LAUSR

Introduction: The incidence of non-tuberculous mycobacteria disease (NTMD) is estimated as 1 to 1.8/100,000 inhabitants. There are clinical, imaging and microbiological criteria that determine the need for treatment. The aim of this paper is to characterize the NTMD reported in Lisbon in a 3-year period. Methods: Retrospective study on NTMD notified by CDP Dr. Ribeiro Sanches (Lisbon) from 2012 to 2014, to characterize the population, diagnostic criteria and therapeutic results. Results: 37 cases of NTMD were reported, corresponding to 0.7/100,000 cases/y. Most were female (62%) with mean age of 56.7y. The most common risk factors were bronchiectasis (17), smoking history(17), HIV infection(10), history of neoplasm(7) and being immigrant(6). Registered mycobacteria were mycobacterium avium complex (14avium, 3intracellular), m. abcessus(4), m. chelonae(3), m. kansasii(2), m. gordonae(2), m. lentiflavum(2), 2co-infections(m. avium with m. xenopi/m. kansasii), m. fortuitum(1), m. xenopi(1) and m. szulgai(1). Isolation was obtained from sputum(16), bronchial lavage(16), blood cultures(2), pleural fluid(1) and skin biopsy(1). The vast majority (89%) had only pulmonary manifestations. Therapy had a median duration of 9.1 months. All schemes included a macrolide and mainly ethambutol (33) and rifampin/rifabutin(28). Recurrence was identified in 1 patient. Conclusions: The diagnosis and treatment of NTM disease remains a clinical challenge. We admit an underdiagnosis of NTM in Lisbon. Most of the patients were treated according to guidelines although the average length of treatment was shorter than recommended. One of the possible reasons is the difficulty to sensitize patients to therapeutic adherence after symptomatic improvement.