Introduction: The aim of this study is to compare characteristics of non-cystic fibrosis bronchiectasis (NCFBE) patients with chronic infections with non-tuberculous mycobacteria (NTM) versus those with Pseudomonas aeruginosa or other colonizations. Methods: This was an observational, perspective study of consecutive NCFBE adult patients attending the outpatient bronchiectasis clinic at the San Gerardo Hospital in Monza, Italy, during 2012 and 2013. Patients with a chronic infection were included in the study and divided into three groups: those with NTM (Group A); those with P. aeruginosa (Group B); and those with other pathogens (Group C). Patients with both NTM and another pathogen were included in Group A. Comparison among the three study groups was performed using X2 or Fisher exact test for categorical variables or Kruskal-Wallis or Mann-Whitney test for continuous variables. Results: A total of 146 patients (median age 67. years, 40% males) were enrolled: 19 belonged to Group A, 34 to Group B and 93 to Group C. Within group A, 6 patients had only NTM isolation, 7 patients had NTM and P. aeruginosa co-infection and 6 patients had NTM plus another pathogen. The most common isolated pathogens among NTM was Mycobacterium avium complex (15 patients, 79%). A total of 4 patients (21%) with NTM were on active treatment. Patients affected by NTM pulmonary infection had a significantly less severe clinical, functional and radiological involvement compared with patients colonized by P. aeruginosa, see Table.Group A (NTM)n=19Group B (P. aeruginosa)n=34Group C (Others)n=93p Value*p Value#p Value+Age (years), median (IQR)70 (64-75)74 (67-79)66 (53-72)0.0010.1720.050Male, n (%)8 (42)15 (44)36 (33)0.660--BMI, median (IQR)22 (19-26)24 (21-25)24 (21-27)0.352--BSI, median (IQR)5 (4-9)12 (8.5-16)5 (3-7)0.0010.0010.090Bhalla score, median (IQR)21 (15-34)36 (30.5-40.5)16 (10.5-21.5)0.0010.0160.076Idiopathic etiology, n (%)8 (42)11 (32)37 (40)0.721--Post-infective etiology, n (%)8 (42)16 (47)29 (31)0.244--Exacerbations/y, median (IQR)1 (0-2)2 (1.5-3.5)2 (1-2)0.0400.0240.132FEV1%, median (IQR)85 (59.75-109.5)58.5 (48.25-74)84 (62-102)0.0020.0100.857FVC%, median (IQR)94.5 (70-109.75)65 (56-81.5)88 (69.5-101.5)0.0030.0030.270*Among the three groups: #Group A vs. Group B; +Group A vs. Group C; BMI: Body mass index; BSI: bronchiectasis severity index; y: year. Conclusions: Colonization with P. aeruginosa seems to have the highest impact on the clinical, functional and radiological status of patients with NCFBE. No specific characteristics may help to identify NTM versus other pathogen colonizations. Thus, diagnostics for atypical mycobacteria should be performed on all patients with NCFBE, as suggested by recent international guidelines.

Chronic infection with non-tuberculous mycobacteria in patients with non-CF bronchiectasis : comparison with other pathogens / G. Bonaiti, S. Aliberti, P. Faverio, S. Lonni, A. Marruchella, S. Annoni, A. Pesci. - In: INTERNATIONAL JOURNAL OF MYCOBACTERIOLOGY. - ISSN 2212-5531. - 4:(2015), pp. 68-69. [10.1016/j.ijmyco.2014.11.040]

Chronic infection with non-tuberculous mycobacteria in patients with non-CF bronchiectasis : comparison with other pathogens

S. Aliberti
Secondo
;
2015

Abstract

Introduction: The aim of this study is to compare characteristics of non-cystic fibrosis bronchiectasis (NCFBE) patients with chronic infections with non-tuberculous mycobacteria (NTM) versus those with Pseudomonas aeruginosa or other colonizations. Methods: This was an observational, perspective study of consecutive NCFBE adult patients attending the outpatient bronchiectasis clinic at the San Gerardo Hospital in Monza, Italy, during 2012 and 2013. Patients with a chronic infection were included in the study and divided into three groups: those with NTM (Group A); those with P. aeruginosa (Group B); and those with other pathogens (Group C). Patients with both NTM and another pathogen were included in Group A. Comparison among the three study groups was performed using X2 or Fisher exact test for categorical variables or Kruskal-Wallis or Mann-Whitney test for continuous variables. Results: A total of 146 patients (median age 67. years, 40% males) were enrolled: 19 belonged to Group A, 34 to Group B and 93 to Group C. Within group A, 6 patients had only NTM isolation, 7 patients had NTM and P. aeruginosa co-infection and 6 patients had NTM plus another pathogen. The most common isolated pathogens among NTM was Mycobacterium avium complex (15 patients, 79%). A total of 4 patients (21%) with NTM were on active treatment. Patients affected by NTM pulmonary infection had a significantly less severe clinical, functional and radiological involvement compared with patients colonized by P. aeruginosa, see Table.Group A (NTM)n=19Group B (P. aeruginosa)n=34Group C (Others)n=93p Value*p Value#p Value+Age (years), median (IQR)70 (64-75)74 (67-79)66 (53-72)0.0010.1720.050Male, n (%)8 (42)15 (44)36 (33)0.660--BMI, median (IQR)22 (19-26)24 (21-25)24 (21-27)0.352--BSI, median (IQR)5 (4-9)12 (8.5-16)5 (3-7)0.0010.0010.090Bhalla score, median (IQR)21 (15-34)36 (30.5-40.5)16 (10.5-21.5)0.0010.0160.076Idiopathic etiology, n (%)8 (42)11 (32)37 (40)0.721--Post-infective etiology, n (%)8 (42)16 (47)29 (31)0.244--Exacerbations/y, median (IQR)1 (0-2)2 (1.5-3.5)2 (1-2)0.0400.0240.132FEV1%, median (IQR)85 (59.75-109.5)58.5 (48.25-74)84 (62-102)0.0020.0100.857FVC%, median (IQR)94.5 (70-109.75)65 (56-81.5)88 (69.5-101.5)0.0030.0030.270*Among the three groups: #Group A vs. Group B; +Group A vs. Group C; BMI: Body mass index; BSI: bronchiectasis severity index; y: year. Conclusions: Colonization with P. aeruginosa seems to have the highest impact on the clinical, functional and radiological status of patients with NCFBE. No specific characteristics may help to identify NTM versus other pathogen colonizations. Thus, diagnostics for atypical mycobacteria should be performed on all patients with NCFBE, as suggested by recent international guidelines.
Bronchiectasis; Colonization; Non-tuberculous mycobacteria; NTM; Pseudomonas aeruginosa; Infectious Diseases; Microbiology (medical)
Settore MED/10 - Malattie dell'Apparato Respiratorio
2015
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/438011
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