M. szulgai,M. simiae,M. peregrinum,

M. szulgai,M. simiae,M. peregrinum,M. scrofulaceum andM. terrae; and 16S ribosomal RNA
sequencing forM. shimoidei [13,14]. Patients with at least two separate culture-positive sputum
samples or one culture-positive bronchial washing or lung tissue sample during the study period
were included. Patients with a single positive sputum culture or PCR positive-culture negative
samples were excluded.
Diagnosis of NTM-LD
Diagnosis was performed by specialists in infectious disease and/or respiratory medicine according to 2007 American Thoracic Society (ATS)/Infectious Diseases Society of America
(IDSA) criteria [1]. In accordance with the criteria, patients with suspected infection with contaminated environmental Mycobacterium species were excluded from study participation. Patients who had been diagnosed with NTM-LD prior to the current study were also excluded.
Epidemiological Study
Among all the patients who had presented at the 11 hospitals during the study period, 975 had
been diagnosed with NTM-LD according to the 2007 ATS/IDSA criteria. After dividing the
prefecture into five regions on the basis of administrative boundaries and medical care zones,
the patients were classified into one region based on the residence listed in their medical records.
To estimate the annual incidence of NTM-LD in each region, data regarding the annual
population of each region were collected from the Nagasaki prefectural government, and data
regarding the incidence of all forms of tuberculosis collected from the healthcare center of each region. In the analysis of the radiological features, 228 patients were excluded due to lack of accurate information about chest computed tomography (CT) scan (Fig 1). Based on the review of the results of chest CT scan, the remaining 747 patients were classified into four patterns according to their radiological characteristics: the nodular-bronchiectatic (NB), cavitary (CAV), hypersensitivity pneumonitis-like, or unclassifiable pattern. The NB pattern and CAV pattern were defined by chest CT scan showing multifocal bronchiectasis with multiple small nodules or cavitary opacities, respectively. If a patient had the characteristics of both the NB and CAV patterns, the patient was classified in accordance with the dominant pattern. Using these data, geographic variations in NTM-LD incidence, isolates, and radiological features were assessed.
Patient Characteristics and Prognostic Factors
Of the 975 patients, 374 were excluded from analysis due to lack of sufficient clinical information in their medical records (Fig 1). The clinical course of the disease was assessed after 1 year of diagnosis. Patient outcome was evaluated by review of (1) clinical, (2) radiological and (3) microbiological responses. Clinical response was defined as resolution of symptoms such as fever, weight loss, cough, sputum, hemoptysis and general fatigue. Radiological response was defined as the clearing or improvement of opacity on chest radiographs/CT. Microbiological response was determined by culturing of sputum. Patients who had shown improvement or no change in the 3 factors and had experienced no deterioration were defined as having achieved “stability”. Patients who had not met the criteria for “stability” definition and had subsequently died from all causes were classified as having experienced “deterioration”.
Statistical Analysis
The data are presented as mean ± SD values. Statistical significance was evaluated using the
chi-square test or the two-tailed Mann-Whitney test, with the level of significance set at

Hasil (Bahasa Indonesia) 1:

M. szulgai, M. simiae, M. peregrinum, M. scrofulaceum andM. Terrae; dan 16S ribosomal RNABentuk Sekuensing. shimoidei [13,14]. Pasien dengan setidaknya dua terpisah budaya-positif dahaksampel atau satu budaya-positif bronkial cuci atau paru-paru jaringan sampel selama masa studidimasukkan. Pasien dengan budaya satu dahak positif atau negatif PCR positif-budayasampel dikeluarkan.Diagnosis NTM-LDDiagnosis ini dilakukan oleh spesialis penyakit menular dan/atau pengobatan respirasi sesuai dengan 2007 American Thoracic Society (ATS) / menular penyakit Society of AmericaKriteria (IDSA) [1]. Sesuai dengan kriteria, pasien dengan infeksi diduga terkontaminasi lingkungan Mycobacterium spesies dikeluarkan dari studi partisipasi. Pasien yang telah didiagnosa dengan NTM-LD sebelum penelitian ini juga dikeluarkan.Studi epidemiologiDi antara semua pasien yang telah disajikan di rumah-sakit 11 selama masa studi, 975 memilikitelah didiagnosa dengan NTM-LD menurut kriteria ATS IDSA 2007. Setelah membagiPrefektur menjadi lima daerah berdasarkan batas-batas administratif dan zona perawatan medis,pasien diklasifikasikan ke dalam satu wilayah berdasarkan tempat tinggal yang tercantum dalam catatan medis mereka.Untuk memperkirakan kejadian tahunan NTM-LD di setiap daerah, data mengenai tahunanPopulasi daerah masing-masing dikumpulkan dari pemerintah Prefektur Nagasaki, dan datamengenai insiden semua bentuk tuberkulosis dikumpulkan dari Pusat Kesehatan masing-masing daerah. Dalam analisis fitur radiologis, 228 pasien dilibatkan karena kurangnya informasi yang akurat tentang dada computed tomography (CT) scan (Fig 1). Berdasarkan Tinjauan terhadap hasil dada CT scan, pasien 747 sisa diklasifikasikan menjadi empat pola sesuai dengan karakteristiknya radiologis: nodular-bronchiectatic (NB), cavitary (CAV), hipersensitivitas seperti pneumonitis, atau pola unclassifiable. NB pola dan pola CAV yang didefinisikan oleh dada CT scan menampilkan multifokal bronchiectasis dengan beberapa nodul kecil atau cavitary opacities, masing-masing. Jika pasien memiliki karakteristik NB maupun CAV pola, pasien diklasifikasikan sesuai dengan pola dominan. Menggunakan data ini, variasi geografis dalam insiden NTM-LD, isolat dan fitur radiologis dinilai. Karakteristik pasien dan faktor-faktor prognostikOf the 975 patients, 374 were excluded from analysis due to lack of sufficient clinical information in their medical records (Fig 1). The clinical course of the disease was assessed after 1 year of diagnosis. Patient outcome was evaluated by review of (1) clinical, (2) radiological and (3) microbiological responses. Clinical response was defined as resolution of symptoms such as fever, weight loss, cough, sputum, hemoptysis and general fatigue. Radiological response was defined as the clearing or improvement of opacity on chest radiographs/CT. Microbiological response was determined by culturing of sputum. Patients who had shown improvement or no change in the 3 factors and had experienced no deterioration were defined as having achieved “stability”. Patients who had not met the criteria for “stability” definition and had subsequently died from all causes were classified as having experienced “deterioration”.Statistical AnalysisThe data are presented as mean ± SD values. Statistical significance was evaluated using thechi-square test or the two-tailed Mann-Whitney test, with the level of significance set at