Clinical Characteristics and Prognosis of Nontuberculous Mycobacterial Lung Disease with Different Radiographic Patterns

Shu, Chin‐Chung; Lee, Chih Hsin; Hsu, Chia-Lin; Wang, Jann-Tay; Yu, Chong‐Jen; Lee, Li-Na

doi:10.1007/s00408-011-9321-4

Cited by 51 publications

(53 citation statements)

References 22 publications

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“…Shu et al have reported that the 6-month survival in NTM patients with lung lesion is poor based on a single hospital study. The survival is particularly poor for those with worsening consolidation and cavitation of lung [33]. An earlier study found that 72% of patients with lung consolidation suffered from ARF [4].…”

Section: Discussionmentioning

confidence: 99%

Nontuberculous Mycobacterial Infection Is Associated with Increased Respiratory Failure: A Nationwide Cohort Study

et al. 2014

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Background and PurposePopulation study on relationship between nontuberculous mycobacterial (NTM) infection and respiratory failure (RF) is limited. This study evaluated the RF risk, including acute respiratory failure (ARF), chronic respiratory failure (CRF) and ARF on CRF, in patients with NTM infection in Taiwan.MethodsWe used the National Health Insurance Research Database of Taiwan to identify 3864 newly diagnosed NTM patients (NTM cohort) from 1999 to 2009, and 15456 non-NTM patients (non-NTM cohort), frequency matched by demographic status for comparison. Incidence and hazard of developing RF were measured by the end of 2010.ResultsThe incidence rate of RF was 4.31-fold higher in the NTM cohort than in the non-NTM cohort (44.0 vs.10.2 per 1000 person-years), with an adjusted hazard ratio (HR) of 3.11 (95% CI: 2.73–3.54). The cumulative proportional incidence of RF was 10% higher in the NTM cohort than in the non-NTM cohort (P<0.0001). The RF risk was much greater within 6 months after the diagnosis of NTM infection with a HR of 7.45 (95% CI = 5.50–10.09). Age-specific comparison showed that the younger NTM patients had a higher HR of RF than the elderly NTM patients (HR: 4.42, 95% CI: 3.28–5.96 vs. HR: 2.52, 95% CI: 2.17–2.92). Comorbidity increased the risk of RF in both cohorts, particularly in those with chronic obstructive pulmonary disease.ConclusionOur study suggests patients with NTM infection are at a high risk of RF. The risk appears much greater soon after patients diagnosed with NTM infection.

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Section: Discussionmentioning

confidence: 99%

Nontuberculous Mycobacterial Infection Is Associated with Increased Respiratory Failure: A Nationwide Cohort Study

et al. 2014

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“…At a hospital in Taipei City, Northern Taiwan, the annual prevalence of NTM PD increased from 1.28/100,000 in 2000, to 7.94/100,000 in 2008 (73). From the same institution, 252 NTM PD patients with classifiable radiographic patterns (cavitary, bronchiectatic, or consolidative) were identified over 2007–2009 (74). The mean age was 63.7 years and 50.8% were men (74).…”

Section: East Asiamentioning

confidence: 99%

“…From the same institution, 252 NTM PD patients with classifiable radiographic patterns (cavitary, bronchiectatic, or consolidative) were identified over 2007–2009 (74). The mean age was 63.7 years and 50.8% were men (74). The studies from Taiwan identified NTM PD patients as being in the same age range as most other studies.…”

Section: East Asiamentioning

confidence: 99%

Epidemiology of Human Pulmonary Infection with Nontuberculous Mycobacteria

Prevots

Marras

2015

Clinics in Chest Medicine

747

554

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Population-based data have documented a continued increase in NTM prevalence since 2000. Annual prevalence in North American and Australia ranges from 3.2–9.8 per 100,000, and is generally higher than in Europe. Studies of NTM PD from South Korea, Japan, and Taiwan, also suggest increasing prevalence. In Africa and the Middle East, prevalence of NTM ranges from 4% –15% among suspected TB cases and 18%–20% among suspected multi-drug resistant TB (MDR TB) cases. M. avium complex (MAC) is predominant in North America and East Asia, whereas M. kansasii, M. xenopi, and M. malmoense are more common in Europe. Host factors important to the current epidemiology of NTM PD include thoracic skeletal abnormalities, rheumatoid arthritis, and use of immunomodulatory drugs. Clustering of disease within families suggests a heritable genetic predisposition to disease susceptibility. Warm, humid environments with high atmospheric vapor pressure contribute to population risk.

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“…This has been reflected in successive guidelines which recommend more aggressive treatment of fibrocavitary disease [5]. Other patterns of disease have been reported, in particular consolidation and infiltrative patterns have been associated with poor outcomes [9–11] however with no agreed consensus regarding definitions for these patterns, the findings remain unique to the individual studies. Even when an additional ‘consolidative’ category was used, one study found that 27% of subjects still did not clearly fit any category [3] and another was still unable to classify the radiological appearances of 229/481 subjects [9].…”

Section: Discussionmentioning

confidence: 99%

“…NTM-pulmonary disease has been observed to commonly fall into two clinico-radiological patterns of disease, fibrocavitary and nodular-bronchiectatic disease, and this classification forms the basis of treatment recommendations in guidelines [5] and has important prognostic implications [6–8]. Whilst being of great clinical utility this division may not capture the spectrum of radiological appearances, some of which may not fit clearly into either group [3, 9–11]. …”

Section: Introductionmentioning

confidence: 99%

Latent class analysis to define radiological subgroups in pulmonary nontuberculous mycobacterial disease

et al. 2018

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BackgroundNontuberculous mycobacterial (NTM) pulmonary disease has conventionally been classified on the basis of radiology into fibrocavitary and nodular-bronchiectatic disease. Whilst being of great clinical utility, this may not capture the full spectrum of radiological appearances present. The aim of this study was to use latent class analysis (LCA) as an unbiased method of grouping subjects with NTM-pulmonary disease based on their CT features and to compare the clinical characteristics of these groups.MethodsIndividuals with NTM-pulmonary disease were recruited and a contemporaneous CT scan obtained. This was scored using an NTM-specific scoring system. LCA was used to identify groups with common radiological characteristics. The analysis was then repeated in an independent cohort.ResultsThree classes were identified in the initial cohort of 85 subjects. Group 1 was characterised by severe bronchiectasis, cavitation and aspergillomas, Group 2 by relatively minor radiological changes, and Group 3 by predominantly bronchiectasis only. These findings were reproduced in an independent cohort of 62 subjects. Subjects in Group 1 had a lower BMI and serum albumin, higher serum CRP, and a higher mortality.ConclusionsThese findings suggest that NTM-pulmonary may be divided into three radiological subgroups, and that important clinical and survival differences exist between these groups.Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0675-8) contains supplementary material, which is available to authorized users.

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Clinical Characteristics and Prognosis of Nontuberculous Mycobacterial Lung Disease with Different Radiographic Patterns

Cited by 51 publications

References 22 publications

Nontuberculous Mycobacterial Infection Is Associated with Increased Respiratory Failure: A Nationwide Cohort Study

Nontuberculous Mycobacterial Infection Is Associated with Increased Respiratory Failure: A Nationwide Cohort Study

Epidemiology of Human Pulmonary Infection with Nontuberculous Mycobacteria

Latent class analysis to define radiological subgroups in pulmonary nontuberculous mycobacterial disease

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