Микробиологические и эпидемиологические особенности микобактериозов Резюме Актуальность. Группа нетуберкулезных микобактерий включает более 200 видов, из которых порядка 50 являются возбудителями микобактериальных инфекций, или микобактериозов, которые клинически и рентгенологически схожи с туберкулезом. Микобактериозы представляют собой мультидисциплинарную, недостаточно изученную проблему. Цель-обобщить современные представления о данных заболеваниях. Заключение. В обзоре представлена информация по основным аспектам рассмотренной проблемы: определены особенности экологии и диагностики нетуберкулезных микобактерий, описана эпидемиология данных заболеваний, установлена возможность вариативности клинических проявлений микобактериозов, в т. ч. среди иммунокомпрометированных лиц и на примере инфекций, связанных с оказанием медицинской помощи. Особое внимание уделено возрастающей необходимости разработки нормативно-правовых документов, касающихся профилактики, диагностики и лечения инфекций, вызываемых нетуберкулезными микобактериями.

Introduction: Healthcare-associated infections are of great socio-economic importance and are characterized by a large number of different pathogens. Nontuberculous mycobacteria are ubiquitous microorganisms that can circulate in a medical organization. The purpose of this review of epidemiologic studies was to establish the main features of mycobacteriosis as a healthcare-associated infection, taking into account the significance of the results and the compliance of the reviewed studies with the criteria of evidence-based medicine. Methods: We did a key word search for “nontuberculous mycobacteria”, “healthcare-associated infections”, and “mycobacteriosis” in several electronic bibliographic databases including Web of Science, PubMed, eLIBRARY, and ResearchGate and selected 127 out of 342 search results. Having analyzed the selected articles, we decided to include 34 of them in this study according to the topic of work. We established that nontuberculous mycobacteria can be found in various objects of health facilities, e.g. water supply systems, medical products and equipment. We also found that mycobacterial infection of nosocomial etiology could have various clinical manifestations (arthritis, keratitis, circulatory and skin diseases, etc.) determined by various aspects, such as heterogeneity of the group of nontuberculous mycobacteria, portals of entry (surgical procedures on various organs and systems of the human body, etc.), pathways of exposure and transmission factors. Resistance of nontuberculous mycobacteria to a number of disinfectants is a special question defining the importance of profound research in terms of ensuring sanitary and anti-epidemic (disinfection) safety within health facilities. Conclusions: Our findings indicate that mycobacterial infection can be considered as a healthcare-associated infection requiring an in-depth assessment from various perspectives including a microbiological monitoring of medical objects, statistical accounting of nosocomial infections, and clinical alertness in the diagnosis of mycobacteriosis by attending physicians and bacteriologists, etc.

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The review presents data on proven clinical manifestations of the disease caused by non-tuberculosis mycobacteria. It was determined that pulmonary mycobacteriosis is one of the most common clinical forms of this mycobacterial infection, which is characterized by intoxication and respiratory syndromes. Dust in the air of the working area, as a professional factor, contributes to the emergence of pneumoconiosis and silicosis associated with mycobacteria. It is proved that M. avium has the ability to damage the intestinal mucosa, causing bacteremia and secondary damage to the bone marrow and spleen. The researchers point to the fact that non-tuberculosis mycobacteria can cause lymphadenopathy with lesions of the intraabdominal and cervical lymph nodes. Also, there is the possibility of mycobacteriosis of the skin. It is proved that mycobacterial infection contributes to the development of calcification of mitral, aortic valves and coronary arteries. It was determined that in the etiology of acute pancreatitis mycobacteriosis also plays definite role. Keywords: Mycobacteriosis, non-tuberculosis mycobacteria, clinical presentations, epidemiology.