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Treatment of Mycobacterium abscessus pulmonary infection requires long-term administration of multiple antibiotics. Little is known, however, about the impact of each antibiotic on treatment outcomes. A retrospective analysis was conducted to evaluate the efficacy and adverse effects of antibiotics administered in 244 cases of M. abscessus pulmonary disease. Only 110 (45.1%) patients met the criteria for treatment success. The efficacy of treating M. abscessus pulmonary disease continues to be unsatisfactory especially for infections involving M. abscessus subsp. abscessus . Treatment with drug combinations that included amikacin [adjusted odds ratio (AOR), 3.275; 95% confidence interval (CI), 1.221–8.788], imipenem (AOR, 2.078; 95% CI, 1.151–3.753), linezolid (AOR, 2.231; 95% CI, 1.078–4.616), or tigecycline (AOR, 2.040; 95% CI, 1.079–3.857) was successful. Adverse side effects affected the majority of patients (192/244, 78.7%). Severe effects that resulted in treatment modification included: gastrointestinal distress (29/60, 48.3%) mostly caused by tigecycline, ototoxicity (14/60, 23.3%) caused by amikacin; and myelosuppression (6/60, 10%) caused mainly by linezolid. In conclusion, the success rate of treatment of M. abscessus pulmonary disease is still unsatisfactory. The administration of amikacin, imipenem, linezolid, and tigecycline correlated with increased treatment success. Adverse side effects are common due to long-term, combination antibiotic therapy. Ototoxicity, gastrointestinal distress, and myelosuppression are the most severe.

IntroductionNontuberculous mycobacteria (NTM) have emerged as critical opportunistic pathogens of lung diseases recently. Patients with preexisting bronchiectasis are susceptible to NTM. Nevertheless, patients with preexisting bronchiectasis are susceptible to NTM but the prevalence of NTM pulmonary infection in different species and geographical areas is still not fully understood.Material and methodsThe relevant data of the prevalence of NTM in patients with bronchiectasis were retrieved by searching the main databases such as PubMed, MEDLINE, Cochrane Library, and EMBASE. This meta-analysis was performed using Rev. Man 5.1 and Stata 11.0 software. The collected information of NTM prevalence was chosen as the effect size.ResultsThe results of the meta-analysis showed that the overall prevalence of NTM was 9.3% in patients with bronchiectasis. The further stratification of subgroup analysis indicated that the combined prevalence of NTM was higher in studies whose “sample size” was more than or equal to 100 (p = 0.002), in studies in which “time of study” was after or equal to 2002 (p < 0.001), in studies in which “participants’ geographic location” was Asian (p < 0.001) and in studies whose “method of study” was retrospective (p = 0.002) as well, compared with corresponding groups.ConclusionsOur findings suggested that the prevalence NTM infection is high in patients with bronchiectasis. A larger number of definitive randomized trials are still required to assess this research issue.

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