Abstract
BackgroundWe aim to investigate the rate of spontaneous sputum conversion and reversion in patients with Mycobacterium abscessus complex (MABC) lung disease.MethodsAmong 241 patients diagnosed with MABC lung disease between July 2012 and December 2018, 126 patients with persistent sputum positivity for ≥ 6 months without treatment were enrolled at a tertiary referral center in South Korea. Patients were subdivided into two groups, depending on whether or not treatment was initiated within 2 years of diagnosis. The rates of spontaneous sputum culture conversion and reversion was investigated in patients who did not receive treatment within 2 years.ResultsThe mean age of 126 patients was 62.9 years. During a mean follow-up duration of 3.2 years, 33 (26.2%) patients received treatment within 2 years of diagnosis. Among the remaining 93 patients not receiving treatment within 2 years, spontaneous sputum conversion occurred in 24 (25.8%) patients during a mean follow-up duration of 3.7 years after diagnosis. No significant differences were observed in time to conversion between Mycobacterium abscessus and Mycobacterium massiliense lung diseases. The Cox regression analysis showed that malignancy as a comorbid disease and the lower number of lobes involved were independent predictors of spontaneous sputum conversion. After spontaneous sputum conversion, reversion occurred in 27.8% patients at a median of 18.2 months after conversion.ConclusionsAmong patients with MABC lung disease who did not receive treatment for at least 2 years after diagnosis, approximately one-fourth experienced spontaneous conversion. However, not a few patients experienced reversion after spontaneous conversion.
Highlights
Mycobacterium abscessus complex (MABC) is a rapidly growing mycobacterium associated with several diseases in humans, of which lung disease is the most common [1]
We aim to investigate the rate of spontaneous sputum conversion and reversion in patients with Mycobacterium abscessus complex (MABC) lung disease
No significant differences were observed in time to conversion between Mycobacterium abscessus and Mycobacterium massiliense lung diseases
Summary
Mycobacterium abscessus complex (MABC) is a rapidly growing mycobacterium associated with several diseases in humans, of which lung disease is the most common [1]. We showed that spontaneous conversion of sputum cultures occurred in approximately half the 93 untreated patients with MAC lung disease [8]. Another study in South Korea found that 34% of patients with NTM lung disease who did not receive treatment showed spontaneous culture conversion [10]. This tendency of spontaneous conversion is one of the main reasons for not recommending immediate treatment initiation for many patients with indolent and mild NC-NB-type MAC lung disease. We aim to investigate the rate of spontaneous sputum conversion and reversion in patients with Mycobacterium abscessus complex (MABC) lung disease
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