Nontuberculous Mycobacteria in Adult Patients with Cystic Fibrosis

Kilby, J Michael; Gilligan, Peter H.; Yankaskas, James R.; Highsmith, W. Edward; Edwards, Lloyd J.; Knowles, Michael R.

doi:10.1378/chest.102.1.70

Cited by 156 publications

(101 citation statements)

References 10 publications

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“…In a recent prospective cohort, WICKREMASINGHE et al [19] reported multiple isolates in one out of 50 screened patients with non-CF bronchiectasis and a further single isolate in one patient. Several groups have reported the prevalence of NTM infection in patients with CF, with results ranging from 2-4% in the UK [4,20], and 6-24% in the USA [5,21,22]. It is also worth noting that all of the current authors' NTM culture-positive specimens were smear-negative.…”

Section: Discussionmentioning

confidence: 58%

Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics

Fowler¹,

French²,

Screaton³

et al. 2006

Eur Respir J

147

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The aim of the current study was to investigate the prevalence and clinical associations of nontuberculous mycobacteria (NTM) in a well-characterised cohort of patients with adult-onset bronchiectasis.The sputum of all patients attending a tertiary referral bronchiectasis clinic between April 2002 and August 2003 was examined for mycobacteria as part of an extensive diagnostic work-up. NTM-positive patients subsequently had further sputa examined. A modified bronchiectasis scoring system was applied to all high-resolution computed tomography (HRCT) scans from NTM-positive patients, and a matched cohort without NTM.Out of 98 patients attending the clinic, 10 had NTM in their sputum on first culture; of those, eight provided multiple positive cultures. Three patients were treated for NTM infection. A higher proportion of NTM-positive than -negative patients were subsequently diagnosed with cystic fibrosis (two out of nine versus two out of 75). On HRCT scoring, more patients in the NTMpositive group had peripheral mucus plugging than in the NTM-negative group.In the current prospective study of a large cohort of patients with bronchiectasis, 10% cultured positive for nontuberculous mycobacteria in a random clinic sputum sample. Few clinical parameters were helpful in discriminating between groups, except for a higher prevalence of previously undiagnosed cystic fibrosis and of peripheral mucus plugging on high-resolution computed tomography in the nontuberculous mycobacteria group.

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Section: Discussionmentioning

confidence: 58%

Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics

Fowler¹,

French²,

Screaton³

et al. 2006

Eur Respir J

147

View full text Add to dashboard Cite

show abstract

“…Reported prevalence from single or multicenter studies ranges from 6 to 57% 10 . Similar to chronic P. aeruginosa isolates, cf patients are colonized with environmental isolates but persistent clones have been described 52 .…”

Section: Aspergillus Fumigatus Pathogen Characteristicsmentioning

confidence: 99%

“…There have been several case reports and studies suggesting a relationship between adverse clinical status and ntm in individual cf patients 50;51 and other studies fail to show a clear association 52 . Not all studies evaluated decline of lung function and other clinical parameters though, making it difficult to study a causal relationship.…”

Section: Clinical Impactmentioning

confidence: 99%

Challenging and emerging pathogens in cystic fibrosis

Vrankrijker

Wolfs

Ent

2010

Paediatric Respiratory Reviews

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“…Al margen de los pacientes con SIDA, la infección por M. avium se ha descrito en casos de bronquiectasias en mujeres de edad avanzada y otros pacientes con procesos pulmonares crónicos [15][16][17][18][19][20] ; a este último tipo de paciente corresponden tres de nuestros pacientes que recibieron tratamiento, en los que si bien se negativizaron los cultivos, la evolución posterior dependió de su proceso pulmonar de base. Lo mismo ocurrió en el caso de M. simia, sin embargo, ésta es una MNT que rara vez se asocia a casos de infección y que se ha descrito como una micobacteria capaz de colonizar temporalmente o por períodos prolongados áreas pulmonares previamente dañadas 21 , por lo que podríamos considerar a estos aislamientos como de un colonizador persistente.…”

Section: Discussionunclassified

Relevancia clínica de los aislamientos de micobacterias no tuberculosas

Salicio

Álvaro

Bermejo

et al. 2008

Anales Sis San Navarra

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RESUMENFundamento. El aislamiento de micobacterias no tuberculosas (MNT) se ha incrementado en los últimos años debido en gran parte a la utilización de medios de cultivo líquidos. Estos aislamientos carecen en muchos casos de relevancia clínica, por lo que la valoración de su significado debe realizarse en base a unos criterios clínicos internacionales. En el presente trabajo hemos estudiado el impacto que supondría la aplicación de los criterios que la American Thoracic Society (ATS) ha establecido para diferenciar en muestras respiratorias una infección de una colonización por MNT.Métodos. Estudio microbiológico y clínico de los pacientes con aislamientos repetidos de MNT en muestras respiratorias registrados en nuestro laboratorio entre los años 2000-2004. Resultados. Se obtuvieron 116 cultivos positivos de MNT aisladas repetidamente en 46 episodios correspondientes a 42 pacientes. Se identificaron 11 especies distintas: M. xenopi (16 casos), M. avium (12), M. kansasii (7), M. fortuitum (5), M. malmoense (2) y finalmente 1 de cada una de las siguientes: M. genavense, M. simiae, M. gordonae y M. lentiflavum. Se pudieron estudiar 36 pacientes, de los que 17 cumplí-an los criterios de la ATS y, de estos, sólo 12 recibieron tratamiento específico. En los casos que no se cumplí-an los criterios de la ATS los aislamientos no tuvieron ninguna repercusión clínica. En ambos grupos, tratados y no tratados, no se observó una evolución claramente diferenciada.Conclusiones. Ante la dificultad de atribuir a una MNT de muestras respiratorias un papel etiológico, es necesario atenerse a criterios internacionales como los de la ATS antes de iniciar un tratamiento específico para evitar tratamientos incorrectos a los pacientes.Palabras clave. Micobacterias no tuberculosas. Significado clínico. Identificación. ABSTRACTBackground. The isolation of nontuberculous mycobacterias (NTM) has increased in recent years largely due to the use of liquid cultivation media. In many cases such isolations lack clinical relevance, which is why the evaluation of their meaning must be carried out on the basis of international clinical criteria. This article studies the impact of using the criteria that the American Thoracic Society (ATS) has established for differentiating an infection of NTM colonisation in respiratory samples.

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Nontuberculous Mycobacteria in Adult Patients with Cystic Fibrosis

Cited by 156 publications

References 10 publications

Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics

Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics

Challenging and emerging pathogens in cystic fibrosis

Relevancia clínica de los aislamientos de micobacterias no tuberculosas

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