2185. Pulmonary Non-Tuberculosis Mycobacteria (NTM) Infections in Adult Patients at a Tertiary Care Hospital in Saudi Arabia

Abstract

Abstract Background Burden of Non-tuberculous Mycobacteria (NTM) disease is increasing in both developed and developing countries. Local data is needed to guide our understanding of the epidemiology and outcome of NTM management in our population. The main objectives of the study are to describe management of patients with NTM infection and determine treatment outcomes in adult patients. Also, to explore the epidemiology of mycobacterial species associated with pulmonary NTM. Methods A 10-year (2010-2020), retrospective cohort study was conducted at a tertiary care hospital in Saudi Arabia. All patients with positive NTM culture were screened. Adult patients (≥ 18 years old) diagnosed with pulmonary NTM disease and received treatment for ≥ two months were included. Clinical data was collected from the patient’s chart using standardised form. The primary end points were overall cure rate (clinical, microbiological, and radiological cure), recurrence, relapse, and re-infection rate. The secondary end points were mortality and hospital admission rate for NTM infection. The Chi-square test was used to compare parameters. Univariate then multivariable logistic regression were used to model the effect of the outcome. Screening of patients with positive Non-tuberculous Mycobacteria culture for eligibility Results Forty-five patients met the study inclusion criteria. 60% were male with a median age of 53. The most common comorbidities were malignancy and bronchiectasis. NTM species were Mycobacterium simiae (35%), Mycobacterium avium Complex (27%), and Mycobacterium abscessus (18%). Overall cure rate was 95%, with 85%, 85% and 74% of microbiological, clinical, and radiological rate achieved, respectively. Greater number of patients were treated before the recent pulmonary NTM guideline. Regimens were based on general treatment for NTM infection with clarithromycin, ethambutol, and rifampicin utilized the most. 69% of regimens were adjusted after speciation. The median duration of treatment was 36 weeks. Relapse, recurrence and reinfection rate was 20%, 9%, and 2%, respectively. NTM related hospital admission rate was 34%. Baseline characteristics of Patients with Pulmonary Non-tuberculous Mycobacteria (n=45) Primary and secondary outcomes Clinical Presentation, diagnosis and treatment of Patients with pulmonary Non-tuberculous Mycobacteria (n=45) This table is showing the clinical course of all patients included in the study with subgroup analysis per each specie of Non-tuberculous Mycobacteria Conclusion Pulmonary NTM disease in our patients was mainly due to three species in 80%. High overall cure rate and low recurrence rate were achieved. The findings of this study will serve as a guide for the management of pulmonary NTM disease in Saudi population. Disclosures All Authors: No reported disclosures.