A Laboratory-based Analysis of Nontuberculous Mycobacterial Lung Disease in Japan from 2012 to 2013

Morimoto, Kozo; Hasegawa, Naoki; Izumi, Kiyohiko; Namkoong, Ho; Uchimura, Kazuhiro; Yoshiyama, Takashi; Hoshino, Yoshihiko; Kurashima, Atsuyuki; Sokunaga, Jun; Shibuya, Shunsuke; Shimojima, Masayuki; Ato, Manabu; Mitarai, Satoshi

doi:10.1513/annalsats.201607-573oc

Cited by 122 publications

(81 citation statements)

References 25 publications

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“…The rate of patients with M. avium infection was similar to other recent reports. 18 Similarly, there were more female than male patients in the present study. Generally, pulmonary MAC diseases develop more frequently in female than in male patients.…”

Section: Discussionsupporting

confidence: 49%

Predictors of exacerbations of pulmonary MAC disease

Kodaka

Nakano

Oshio

et al. 2019

Preprint

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Background and Objectives The number of patients with pulmonary Mycobacterium avium complex (MAC) disease is increasing worldwide, especially among middle-aged women and never-smokers. Although sex and smoking status have attracted attention as predictors of the development and exacerbation of pulmonary MAC disease, the exact associations remain unknown.The aim of the present study was to clarify the associations of sex and smoking status with the clinical characteristics of pulmonary MAC disease and to identify the predictors of exacerbations of pulmonary MAC disease. Methods From April 2011 to May 2016, 128 MAC patients at our institute were newly diagnosed with pulmonary MAC disease according to the 2007 American Thoracic Society/Infectious Disease Society guideline. Their medical records were retrospectively examined for their clinical findings. The radiological findings at the time of the diagnosis and 1 year later were evaluated. Clinical characteristics were compared by smoking status and sex. To identify the natural predictors of exacerbation, multivariable analysis was performed with the data of 80 treatment-naïve patients. Results Female, never-smoker, and nodular/bronchiectatic (NB) type were common in patients with pulmonary MAC disease. Univariate analysis of data from treatment-naïve subjects showed that female, never-smoker, fewer lung diseases other than MAC, extensive radiological findings, and ≥3 lobes involved were significantly associated with exacerbations. On multivariate analysis, fewer lung diseases other than MAC, extensive radiological findings, and ≥3 lobes involved were significantly associated with exacerbations, but female and never-smoker were not. Conclusions In this study, the presence of extensive radiological findings, especially abnormal shadows in ≥3 lobes and absence of lung diseases other than MAC, rather than sex and smoking status, was a predictor of exacerbations of treatment-naïve pulmonary MAC disease.

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Section: Discussionsupporting

confidence: 49%

Predictors of exacerbations of pulmonary MAC disease

Kodaka

Nakano

Oshio

et al. 2019

Preprint

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“…have comorbidities and/or are immunosuppressed but infections are increasingly being seen in otherwise healthy individuals 26 . In the majority of countries, the most common manifestation of NTM infection is sporadic pulmonary disease caused by members of the Mycobacterium avium complex (MAC) -a group of organisms that includes M. avium, M. intracellulare and M. chimaera [26][27][28][29][30][31] .…”

Section: Burden and History Of Non-tuberculous Mycobacteria (Ntm)mentioning

confidence: 99%

Microbiological problems and biofilms associated with Mycobacterium chimaera in heater–cooler units used for cardiopulmonary bypass

Walker

Moore

Collins

et al. 2017

Journal of Hospital Infection

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Summary:The role of heater cooler units (HCUs) in the transmission of Mycobacterium chimaera during open heart surgery has been recognised since 2013. Subsequent investigations uncovered a remarkable global outbreak reflecting the wide distribution of implicated devices. HCUs are an essential component of cardiopulmonary bypass operations and their withdrawal would severely affect capacity for life-saving cardiac surgery. However, studies have demonstrated that many HCUs are contaminated with a wide range of microorganisms, including M. chimaera and complex biofilms. Whole genome sequencing of M. chimaera isolates recovered from one manufacturer's HCUs, worldwide, has demonstrated a high level of genetic similarity, for which the most plausible hypothesis is a point source contamination of the devices. Dissemination of bioaerosols through breaches in the HCU water tanks is the most likely route of transmission and airborne bacteria have been shown to have reached the surgical field even with the use of ultraclean theatre ventilation. Controlling the microbiological quality of the water circulating in HCUs and reducing biofilm formation has been a major challenge for many hospitals. However, enhanced decontamination strategies have been recommended by manufacturers and while not always effective in eradicating M. chimaera from HCUs, UK hospitals have not reported any new cases of M. chimaera infection, since implementing these mitigation strategies. Water safety groups in hospitals should be aware that water in medical devices such as HCUs can act as a vector in the transmission of potentially fatal water-borne infections.

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“…In the USA, the area of highest endemicity is the southeast, stretching from roughly Florida to Texas, although cases are described throughout the broader USA as well as the rest of the world, with endemicity in eastern Asia [37, 38]. To what degree globalization, multicultural societies, and increased travel (especially for medical tourism) are affecting the epidemiology of M. abscessus complex infections in children is as yet incompletely understood [39].…”

Section: Epidemiologymentioning

confidence: 99%

Mycobacterium abscessus Complex Infections in Children: A Review

Sabin

Ferrieri

Kline

2017

Curr Infect Dis Rep

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Purpose of Review Infections in children with Mycobacterium abscessus complex represent a particular challenge for clinicians. Increasing incidence of these infections worldwide has necessitated focused attention to improve both diagnostic as well as treatment modalities. Published medical literature was reviewed, with emphasis on material published in the past 5 years. Recent Findings Increasing availability of new diagnostic tools, such as matrix-assisted laser desorption ionization-time of flight mass spectrometry and custom PCRs, has provided unique insights into the subspecies within the complex and improved diagnostic certainty. Microbiological review of all recent isolates at the University of Minnesota Medical Center was also conducted, with description of the antimicrobial sensitivity patterns encountered in our center, and compared with those published from other centers in the recent literature. A discussion of conventional antimicrobial treatment regimens, alongside detailed description of the relevant antimicrobials, is derived from recent publications. Summary Antimicrobial therapy, combined with surgical intervention in some cases, remains the mainstay of pediatric care. Ongoing questions remain regarding the transmission mechanics, immunologic vulnerabilities exploited by these organisms in the host, and the optimal antimicrobial regimens necessary to enable a reliable cure. Updated treatment guidelines based on focused clinical studies in children and accounting especially for the immunocompromised children at greatest risk are very much needed.

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A Laboratory-based Analysis of Nontuberculous Mycobacterial Lung Disease in Japan from 2012 to 2013

Cited by 122 publications

References 25 publications

Predictors of exacerbations of pulmonary MAC disease

Predictors of exacerbations of pulmonary MAC disease

Microbiological problems and biofilms associated with Mycobacterium chimaera in heater–cooler units used for cardiopulmonary bypass

Mycobacterium abscessus Complex Infections in Children: A Review

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