Aspergillus isolation in nontuberculous mycobacterial pulmonary disease: Associated with antimycobacterial treatment initiation but not response

Raats, Daan; Aldhaheri, Sharina; Marras, Theodore K.; Mehrabi, Mahtab; Brode, Sarah K.

doi:10.1016/j.rmed.2021.106338

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…Total 1,439 patients from 11 studies were included in the review of factors associated with radiographic progressive disease 20 , 30 , 42 – 50 . Figures 4 and S3 present the pooled adjusted RRs and unadjusted RRs, which estimated the association between factors and progressive disease using forest plots.…”

Section: Resultsmentioning

confidence: 99%

The factors associated with mortality and progressive disease of nontuberculous mycobacterial lung disease: a systematic review and meta-analysis

Hwang

Lee

Heo

et al. 2023

Sci Rep

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This systematic review and meta-analysis aimed to comprehensively evaluate the factors associated with mortality and progressive disease in NTM-LD patients. We conducted a literature search to identify the eligible studies, dated between January 1, 2007, and April 12, 2021. Forty-one studies with total 10,452 patients were included. The overall all-cause mortality rate was 20% (95% CI 17–24%). The overall rates of clinical and radiographic progressive disease were 46% (95% CI 39–53%) and 43% (95% CI 31–55%), respectively. Older age, male sex, history of TB, diabetes, chronic heart disease, malignancy, systemic immunosuppression, chronic liver disease, presence of cavity, consolidative radiologic features, acid-fast bacillus (AFB) smear positivity, hypoalbuminemia, anemia, increasing platelet count, high CRP, and high ESR were significantly associated with increased all-cause mortality, whereas increasing body mass index (BMI), hemoptysis, and treatment with rifamycin regimen (in M. xenopi) were significantly associated with decreased all-cause mortality in multivariable analysis. History of TB, Aspergillus co-infection, cough, increased sputum, weight loss, presence of cavity, and AFB smear positivity were significantly associated with increased clinical progression with treatment, while older age and low BMI were significantly associated with decreased clinical progression in multivariable analysis. Older age, interstitial lung disease, presence of cavity, consolidative radiologic feature, anemia, high CRP, and leukocytosis were significantly associated with increased radiographic progression after adjusting for covariates. Older age, history of tuberculosis, presence of cavity, consolidative radiologic features, AFB smear positivity, anemia, and high C-reactive protein were common significant factors associated with the all-cause mortality and clinical or radiographic progressive disease of NTM-LD. These factors are thought to directly affect NTM-LD related mortality. The future prediction models for the prognosis of NTM-LD should be established considering these factors.

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Section: Resultsmentioning

confidence: 99%

The factors associated with mortality and progressive disease of nontuberculous mycobacterial lung disease: a systematic review and meta-analysis

Hwang

Lee

Heo

et al. 2023

Sci Rep

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“…Some studies suggest that most cases of aspergillus infection in NTM patients reflect colonisation without an increase in mortality, while others stipulate that simultaneous CPA and NTM infections are indicative of a higher mortality risk [ 4 , 16 , 17 ]. Our observation period of 20 months on average showed no relapses of TB or NTM or post-treatment-diagnosed CPA and did not distinguish between CPA colonisation or clinical infection in need of treatment.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Chronic Pulmonary Aspergillosis in Patients with Suspected or Confirmed NTM and TB—A Population-Based Retrospective Cohort Study

Klinting

Laursen

Titlestad

2022

JoF

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Chronic pulmonary aspergillosis (CPA) is a severe and underdiagnosed pulmonary fungal infection with a significant overlap in symptoms and imaging findings of mycobacterium tuberculosis (TB) and non-tuberculous mycobacterium (NTM). Infection with TB or NTM is a predisposing underlying condition for CPA in approximately one-third of patients. A previously published study from Uganda showed increased incidence and complication rate of CPA with respect to pre-existing radiographic cavitation in a post-treatment TB population. The aim of this study was to investigate the incidence of CPA in a low-endemic population of confirmed or suspected TB and NTM patients. We manually reviewed 172 patients referred on suspicion or for treatment of TB or NTM at the Department of Respiratory Medicine, Odense University Hospital during the period of 1 January 2018 to 31 December 2020. We found no CPA amongst TB patients as opposed to an incidence of 8.2% (n = 4) in NTM-infected patients. We identified possible investigatory differences in Aspergillus blood sample screening protocols depending on NTM or TB, initiated at the Department of Respiratory Medicine at Odense University Hospital. A focused screening and investigatory protocol in NTM patients with persisting or developing symptoms is warranted in relation to suspected CPA.

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Aspergillus isolation in nontuberculous mycobacterial pulmonary disease: Associated with antimycobacterial treatment initiation but not response

Cited by 2 publications

References 23 publications

The factors associated with mortality and progressive disease of nontuberculous mycobacterial lung disease: a systematic review and meta-analysis

The factors associated with mortality and progressive disease of nontuberculous mycobacterial lung disease: a systematic review and meta-analysis

Incidence of Chronic Pulmonary Aspergillosis in Patients with Suspected or Confirmed NTM and TB—A Population-Based Retrospective Cohort Study

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