positive and positive after an initial negative culture occurred in
58,8%, 11,7% and 11,7% of patients, respectively. During the follow-up period, the death rate
was 17,7%. Our data suggest that of pulmonary nontuberculous mycobacteriosis has become
a disease with increasing importance in our region. Additionally, the response to treatment
performed in major hospital has been quite satisfactory when compared to literature. However,
it is necessary to follow these patients for a longer period to determine the actual success rate
of our therapeutic approach.
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