782. Risk Factors, Clinical Characteristic, and Treatment Outcomes for Nontuberculous Mycobacterial Disease in Mexico

Abstract

BackgroundNontuberculous Mycobacteria (NTM) cause diverse clinical manifestations in multiples clinical setting, and in the past years, there has been an increasing prevalence and variability among geographic regions, this associated with a diversity of hosts and clinical manifestations. We objective was evaluated the clinical and microbiologic characteristic, and the treatment outcomes related to slowly growing mycobacteria (SGM) and rapidly growing mycobacteria (RGM).MethodsWhen conducting a retrospective study between January 2001 and December 2017, retrospectively their medical records were reviewed for obtainments of site of isolation or infection, comorbidities or predisponent condition, clinical and radiographic presentation, and treatment outcomes.ResultsA total of 90 patients with isolated of RGM and 87 within SGM were evaluated among these M. avium and M. fortuitum were the most predominant species. HIV infection was the predominat risk factor for SGM infections (P < 0.001); the conditions associated to RGM infections were cancer (P = 0.02787); diabetes mellitus (DM) (P = 0.01418), chronic kidney disease (CKD)(P = 0.04662), use of immunosuppressive medication (P < 0.001), and use of invasive device only were present in the RGM group. In the RGM group, lung infection was the most common site of infection (43%); in the SGM group, the disseminated disease was the most common (54%). The time of treatment was more prolonged in the SGM group (196 vs. 229 days, P = 0.0309). In the RGM group, the rate of cure was higher in the subgroup of Mycobacterial stream infections and disseminated disease (15 vs. 5, P = 0.0146). In the analysis of lung infection who meet the IDSA/ATS criteria were divided into the group with treatment and the group without treatment, the outcomes were not significative in both groups.ConclusionThe NTM infections are an important cause of disease in patients with chronic conditions such as cancer, immunosuppressive medication, CKD, use of invasive device, and DM. HIV infection persist as the first risk factor for M. avium disseminated disease, the treatment for this latter condition in spite of more prolonged, it had a lower rate of cure. The treatment of lung infections for NTM must be individualized although the IDSA/ATS criteria are met.Disclosures All authors: No reported disclosures.