Microbiological persistence in patients with Mycobacterium abscessus complex lung disease: The prevalence, predictors, and the impact on progression

Persistent growth of Mycobacterium abscessus complex (MABC) in the respiratory system is not uncommon and may indicate continuous infection of MABC lung disease (MABC-LD), but its prevalence, risk factors, and clinical impact have not been investigated. The present study was conducted in two medical...

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Published in:International journal of infectious diseases 2024-02, Vol.139, p.118-123
Main Authors: Chang, Ling-Kai, Wang, Ping-Huai, Lee, Tai-Fen, Huang, Yu-Tsung, Shu, Chin-Chung, Wang, Hao-Chien, Yu, Chong-Jen
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Disease progression
Humans
Lung Diseases - microbiology
Microbiological persistence
Mycobacterium abscessus
Mycobacterium abscessus complex (MABC)
Mycobacterium Infections, Nontuberculous - microbiology
Nontuberculous mycobacteria (NTM)
Predictor
Prevalence
Risk Factors
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Summary:Persistent growth of Mycobacterium abscessus complex (MABC) in the respiratory system is not uncommon and may indicate continuous infection of MABC lung disease (MABC-LD), but its prevalence, risk factors, and clinical impact have not been investigated. The present study was conducted in two medical centers in northern Taiwan. We enrolled patients with MABC-LD and investigated the prevalence and predictors of persistent culture positivity (MABC-PP). Furthermore, we analyzed the association between MABC-PP and radiographic or clinical progression. Among 189 patients with MABC-LD, 58 were in the MABC-PP group. Independent predictors for MABC-PP included an increasing radiographic score and highest acid-fast stain (AFS) of strong positivity (3-4+) at initial diagnosis (compared with negative AFS). MABC-PP and highest AFS were independently associated with MABC-LD progression by the multivariable analysis model. The adjusted hazard ratio increased to 3.56 when the two independent factors existed. MABC-PP accounted for 30.7% and was predicted by initial AFS grade and radiographic score. Patients with MABC-PP, and highest AFS grade might have disease progression.
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2023.11.018