Treatment outcomes of nontuberculous mycobacterial pulmonary disease in lung transplant recipients

Transpl Infect Dis. 2021 Aug;23(4):e13679. doi: 10.1111/tid.13679. Epub 2021 Jul 12.

Abstract

Background: Lung transplant (LTX) recipients are at risk miscellaneous infections, among whom the clinical significance of nontuberculous mycobacteria (NTM) is increasingly recognized. Despite anti-mycobacterial therapy becoming standardized worldwide, there is a lack of data on treatment outcomes in LTX recipients who develop NTM-pulmonary disease (PD). We aimed to review the treatment outcomes of NTM-PD among LTX recipients in our center.

Methods: Patients who underwent LTX from January 2013 to December 2014 were consecutively enrolled in the retrospective cohort, with follow-up of data retrieved to December 2017. Clinical and radiological improvement and culture conversion after anti-mycobacterial therapy were reviewed in those who developed post-transplant NTM-PD.

Results: Sixteen of 230 LTX recipients developed post-transplant NTM-PD. Ten of 16 patients with post-transplant NTM-PD were treated with macrolide-containing anti-mycobacterial therapy, leading to clinical improvement in 5/10 (50%), radiological improvement in 5/10 (50%) and culture conversion in 6/10 (60%) patients.

Conclusion: Anti-mycobacterial therapy may relieve pulmonary symptoms and reduce microbial load among individuals with post-transplant NTM-PD.

Keywords: Mycobacterium avium (MAC); lung transplant (LTX); nontuberculous mycobacteria (NTM); respiratory infection; treatment outcome.

MeSH terms

  • Humans
  • Lung
  • Lung Diseases* / drug therapy
  • Mycobacterium Infections, Nontuberculous* / drug therapy
  • Nontuberculous Mycobacteria
  • Retrospective Studies
  • Transplant Recipients
  • Treatment Outcome