Profiles of Extrapulmonary Nontuberculous Mycobacteria Infections and Predictors for Species: A Multicenter Retrospective Study.

Joon-Sup Yeom,Eun Jin Kim,Jun Yong Choi,Jung Ho Kim,Hye Seong,Jin Young Ahn,Su Jin Jeong,Woon Ji Lee,Young Goo Song,Je Eun Song,Jun Hyoung Kim,Nam Su Ku,In Young Jung

doi:10.3390/pathogens9110949

Abstract

Extrapulmonary nontuberculous mycobacteria (NTM) infections contribute to morbidity and mortality worldwide. However, studies about extrapulmonary NTM infections have been limited. Therefore, we aim to describe the diversity of extrapulmonary NTM infections and identify predictors for species. Information regarding diversity of NTM isolates, antimicrobial susceptibility testing, treatment regimens, and outcomes were collected from four tertiary care centers in South Korea. Comparisons were made between patients with rapidly growing mycobacteria (RGM) and slowly growing mycobacteria (SGM) infections. A total of 117 patients (46 males vs. 71 females) were included. Skin and soft tissue infections (SSTIs) predominated (34.2%), followed by bone and joint infections (28.2%). In SSTIs, RGM species were predominantly identified (26/28, 92.9%), whereas SGM species were mainly identified in bone and joint infections (18/26, 69.2%), and the difference of isolated sites was verified by a post hoc test (p < 0.001). Multivariable regression analysis revealed that male sex (vs. female sex; OR 5.30, CI 1.35–24.26, p = 0.020) and bone and joint infections (vs. SSTIs; OR 18.10, CI 3.28–157.07, p = 0.002) were predictors of SGM infections, whereas the opposite was observed for RGM infections. Bone and joint infections and male sex were predictors for SGM infections, whereas SSTIs and female sex were predictors for RGM infections.

Highlights

Nontuberculous mycobacteria (NTM) are ubiquitous environmental organisms most commonly found in water and soil, and are a cause of pulmonary and extrapulmonary infections [1]
CI: confidence interval; OR: odds ratio. In this multicenter retrospective study, we described the clinical characteristics of patients with extrapulmonary nontuberculous mycobacteria (NTM) infections
We compared slowly growing mycobacteria (SGM) and rapidly growing mycobacteria (RGM) infections; the results showed differences between the two groups depending on the sex and isolated sites

Summary

Introduction

Nontuberculous mycobacteria (NTM) are ubiquitous environmental organisms most commonly found in water and soil, and are a cause of pulmonary and extrapulmonary infections [1]. NTM disease is on the rise worldwide and is an important cause of morbidity and mortality [2,3]. Advances in identification techniques have increased physicians’ awareness of the heterogeneity of NTM isolates, the surge in the number of cases cannot be solely explained by those advances and increased awareness [4]. NTM can be categorized into slowly growing mycobacteria (SGM) and rapidly growing mycobacteria (RGM), according to Runyon’s classification [5]. Species comprising SGM such as Mycobacterium avium complex are the most common NTM species responsible for diseases. Infections caused by RGM such as M. abscessus complex are more difficult to treat due to antimicrobial drug resistance [6,7]

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