Surgical Aspects of Diagnosis and Treatment of Pulmonary Mycobacteriosis

The objective: to study results of using surgical methods for diagnosis and treatment of pulmonary mycobacteriosis. Subjects and Methods. The study was conducted in Thoracic Surgery Department of National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health, from 2022 to 2024. The data of 29 patients with pulmonary mycobacteriosis were analyzed. All those patient underwent surgical treatment, 22 patients had it for therapeutic and diagnostic purposes, and 7 for therapeutic purposes only. Non-tuberculous mycobacteria (NTMB) from specimens were detected by fluorescence microscopy, molecular genetic methods, and culture on liquid nutrient media. When isolating NTMB culture, mass spectrometry was used for species identification. Results. In 22 patients with suspected pulmonary mycobacteriosis without bacteriological confirmation before surgery, 16 segmentectomies, 4 lobectomies, and 2 combined resections were performed. By culture of surgical specimens on liquid nutrient media, growth of NTMB was obtained in 9/22 (40.9%) patients. The species spectrum of NTMB included M. chimaera intracellulare group, M. xenopi, and M. kansasii (3 cases each, 33.3%). Using the molecular genetic method, NTMBs were obtained in 20/22 (91%) patients.