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Mycobacterioses are caused by nontuberculous mycobacteria which are common in natural environment. They were isolated from water and soil. Patients with suppressed immune system are most likely to be affected. Mycobacteria are transferred to human through damaged skin, the respiratory system, and digestive system. The most common clinical manifestation has been observed in the lungs. Diagnosis of disease is still current clinical problem and the effectiveness of therapy is not satisfy.

Nontuberculous mycobacteria (NTM) are a group of bacteria that may cause human disease mycobacteriosis, but do not cause tuberculosis or leprosy. NTM are acquired through environmental exposure to water, aerosols, soil, dust and are transferred to humans through inhalation, ingestion, and skin lesions, due to injuries, surgical procedures, or intravenous catheters. People with suppressed immune response, with pre-existing lung damage in the course of various lung diseases are most likely to be affected. There is no evidence of person-to-person spread of these diseases. A variety of manifestations of NTM infection have been described, but the lungs remain the most commonly involved site. Molecular methods allow the quicker differentiation of NTM from TB isolates and help to identify new NTM species. The purpose of this article is to review the common clinical manifestations of NTM lung disease, the conditions associated with NTM lung disease, diagnostic criteria and treatment of the most frequent species of NTM.

The aim of the study was to compare humoral immune response against various mycobacterial antigens in TB and MOTT vs healthy control group. 350 serum samples from TB patients, 20 samples from MOTT patients and 58 samples from healthy donors were examined. ELISA detecting IgG, IgA and IgM against antigens: 38 kDa and 16 kDa, 38kDa and lipoarabinomannan, and A-60 were used. Mean IgG level was higher in TB compared to healthy controls (p<0,001). Mean IgG level against 38kDa and 38 + 16 kDa mycobacterial antigens was higher in TB than in MOTT group. Mean level of the IgG, IgA and IgM antibodies against LAM was higher in MOTT compared to TB patients. In all subgroups person-to-person heterogeneity of antigen recognition was observed. Humoral immune response to recombinant mycobacterial antigens significantly differs in TB and MOTT patients.

Over the last decades the incidence of infections with non-tuberculous mycobacteria (NTM) has increased. It has been noted in various regions of the world and it seems to concern also our country. The aim of this review is to call attention to clinical presentation and diagnostic criteria of mycobacterioses. The environmental sources of NTM, predispositions to dissemination of NTM infection and current epidemiological data on mycobacterioses are discussed. Since the accuracy of mycobacterial strain identification is most important for microbiological diagnosis of disease, it is suggested to perform it according to modern requirements, exclusively in selected, well-equipped laboratories.

Diagnosis of tuberculosis is based on clinico-radiological symptoms and on identification of mycobacteria. Accuracy of both methods is limited. Therefore reliable serologic test would have considerable advantage. The goal of our study was to evaluate serologic response against A60 mycobacterial antigen in group of 270 patients (pts) (137 pts with active tuberculosis (TB), 15 pts with mycobacterial infections other than TB (MOTT), 58 pts with sarcoidosis, 26 pts with lung cancer and 34 healthy controls. We used commercially available ELISA based kits against antigen A60 (ANDA-TB). Specificity of 87% for IgG, of 94% for IgA and for IgM, of 85% for IgG + IgA, of 89% for IgA + IgM, of 80% for IgG + IgM, and of 79% for IgG + IgA + IgM was achieved. Sensitivity of 40% for IgG, of 30% for IgA, of 18% for IgM, of 56% for IgG + IgA, of 35% for IgM + IgA, of 50% for IgG + IgM, and of 59% for IgG + IgA + IgM was obtained. The results demonstrated that humoral response differs depends on the immunoglobulin class. Measurements of IgG or IgG and IgA as most sensitive against A60 are potentially more useful serological tests in clinical practice. It is not recommended to use tests based on antigen A60 for differentiation tuberculosis and MOTT.

Measurement of antimycobacterial antibody may be used as potential diagnostic tool in tuberculosis. The aim of the study was to evaluate the diagnostic value of serum IgG level against A60 mycobacterial antigen measured by ELISA method. Material consisted of 144 persons divided into 5 groups (76 tuberculosis patients, 20 sarcoidosis patients, 17 lung cancer patients, 8 patients with mycobacterial infections other than tuberculosis and 23 healthy controls). In the tuberculosis group there were 50 culture positive cases and 26 culture negative ones, 43 new cases and 32 chronic cases. Positive results were obtained in 51% of tuberculosis patients. Sensitivity increased to 62% in culture positive group and 63% in chronic cases. Specificity of the test was 96%. The results indicate that Immunozyme Mycobacterium test is a valuable tool in tuberculosis diagnosis.

The diagnosis of pulmonary mycobacteriosis was verified in 267 patients in Poland, classified in the years 1991-1995 to group VI M. Among 267 patients, 213 were men in age 28-83 years (median 43 years) and 54 women in age 24-81 years (median 50 years). The verification of the diagnosis was based on the authors own criteria of pulmonary mycobacteriosis and colonisation. These criteria included at least two positive sputum cultures and presence or absence of the respiratory tract inflammation. Pulmonary mycobacteriosis was recognised in 199 patients (168 men and 31 women). Colonisation was diagnosed in 41 patients (23 men and 18 women). Non-tuberculous mycobacteria most often responsible for pulmonary mycobacteriosis were identified as M. kansasii, M. avium--intracellulare and M. xenopi. Majority of patients with pulmonary mycobacteriosis or with colonisation had pulmonary lesions caused by tuberculosis in the past or suffered from chronic obstructive pulmonary disease. In 63 cases, data concerning previous diseases of the respiratory tract were not available.