Implication of species change of Nontuberculous Mycobacteria during or after treatment

BMC Pulmonary Medicine

Research Article

Taek Soo Kim¹  Moon-Woo Seong¹  Soon Ho Yoon²  Jong Hyuk Lee²  Jong Sik Lee³  Jae-Joon Yim³  Sung Koo Han³ 

[1] Department of Laboratory Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea;Department of Radiology, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea;Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea;

关键词: Nontuberculous mycobacteria species change;    Mycobacterium avium;    Mycobacterium abscessus;    Clarithromcycin resistance;   

DOI  :  10.1186/s12890-017-0539-7

 received in 2017-07-10, accepted in 2017-11-29,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCo-existence or subsequent isolation of multiple nontuberculous mycobacteria (NTM) species in same patient has been reported. However, clinical significance of these observations is unclear. The aim of this study was to determine clinical implications of changes of NTM species during or after treatment in patients with NTM lung disease.MethodsPatients with NTM lung disease, who experienced changes of NTM species during treatment or within 2 years of treatment completion between January 1, 2009 and December 31, 2015, were included in the analysis. Demographic, clinical, microbiological, and radiographic data were reviewed and analyzed.ResultsDuring the study period, 473 patients were newly diagnosed with NTM lung disease. Treatment was started in 164 patients (34.6%). Among these 164 patients, 16 experienced changes of NTM species during or within 2 years of treatment completion. Seven showed changes from M. avium complex (MAC) to M. abscessus subspecies abscessus (MAA) and five patients displayed changes from M. abscessus subspecies massiliense (MAM) to MAC. With isolation of new NTM species, 6 out of 7 patients with change from MAC to MAA reported worsening of symptoms, whereas none of the five patients with change from MAM to MAC reported worsening of symptoms. All MAA isolated during or after treatment for MAC lung diseases showed inducible resistance to clarithromycin.ConclusionsChange of NTM species may occur during or after treatment for NTM lung disease. Especially, changes from MAC to MAA is accompanied by symptomatic and radiographic worsening as well as inducible resistance to clarithromycin.

【 授权许可】

CC BY   
© The Author(s). 2017