Characterizing non-tuberculous mycobacteria infection in bronchiectasis

TY - JOUR

T1 - Characterizing non-tuberculous mycobacteria infection in bronchiectasis

AU - Faverio, Paola

AU - Stainer, Anna

AU - Bonaiti, Giulia

AU - Zucchetti, Stefano C.

AU - Simonetta, Edoardo

AU - Lapadula, Giuseppe

AU - Marruchella, Almerico

AU - Gori, Andrea

AU - Blasi, Francesco

AU - Codecasa, Luigi

AU - Pesci, Alberto

AU - Chalmers, James D.

AU - Loebinger, Michael R.

AU - Aliberti, Stefano

N1 - No funding

PY - 2016/11/16

Y1 - 2016/11/16

N2 - Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease. This was a prospective, observational study enrolling 261 adult bronchiectasis patients during the stable state at the San Gerardo Hospital, Monza, Italy, from 2012 to 2015. Three groups were identified: pNTM disease; chronic P. aeruginosa infection; chronic infection due to bacteria other than P. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronic P. aeruginosa infection, patients with pNTM were more likely to have cylindrical bronchiectasis and a "tree-in-bud" pattern, a history of weight loss, a lower disease severity and a lower number of pulmonary exacerbations. Among pNTM patients who started treatment, 68% showed a radiological improvement, and 37% achieved culture conversion without recurrence, while 21% showed NTM isolation recurrence. NTM isolation seems to be a frequent event in bronchiectasis patients, and few parameters might help to suspect NTM infection. Treatment indications and monitoring still remain an important area for future research.

AB - Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease. This was a prospective, observational study enrolling 261 adult bronchiectasis patients during the stable state at the San Gerardo Hospital, Monza, Italy, from 2012 to 2015. Three groups were identified: pNTM disease; chronic P. aeruginosa infection; chronic infection due to bacteria other than P. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronic P. aeruginosa infection, patients with pNTM were more likely to have cylindrical bronchiectasis and a "tree-in-bud" pattern, a history of weight loss, a lower disease severity and a lower number of pulmonary exacerbations. Among pNTM patients who started treatment, 68% showed a radiological improvement, and 37% achieved culture conversion without recurrence, while 21% showed NTM isolation recurrence. NTM isolation seems to be a frequent event in bronchiectasis patients, and few parameters might help to suspect NTM infection. Treatment indications and monitoring still remain an important area for future research.

KW - non-cystic fibrosis bronchiectasis

KW - non-tuberculous mycobacteria

KW - pulmonary infection

U2 - 10.3390/ijms17111913

DO - 10.3390/ijms17111913

M3 - Article

C2 - 27854334

SN - 1661-6596

VL - 17

JO - International Journal of Molecular Sciences

JF - International Journal of Molecular Sciences

IS - 11

M1 - 1913

ER -