Non-tuberculous mycobacterial disease is common in patients with non-cystic fibrosis bronchiectasis

Abstract

Background: Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms. Cystic fibrosis (CF) patients are susceptible to NTM, but data about NTM in patients with non-CF bronchiectasis are limited.

Methods: We conducted a retrospective, descriptive study at the University of Illinois Medical Center. All patients diagnosed with bronchiectasis (code 494) using the International Classification of Diseases, ninth revision (ICD-9), between 1999 and 2006, were identified. Clinical data including lung function, radiology studies, and presence of NTM in sputum were abstracted for those who met the study criteria.

Results: One hundred eighty-two patients were enrolled in the study. Patients were divided into two groups: bronchiectasis with NTM isolates (n = 68) and bronchiectasis without isolates (n =114), and compared for clinical characteristics and underlying diseases. Mycobacterium avium complex (MAC) was the most common isolate. Fifty-five patients (30%) met the American Thoracic Society criteria for diagnosis of NTM disease. Gram-negative rods were commonly co-isolated. The probability of NTM isolation was significantly higher in elderly female patients (p = 0.04). Moreover, the probability of NTM isolation was significantly higher in the female group with low body mass index (BMI) (p = 0.002).

Conclusions: NTM infections are common in non-CF bronchiectasis. MAC is the most frequently isolated NTM in these patients. There is also great variability in age and sex characteristics for NTM in non-CF bronchiectasis patients. Female patients with a low BMI are a high risk group for NTM infection in non-CF bronchiectasis. Routine screening for NTM is strongly recommended in this patient population.

Keywords: BMI; Bronchiectasis; NTM; Non-CF; Non-tuberculous mycobacterial diseases.

Published by Elsevier Ltd.

Figures

Figure 1

Study flowchart of non-tuberculous mycobacterial disease in patients with non-cystic fibrosis bronchiectasis.

Figure 2

The Kaplan–Meier estimate curve for the cumulative probability of NTM isolation according to age and sex in patients with non-cystic fibrosis bronchiectasis.

Figure 3

The Kaplan–Meier estimate curve for the cumulative probability of NTM isolation according to body mass index (BMI) and sex in patients with non-cystic fibrosis bronchiectasis.