Household proximity to water and nontuberculous mycobacteria in children with cystic fibrosis

Abstract

In the regions studied, children with CF who live closer to water are more likely to acquire nontuberculous mycobacteria. Future studies in other geographic areas are needed to determine if these results are generalizable. Pediatr Pulmonol. 2017;52:324-330. © 2016 Wiley Periodicals, Inc.

Risk factors for nontuberculous mycobacterial isolation in patients with cystic fibrosis: A meta‐analysis

“…This present analysis corroborates previously reported associations for S. aureus, 8,13,18,40 S. maltophilia, 6,9,10,19 and A. fumigatus. 3,6,9,13,20,41,42 These results may allude to the fact that patients with these chronic colonizations had a long history of CF-related infections and more extensive lung damage pre- been shown to modestly improve lung function and to decrease pulmonary exacerbations, 45,46 but this use of long-term antibiotics raises several concerns. Azithromycin use has been shown to block autophagy, suggesting that it has the potential to predispose patients with CF to mycobacterial infection.…”

“…The full texts of the remaining 38 records were read in full; 19 articles were excluded-seven because of the absence of a control group, one because of the small sample size (<6 NTM-positive patients), and 11 because of the lack of data on risk factors. A total of 19 studies 5,12,19,20,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] were finally included (Figure 1), totaling 23 418 patients, of whom 1421 (6%) patients were diagnosed as NTM positive.…”

“…The publication date of the included studies ranged from 1992 to 2019. Ten studies were conducted in Europe, 19,25,[27][28][29][30]32,33,35,37 seven in North America 5,12,24,26,34,36,38 and two in the Middle East 3,20 ( Table 1). Among the seven case-control studies, five were matched on age and sex, 19,24,27,29,32 one on respiratory function, 39 and one on cystic fibrosis transmembrane conductance regulator (CFTR) mutation.…”

Nontuberculous Mycobacteria in Cystic Fibrosis

“…The CF airways have a complex microbiome, but no organism has been definitively demonstrated to be protective against or facilitate infection with NTM; however, there is an association with Aspergillus, in particular there is an association with allergic bronchopulmonary aspergillosis (ABPA). 1,16,18,21,24,[26][27][28][29][30][31][32][33] Analysis of European registry data demonstrated that ABPA was associated with a 2.36 times chance of having a respiratory culture grow an NTM organism. 33 It has been hypothesized that a change in the immune system favoring a T-helper (Th)2 CD4þ T cell response, as is seen in ABPA, downregulates cytokines essential for eradication of NTM, thus allowing a favorable environment for the mycobacteria to survive and replicate.…”

Cystic fibrosis year in review 2017

“…Ascertaining risk factors for NTM infection could lead to more frequent monitoring of some patients. To evaluate an association between household proximity to water and NTM infection, a retrospective chart review of 150 children with CF in Florida who had regular follow‐up, at least two surveillance cultures foracid‐fast bacilli, and a consistent home address over a 3‐year period was performed . The distance from each patient's home to the nearest body of water was measured using a Geographic Information System.…”