Characterizing Non-Tuberculous Mycobacteria Infection in Bronchiectasis

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 wit...

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Veröffentlicht in:International journal of molecular sciences Jg. 17; H. 11; S. 1913
Hauptverfasser: Faverio, Paola, Stainer, Anna, Bonaiti, Giulia, Zucchetti, Stefano, Simonetta, Edoardo, Lapadula, Giuseppe, Marruchella, Almerico, Gori, Andrea, Blasi, Francesco, Codecasa, Luigi, Pesci, Alberto, Chalmers, James, Loebinger, Michael, Aliberti, Stefano
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Switzerland MDPI AG 16.11.2016
MDPI
Schlagworte:
Aged
Airway management
Anti-Bacterial Agents - therapeutic use
Bronchiectasis - complications
Bronchiectasis - drug therapy
Bronchiectasis - virology
Female
Fungal infections
Humans
Lung - virology
Male
Middle Aged
Mycobacterium Infections, Nontuberculous - complications
Mycobacterium Infections, Nontuberculous - drug therapy
Mycobacterium Infections, Nontuberculous - virology
Nontuberculous Mycobacteria - drug effects
Nontuberculous Mycobacteria - virology
Pathogenesis
Prospective Studies
Pseudomonas aeruginosa
Pseudomonas aeruginosa - isolation & purification
Pseudomonas Infections - complications
Pseudomonas Infections - drug therapy
Pseudomonas Infections - virology
Tuberculosis
non-tuberculous mycobacteria
pulmonary infection
non-cystic fibrosis bronchiectasis
ISSN:1422-0067, 1661-6596, 1422-0067
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Zusammenfassung: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.
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ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms17111913