Health‐related quality of life, comorbidities and mortality in pulmonary nontuberculous mycobacterial infections: A systematic review

Yeung, Man Wah; Khoo, Edwin; Brode, Sarah K.; Kamiya, Hiroyuki; Kwong, Jeffrey C.; Macdonald, Liane; Marras, Theodore K.; Morimoto, Kozo; Sander, Beate

doi:10.1111/resp.12767

Cited by 27 publications

(24 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may arise following pneumonia, and is described frequently following infection with Mycobacterium tuberculosis. Nontuberculous mycobacteria (NTM), such as M. avium and M. abscessus , are strongly associated with bronchiectasis and CF, although in the case of non-CF bronchiectasis is not always clear whether NTM is cause or a complication of bronchiectasis [ 20 , 21 ]. Viral infections are also described as a cause of bronchiectasis [ 22 ].…”

Section: What Causes Bronchiectasis?mentioning

confidence: 99%

Global impact of bronchiectasis and cystic fibrosis

Redondo

Keyt

Dhar

et al. 2016

Breathe

View full text Add to dashboard Cite

Educational aimsTo recognise the clinical and radiological presentation of the spectrum of diseases associated with bronchiectasis.To understand variation in the aetiology, microbiology and burden of bronchiectasis and cystic fibrosis across different global healthcare systems.Bronchiectasis is the term used to refer to dilatation of the bronchi that is usually permanent and is associated with a clinical syndrome of cough, sputum production and recurrent respiratory infections. It can be caused by a range of inherited and acquired disorders, or may be idiopathic in nature. The most well recognised inherited disorder in Western countries is cystic fibrosis (CF), an autosomal recessive condition that leads to progressive bronchiectasis, bacterial infection and premature mortality.Both bronchiectasis due to CF and bronchiectasis due to other conditions are placing an increasing burden on healthcare systems internationally. Treatments for CF are becoming more effective leading to more adult patients with complex healthcare needs. Bronchiectasis not due to CF is becoming increasingly recognised, particularly in the elderly population. Recognition is important and can lead to identification of the underlying cause, appropriate treatment and improved quality of life. The disease is highly diverse in its presentation, requiring all respiratory physicians to have knowledge of the different “bronchiectasis syndromes”. The most common aetiologies and presenting syndromes vary depending on geography, with nontuberculous mycobacterial disease predominating in some parts of North America, post-infectious and idiopathic disease predominating in Western Europe, and post-tuberculosis bronchiectasis dominating in South Asia and Eastern Europe.Ongoing global collaborative studies will greatly advance our understanding of the international impact of bronchiectasis and CF.

show abstract

Section: What Causes Bronchiectasis?mentioning

confidence: 99%

Global impact of bronchiectasis and cystic fibrosis

Redondo

Keyt

Dhar

et al. 2016

Breathe

View full text Add to dashboard Cite

show abstract

“…Thus, it is not possible to draw firm conclusions regarding longer-term mortality from this report. Another recent systematic review sought to examine comorbidities, health-related quality of life and mortality associated with NTM disease in various patient populations [ 10 ]. Again, variable follow-up times in the included studies (30 days to over 10 years) limited the understanding of long-term mortality.…”

Section: Introductionmentioning

confidence: 99%

High mortality in patients with Mycobacterium avium complex lung disease: a systematic review

Diel

Lipman

Hoefsloot³

2018

BMC Infect Dis

128

View full text Add to dashboard Cite

BackgroundThe incidence of nontuberculous mycobacterial (NTM) pulmonary disease caused by Mycobacterium avium complex (MAC) in apparently immune-competent people is increasing worldwide. We performed a systematic review of the published literature on five-year all-cause mortality in patients with MAC lung disease, and pooled the mortality rates to give an overall estimate of five-year mortality from these studies.MethodsWe systematically reviewed the literature up to 1st August 2017 using PubMed® and ProQuest Dialog™ to search Medline® and Embase® databases, respectively. Eligible studies contained > 10 patients with MAC, and numerical five-year mortality data or a treatment evaluation for this patient group. Mortality data were extracted and analysed to determine a pooled estimate of all-cause mortality.ResultsFourteen of 1035 identified studies, comprising 17 data sets with data from a total of 9035 patients, were eligible. The pooled estimate of five-year all-cause mortality was 27% (95% CI 21.3–37.8%). A high degree of heterogeneity was observed (I2 = 96%). The mortality in the data sets varied between 10 and 48%. Studies predominantly including patients with cavitary disease or greater comorbidity reported a higher risk of death. Patients in Asian studies tended to have a lower mortality risk. Predictors of mortality consistent across studies included male sex, presence of comorbidities and advanced patient age.ConclusionsDespite high heterogeneity, most studies in patients with MAC pulmonary disease document a five-year all-cause mortality exceeding 25%, indicating poor prognosis. These findings emphasise the need for more effective management and additional prospective mortality data collection.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3113-x) contains supplementary material, which is available to authorized users.

show abstract

“…Pulmonary NTM disease is characterized by respiratory and constitutional symptoms, with significant impact on quality of life [3, 4]. Treatment requires long-courses of antibiotics, which often do not eradicate the mycobacteria [5].…”

Section: Introductionmentioning

confidence: 99%

An association between pulmonary Mycobacterium avium-intracellulare complex infections and biomarkers of Th2-type inflammation

et al. 2017

View full text Add to dashboard Cite

BackgroundThe rising incidence of pulmonary Mycobacterium avium-intracellulare complex (MAI) infection is unexplained but parallels the growing world-wide epidemic of allergic disease. We hypothesized an association between pulmonary MAI infection and Th2-type immune responses as seen in allergy.MethodsBiomarkers of patient Th2-type immune responses (peripheral blood eosinophil counts and serum IgE levels) were compared between patients with positive pulmonary samples for tuberculosis and non-tuberculous mycobacterial (NTM) infection. A further comparison of clinical characteristics, including respiratory co-morbidities, and biomarkers, was conducted between patients culturing MAI NTM and those culturing NTM other than MAI.ResultsPatients culturing NTM from pulmonary samples had significantly higher peripheral blood eosinophil levels than those culturing Mycobacterium tuberculosis. Furthermore, patients culturing MAI compared to those culturing NTM other than MAI had higher eosinophil counts (mean 0.29x109/L vs 0.15x109/L, p = 0.010) and IgE levels (geometric mean 138kU/L vs 47kU/L, p = 0.021). However there was no significant difference in the frequency of asthma between the two NTM groups.ConclusionsThere is an association between biomarkers of Th2-type immune responses and pulmonary MAI. Prospective and translational research could identify the direction of causation; and so determine whether our finding may be utilized within future management strategies for MAI.

show abstract

Health‐related quality of life, comorbidities and mortality in pulmonary nontuberculous mycobacterial infections: A systematic review

Cited by 27 publications

References 51 publications

Global impact of bronchiectasis and cystic fibrosis

Global impact of bronchiectasis and cystic fibrosis

High mortality in patients with Mycobacterium avium complex lung disease: a systematic review

An association between pulmonary Mycobacterium avium-intracellulare complex infections and biomarkers of Th2-type inflammation

Contact Info

Product

Resources

About