Abstract
BackgroundData on the prevalence of and factors associated with nontuberculous mycobacteria (NTM) in patients with non–cystic fibrosis (CF) bronchiectasis are limited. Our aim was to determine the prevalence and factors associated with isolation of NTM in this population.MethodsWe performed a multicenter observational study of historical cohorts comprising consecutive patients with non-CF bronchiectasis and at least 2 sputum samples cultured for mycobacteria over a period of 5 years.ResultsThe study population included 218 adult patients (61.9 % women) with a mean (SD) age of 55.7 (16) years and a mean (SD) of 5.1 (3.3) cultures/patient. NTM was isolated from sputum in 18 patients (8.3 %). Of these, 5 patients (28 %) met the American Thoracic Society criteria for NTM disease. Mycobacterium avium complex was the most frequently isolated microorganism (9 patients, 4.1 %). The variables independently associated with isolation of NTM were FVC ≥ 75 % predicted (OR, 4.84; 95 % CI 1.47 to 15.9; p < 0.05), age ≥ 50 years (OR, 4.74; 95 % CI 1.25 to 17.97; p < 0.05), and body mass index (BMI) ≤ 23 kg/m2 (OR, 2.97; 95 % CI 1.03-8.58; p < 0.05). Patients with these three characteristics had a 40 % probability of having at least one isolation of NMT.ConclusionsA significant number of patients with non-CF bronchiectasis are positive for the isolation of NTM. M. avium complex is the most frequently isolated mycobacteria. FVC ≥ 75 % predicted, age ≥ 50 years, and a BMI ≤ 23 kg/m2 were independently associated with the presence of NTM in patients with non-CF bronchiectasis.
Highlights
Data on the prevalence of and factors associated with nontuberculous mycobacteria (NTM) in patients with non–cystic fibrosis (CF) bronchiectasis are limited
All patients had at least 2 sputum samples cultured for mycobacteria during the 5-year study, with a mean of 5.1 (3.3) cultures/patient
Our study indicates that the prevalence of NTM isolates is high in patients with non-CF bronchiectasis and that M. avium complex is the most commonly isolated p-value positive negative
Summary
Data on the prevalence of and factors associated with nontuberculous mycobacteria (NTM) in patients with non–cystic fibrosis (CF) bronchiectasis are limited. Our aim was to determine the prevalence and factors associated with isolation of NTM in this population. Bronchiectasis is a chronic respiratory condition characterized by cough, sputum production, and increased susceptibility to lower respiratory tract infections. While the lower respiratory tract is normally sterile, conditions such as bronchiectasis enable colonization by microbes such as bacteria. The incidence of lung colonization and infection due to NTM in patients with cystic fibrosis (CF) and non-CF bronchiectasis is increasing worldwide [4]. Since NTM diseases are not notifiable, epidemiological data are not readily available. The organism most frequently associated with these infections is Mycobacterium avium complex [5,6,7]. Isolation of pulmonary NTM does not necessarily indicate advanced infection or “disease,” since NTM may
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