Clinical Characteristics and Outcome of Disseminated Nontuberculous Mycobacteria Infections in Patients With Solid Organ Transplant

Abstract

Introduction Solid organ transplant recipients are predisposed to nontuberculous mycobacteria (NTM) infections due to the use of immunosuppressant drugs. This metasummary aims to characterize the clinical characteristics and outcomes of disseminated NTM infection in solid organ transplant recipients. Methods A systematic literature search was conducted using different electronic databases (PubMed, Scopus, and Ovid SP) to identify relevant case reports. Case reports involved patients with diagnosis of disseminated NTM infection after solid organ transplant. Statistical analyses were performed using JMP software (version 15; SAS Institute, Cary, NC). Results A total of 34 case reports with 36 patients were included in this study. The mean age of the patients was 49.6 ± 13.0 years, and 44.4% of the patients were male. The majority of the patients had kidney transplant (61.1%). Fever (58.3%) was the most common presenting symptoms of disseminated NTM disease, followed by skin manifestations (44.0%), gastrointestinal symptoms (38.9%), and constitutional symptoms (30.6%). The most frequent organs involved were skin (44.4%), blood (36.1%), and lungs (36.1%). The most common cause of disseminated NTM infection was Mycobacterium avium complex (30.6%). The overall mortality rate was 22.2%. Univariate regression analysis demonstrated that infection of bone marrow (odds ratio, 6.00; 95% confidence interval, 1.05–34.32) and infection of the gastrointestinal tracts (odds ratio, 8.33; 95% confidence interval, 1.33–52.03) were independent predictors of mortality. Conclusion Disseminated NTM infection in solid organ recipients may present with different clinical features and involve a wide spectrum of different organs.