Distribution of Mycobacterium Avium Complex in Bulgaria

Abstract

The members of Mycobacterium avium complex (MAC) are opportunistic microorganisms, common in the environment (soil and water) and cause infections in birds, mammals and humans. The objective of the present study was to determine the prevalence of MAC representatives among suspected for tuberculosis patients in Bulgaria over an eight-year period – from 2010 to 2017. The exact epidemiology of pulmonary non-tuberculous mycobacterial (NTM) disease was difficult to determine because unlike cases of infection with M. tuberculosis complex, notification of NTM and MAC in particular, is not mandatory in terms of Ordinance 21 of the Ministry of Health (1) and there is no any accurate information about their prevalence in Bulgaria. The survey was conducted in the National Reference Laboratory of Tuberculosis at the National Centre of Infectious and Parasitic Diseases. MAC was identified using phenotypic methods, biochemical features and molecular genetic assay (LPA).
 A total of 596 NTM strains were identified during the study period and 16.8% (n=100) of them were MAC. In EU countries, MAC representatives areprevalent among NTM isolates, but in Bulgaria they are significantly less in number.