Clinical characteristics of patients with bronchiectasis with nontuberculous mycobacterial disease in Mainland China: a single center cross-sectional study

BMC Infectious Diseases

Guohui Fan¹  Xiaoying Gu¹  Chen Wang²  Bin Cao³  Binghuai Lu⁴  Chunlei Wang⁴  Yimin Wang⁵  Min Liu⁶  Hongjun Yin⁷ 

[1] Department of Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China;Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China;National Clinical Research Center of Respiratory Diseases, Beijing, China;Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, East Yinghua Road, Chaoyang District, Beijing, China;Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China;Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China;Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, East Yinghua Road, Chaoyang District, Beijing, China;Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China;Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China;Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China;Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, East Yinghua Road, Chaoyang District, Beijing, China;Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan, Friendship Hospital, Beijing, China;Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, East Yinghua Road, Chaoyang District, Beijing, China;National Clinical Research Center of Respiratory Diseases, Beijing, China;Department of Radiology, China-Japan Friendship Hospital, Beijing, China;Xuanwu Hospital of Capital Medical University, Beijing, China;Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, East Yinghua Road, Chaoyang District, Beijing, China;Department of Infectious Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China;

关键词: Bronchiectasis;    NTM pulmonary disease;    Clinical characteristics;    Associated factors;   

DOI  :  10.1186/s12879-021-06917-8

来源: Springer

【 摘 要 】

BackgroundThe diagnosis and treatment of patients with bronchiectasis and nontuberculous mycobacterium (NTM) pulmonary disease are challenging issues and the treatment is also prolonged and depends on the species. There is limited information on patients with bronchiectasis and NTM pulmonary disease in Mainland China.MethodsThis cross-sectional study was conducted at the China–Japan Friendship Hospital, Beijing, China. Those adult patients who met the diagnostic criteria for bronchiectasis and obtained a culture result of mycobacteria from lower respiratory tract specimens or lung tissue were included in this study. A logistic regression model was used to identify the related factors in patients with NTM pulmonary disease.ResultsA total of 202 patients with bronchiectasis from 19 cities, 155 without and 47 (23.3%) with NTM pulmonary disease, were included. In all the 47 patients with NTM pulmonary disease, Mycobacterium avium complex was the most common species (66.0%), and 72.3% of them were initiated on standard anti-NTM treatment within 3 months after the diagnosis of NTM pulmonary disease. A larger proportion of patients with NTM pulmonary disease had acute exacerbations of ≥ 3 times within 1 year and were diagnosed bronchiectasis ≥ 50 years among patients with NTM pulmonary disease. The HRCT chest images revealed higher proportions of nodular shadow (100% vs. 35.3%), tree-in-bud sign (97.9% vs. 29.0%), cavities (29.8% vs. 5.8%), and airway dilation of the right middle lobe or the left lingular lobe (63.8% vs. 23.9%) in patients with NTM pulmonary disease than in those without NTM pulmonary disease (all P values = 0.001). The multivariable logistic regression model indicated that three and more abnormal features (OR 33.8; 95% CI 11.1–102.8) and main lesions of bronchial expansion in the middle or lingual lobe (OR 6.4; 95% CI 2.4–16.6) in HRCT chest images were independently associated with NTM pulmonary disease (P values = 0.001).ConclusionIn a single center of Mainland China, > 23% of patients with bronchiectasis had NTM pulmonary disease, and most patients were started on standard treatment within 3 months after the diagnosis of NTM pulmonary disease. These findings suggest that patients with bronchiectasis should be thoroughly examined for the presence of NTM pulmonary disease.Trial registrationNCT03594032.

【 授权许可】

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