Association between Inhaled Corticosteroid Use and Pulmonary Nontuberculous Mycobacterial Infection

Liu, Vincent X; Winthrop, Kevin; Lu, Yun; Sharifi, Husham; Nasiri, Hekmat; Ruoss, Stephen J.

doi:10.1513/annalsats.201804-245oc

Cited by 59 publications

(47 citation statements)

References 47 publications

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“…• Daytime sleepiness • Depression and memory loss 13,19,33 • Polysomnography (gold standard) 19 • pathology such as tracheobronchial tumours or subglottic stenoses before considering a diagnosis of VCD 37,38 . The gold standard for diagnosing VCD is endoscopic examination with direct visualisation of the vocal cords via laryngoscopy, possibly after bronchial challenge or during an acute attack 39 .…”

Section: Symptoms and Diagnosismentioning

confidence: 99%

Impact of comorbid conditions on asthmatic adults and children

Kaplan

Szefler

Halpin

2020

npj Prim. Care Respir. Med.

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Comorbid conditions (comorbidities) can complicate the diagnosis and management of asthma. In different age groups, comorbid conditions can present varying challenges, including diagnostic confusion due to mimicking asthma symptoms, exacerbation of asthma symptoms, therapy for comorbid conditions affecting asthma or therapy for asthma affecting these conditions. This review aims to summarise some common comorbid conditions with asthma, such as rhinitis, vocal cord dysfunction, gastro-oesophageal reflux, psychiatric disorders, obesity and obstructive sleep apnoea, and discuss their prevalence, symptoms, diagnosis and treatment, highlighting any differences in how they impact children and adults. Overall, there is a lack of data on the impact of treating comorbid conditions on asthma outcomes and further studies are needed to guide age-appropriate asthma management in the presence of these conditions.

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Section: Symptoms and Diagnosismentioning

confidence: 99%

Impact of comorbid conditions on asthmatic adults and children

Kaplan

Szefler

Halpin

2020

npj Prim. Care Respir. Med.

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“…Andrejak and her colleagues described the association of NTM infection in subjects with COPD, describing an odd ratio (OR) of 15.7 (95% CI 5.2–11.6) for NTM infection among patients with COPD and a higher OR of 29.1 for COPD patients receiving inhaled corticosteroid therapy ( 19 ). Recent literature has confirmed the association between inhaled corticosteroid use and risk of pulmonary NTM ( 20 ).…”

Section: Discussionmentioning

confidence: 85%

Increasing Non-tuberculous Mycobacteria Infections in Veterans With COPD and Association With Increased Risk of Mortality

et al. 2018

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Background: There are limited data on the epidemiology of Non-tuberculous mycobacteria (NTM) infections among patients with COPD, particularly in the veteran population. This study examined the prevalence, incidence, and mortality of pulmonary NTM infections among veterans with COPD population in the United States.Methods: We analyzed nationwide data from Veterans Affairs Hospitals from 2001 to 2015. First, we determined the incidence and prevalence rates and geographic distribution of NTM infections among veterans with COPD and then we evaluated the association between NTM infections with mortality among veterans with COPD. Pulmonary NTM and COPD diagnosis were defined based on charting claims for each condition on ≥2 occasions and ≥30 days apart. COPD diagnoses had to precede diagnosis of NTM. Cox Proportional-Hazards Regression was performed to determine the dependency of survival time of COPD patients with NTM.Results: The incidence and prevalence rates of NTM rose over the study period, with a sharp rise in incidence after 2012. The areas with the highest NTM period prevalence were Puerto Rico (370), followed by Florida (351) and District of Columbia (309) in 100,000 COPD population. Mortality registered for those patients with COPD Patients and NTM infection was 1.43 times higher compared to those that were uninfected.Conclusions: NTM rates have been increasing in veterans with COPD since 2012. NTM infection is associated with increased risk of mortality. This highlights the importance of identifying preventable risk factors associated with NTM infections in subjects with COPD.

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“…Growing incidence of NTM-LD in obstructive lung diseases requires an awareness among medical staff concerning the probability of NTM infection. One of the predisposing factors is treatment with inhaled corticosteroids (ICS) [9,14]. ICS are the first-line therapy in asthma patients, but in COPD they are indicated only in those who are highly symptomatic, with increased number of hospitalizations (>2/per year) and severe bronchial obstruction [15].…”

Section: Discussionmentioning

confidence: 99%

Non-Tuberculous Mycobacteria in Respiratory Specimens of Patients with Obstructive Lung Diseases—Colonization or Disease?

Szturmowicz¹,

Oniszh²,

Wyrostkiewicz³

et al. 2020

Antibiotics

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Non-tuberculous mycobacteria (NTM) are increasingly a cause of human respiratory tract colonization and mycobacterial lung disease (NTM-LD), especially in patients with chronic lung diseases. The aim of the present study was to find the factors predictive of NTM-LD in patients with obstructive lung diseases and NTM respiratory isolates. A total of 839 isolates of NTM, obtained from 161 patients between 2010 and 2020 in a single pulmonary unit, have been retrospectively reviewed. Of these isolates, 73 concerned 36 patients with obstructive lung diseases (COPD-26, asthma-3, COPD/asthma overlap syndrome-7). NTM-LD was recognized according to the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) criteria in 17 patients, colonization in 19. Lower BMI, elevated body temperature on admission, infiltrative/cavitary lesions on chest CT, and NTM species other than Mycobacterium gordonae were the significant predictors of NTM-LD recognition. Based on the above-mentioned predictive factors, an original scoring system was implemented. The diagnostic utility of the scoring system was higher than that of single parameters. We conclude that NTM-LD prediction in patients with obstructive lung diseases and positive respiratory isolates is difficult. A scoring system based on clinical, radiological and microbiological characteristics was capable of facilitating the differential diagnosis, but it needs further validation in a larger study group.

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Association between Inhaled Corticosteroid Use and Pulmonary Nontuberculous Mycobacterial Infection

Abstract: Inhaled corticosteroid use, and particularly high-dose inhaled corticosteroid use, was associated with an increased risk of NTM pulmonary infection.

Cited by 59 publications

References 47 publications

Impact of comorbid conditions on asthmatic adults and children

Impact of comorbid conditions on asthmatic adults and children

Increasing Non-tuberculous Mycobacteria Infections in Veterans With COPD and Association With Increased Risk of Mortality

Non-Tuberculous Mycobacteria in Respiratory Specimens of Patients with Obstructive Lung Diseases—Colonization or Disease?

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