Outcomes of Mycobacterium avium complex lung disease based on clinical phenotype
Won-Jung Koh, Seong Mi Moon, Su-Young Kim, Min-Ah Woo, Seonwoo Kim, Byung Woo Jhun, Hye Yun Park, Kyeongman Jeon, Hee Jae Huh, Chang-Seok Ki, Nam Yong Lee, Myung Jin Chung, Kyung Soo Lee, Sung Jae Shin, Charles L Daley, Hojoong Kim, O Jung Kwon, Won-Jung Koh, Seong Mi Moon, Su-Young Kim, Min-Ah Woo, Seonwoo Kim, Byung Woo Jhun, Hye Yun Park, Kyeongman Jeon, Hee Jae Huh, Chang-Seok Ki, Nam Yong Lee, Myung Jin Chung, Kyung Soo Lee, Sung Jae Shin, Charles L Daley, Hojoong Kim, O Jung Kwon
Abstract
The effect of the clinical phenotype of Mycobacterium avium complex (MAC) lung disease on treatment outcome and redevelopment of nontuberculous mycobacterial (NTM) lung disease after treatment completion has not been studied systematically.We evaluated 481 treatment-naïve patients with MAC lung disease who underwent antibiotic treatment for ≥12 months between January 2002 and December 2013.Out of 481 patients, 278 (58%) had noncavitary nodular bronchiectatic (NB) disease, 80 (17%) had cavitary NB disease and 123 (25%) had fibrocavitary disease. Favourable outcome was higher in patients with noncavitary disease (88%) than in patients with cavitary disease (76% for fibrocavitary and 78% for cavitary NB disease; p<0.05). Cavitary disease was independently associated with unfavourable outcomes (p<0.05). Out of 402 patients with favourable outcomes, 118 (29%) experienced redevelopment of NTM lung disease, with the same MAC species recurring in 65 (55%) patients. The NB form was an independent risk factor for redevelopment of NTM lung disease (p<0.05). In patients with recurrent MAC lung disease due to the same species, bacterial genotyping revealed that 74% of cases were attributable to reinfection and 26% to relapse.Treatment outcomes and redevelopment of NTM lung disease after treatment completion differed by clinical phenotype of MAC lung disease.
Conflict of interest statement
Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com
Copyright ©ERS 2017.
Source: PubMed