Adjuvant Surgical Treatment of Nontuberculous Mycobacterial Lung Disease

Shiraishi, Yuji; Katsuragi, Naoya; Kita, Hidefumi; Hyogotani, Akira; Saito, Mieko; Shimoda, Kiyomi

doi:10.1016/j.athoracsur.2013.03.008

Cited by 48 publications

(44 citation statements)

References 16 publications

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“…The increasing prevalence of NTM lung disease has been paralleled by increasing reports on the role of surgery since the introduction of the newer macrolides [12-25], suggesting more frequent use of thoracic surgery in the management of NTM lung disease. However, a majority of these reports were from limited centers in the Unites States and Japan, and the criteria for selecting the patients who may benefit from the operation remain controversial [10,26,27].…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes of adjuvant resectional surgery for nontuberculous mycobacterial lung disease

et al. 2015

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Background: Outcomes of antibiotic treatment for lung disease caused by nontuberculous mycobacteria (NTM) are unsatisfactory. The role of adjunctive surgery in the treatment of NTM lung disease is still unclear. Methods: We conducted a retrospective review of 70 patients who underwent pulmonary resection for NTM lung disease from March 2007 to February 2013. All patients received recommended antibiotic treatment before and after the surgery. Results: A total of 70 patients underwent 74 operations. The median age of the patients was 50 years. Of the 70 patients, 45 (64%) had Mycobacterium avium complex infection (24 M. intracellulare and 21 M. avium) and 23 (33%) had M. abscessus complex infection (15 M. abscessus and 8 M. massiliense). Thirty-eight (54%) patients had the nodular bronchiectatic form and 28 (40%) had the fibrocavitary form of NTM lung disease. The indications for surgery were a poor response to drug therapy (n=52), remnant cavitary lesions and severe bronchiectasis (n=14), and hemoptysis (n=4). Preoperative sputum acid-fast bacilli staining results were positive in 44 (63%) patients, and sputum culture was positive in 54 (76%). The surgery included lobectomy or lobectomy plus segmentectomy (n=50, 68%), segmentectomy (n=11, 15%), pneumonectomy or completion pneumonectomy (n=8, 11%), bilobectomy or bilobectomy plus segmentectomy (n=4, 5%), and wedge resection (n=1, 1%). Postoperative complications occurred in 15 (21%) patients, including one postoperative death and bronchopleural fistula in 5 patients with the fibrocavitary form of the disease. A negative sputum culture was achieved and maintained in 57 (81%) patients.

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Section: Introductionmentioning

confidence: 99%

Treatment outcomes of adjuvant resectional surgery for nontuberculous mycobacterial lung disease

et al. 2015

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“…[4][5][6][7][8][9] In general, these operations, despite their complexity, may be performed with low morbidity and mortality. Some of the reported differences may be attributed to the varying patient populations and operations described.…”

Section: Complications and Outcomesmentioning

confidence: 99%

Surgical Approach to Pulmonary Nontuberculous Mycobacterial Infections

Mitchell

2015

Clinics in Chest Medicine

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“…Patients whose disease is predominantly localized to one lung, poor response to drug therapy, the development of macrolide-resistant MAC disease or the presence of significant disease-related complications such as hemoptysis might be considered for surgery. Although adjuvant pulmonary resection is complicated, it provides high level of treatment success rate in selected patients [143,144]. Successful treatment of disseminated MAC in persons with AIDS is based on treatment of both the mycobacterial infection and the HIV infection.…”

Section: Minimum Of 12 Months After Culture Conversionmentioning

confidence: 99%

Overview of Non Tuberculosis Mycobacterial Lung Diseases

Diseases¹

2018

Mycobacterium - Research and Development

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Nontuberculosis mycobacteria (NTM) are ubiquitous in nature and opportunistically infect different animals, including humans. Currently, NTM is emerging as an important cause of pulmonary infection among both immunocompromised and immunocompetent persons worldwide. The clinical relevance of pulmonary NTM varies among species while showing geographical heterogeneity in distribution as well as pathogenicity. The outcome of the respiratory NTM disease is a consequence of a complex interplay between microbial factors and host susceptibility. Furthermore, HIV infection, cystic fibrosis, cancer, underlying chronic lung disease and history of tuberculosis (TB) may be associated as risk factors for active nontuberculosis pulmonary diseases (NTMPD). The diagnosis of NTMPD requires the presence of symptoms, radiographic evidences, microscopic observations and definitive laboratory diagnostics. Lung infections resulted from a clinically significant NTM species should be treated with appropriate antimicrobial regimen. M. leprae and M. lepraemurium are uncultivable and require the intracellular milieu for survival and propagation [4]. The obligatory causative agents of the genus Mycobacterium, responsible for TB are classified into Mycobacterium tuberculosis complex (MTC). It comprises M. tuberculosis, M.bovis, M. africanum, M. microti [5], M. canettii [6], M. caprae [7], M. pinnipedii [8], M. mungi [9], M. orygis [10] and M. suricattae [11] species. M. tuberculosis, M. africanum, M. canettii and M. orygis cause TB primarily in human [4, 10], whereas M. bovis [12], M. microti [13], M. caprae [7] M. pinnipedii [8], M. mungi [9] and M. suricattae [11] infect cattle, domestic animals, goats, seals, mongooses and meerkats, respectively, and animal tuberculosis can also be zoonotic [14, 15]. However, geographical variation of the MTC species distribution has been identified. As an example, M. africanum is a common cause of human pulmonary TB (39%) as much as M. tuberculosis (55%) in West Africa [16]. In Ghana, 3% of pulmonary TB cases are represented by M. bovis, while 20% are M. africanum and 73% are M. tuberculosis [17].Other medically important mycobacteria such as M. avium, M. intracellulare complex, M. kansasii, M. marinum, M. fortuitum, M. chelonae complex, M. abscessus and M. scrofulaceum are known as nontuberculosis mycobacteria (NTM) species or atypical mycobacteria or mycobacteria other than tuberculosis (MOTT). They are responsible for diseases including lymphadenitis in children, chronic pulmonary diseases, skin and soft-tissue diseases and infections of the skeletal system [18]. NTM are ubiquitous in nature and are widely distributed in water, soil and animals. Among prevailing NTM species, only a few species have a clinical impact on humans as opportunistic pathogens [19]. M. avium complex (MAC), M. abscessus, M. kansasii, M. fortuitum, M. chelonae, M. szulgai, M. triviale and M. scrofulaceum are common NTM species that cause pulmonary diseases in human [20]. Additionally, M. riyadhense was recently proposed as a cau...

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Adjuvant Surgical Treatment of Nontuberculous Mycobacterial Lung Disease

Cited by 48 publications

References 16 publications

Treatment outcomes of adjuvant resectional surgery for nontuberculous mycobacterial lung disease

Treatment outcomes of adjuvant resectional surgery for nontuberculous mycobacterial lung disease

Surgical Approach to Pulmonary Nontuberculous Mycobacterial Infections

Overview of Non Tuberculosis Mycobacterial Lung Diseases

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