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

Ling-Kai Chang; Ping-Huai Wang; Tai-Fen Lee; Yu-Tsung Huang; Chin-Chung Shu; Hao-Chien Wang; Chong-Jen Yu

doi:10.1016/j.ijid.2023.11.018

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

Int J Infect Dis. 2024 Feb:139:118-123. doi: 10.1016/j.ijid.2023.11.018. Epub 2023 Nov 16.

Authors

Ling-Kai Chang¹, Ping-Huai Wang², Tai-Fen Lee³, Yu-Tsung Huang³, Chin-Chung Shu⁴, Hao-Chien Wang⁵, Chong-Jen Yu⁶

Affiliations

¹ Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch BioMedical Park Hospital, Zhubei City, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan.
² Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
³ Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁴ College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: ccshu@ntu.edu.tw.
⁵ College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.
⁶ Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch BioMedical Park Hospital, Zhubei City, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

PMID: 37977501
DOI: 10.1016/j.ijid.2023.11.018

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Disease progression; Microbiological persistence; Mycobacterium abscessus complex (MABC); Nontuberculous mycobacteria (NTM); Predictor.

MeSH terms

Anti-Bacterial Agents / therapeutic use
Humans
Lung Diseases* / microbiology
Mycobacterium Infections, Nontuberculous* / microbiology
Mycobacterium abscessus*
Prevalence
Risk Factors

Substances

Anti-Bacterial Agents