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Radiologic types of Mycobacterium xenopi pulmonary disease: different patients with similar short-term outcomes

  • Takashi HiramaEmail author
  • Sarah K. Brode
  • Theodore K. Marras
Original Article
  • 79 Downloads

Abstract

Mycobacterium xenopi pulmonary disease (Mxe-PD) is common among nontuberculous mycobacterial infections in Europe and Canada. Associations between radiological pattern and clinical features and outcomes are inadequately studied in Mxe-PD. We sought to investigate clinical characteristics and outcomes according to the dominant radiological pattern among patients with Mxe-PD. We retrospectively studied patients with Mxe-PD seen in our clinic, categorizing their predominant CT pattern as nodular bronchiectasis, fibrocavitary, or unclassifiable, and compared clinical characteristics, treatment, and outcomes between radiologic groups. Of 94 patients with Mxe-PD, CT patterns comprised nodular bronchiectasis (40/94, 42.6%), fibrocavitary (37/94, 39.4%), and unclassifiable (17/94, 18.1%). Compared with fibrocavitation, patients with nodular bronchiectasis were female dominant, less often had COPD, less often had AFB smear-positive sputum, and more frequently had co-isolation of Pseudomonas. Patients with nodular bronchiectasis were less often treated (65% versus 91.9%) and when treated, they received fewer anti-mycobacterial drugs (on average 3 versus 4). Outcomes did not differ significantly by radiological pattern. Nodular bronchiectasis was common among Mxe-PD patients in our clinic. Compared with fibrocavitary disease, patients with nodular bronchiectasis had features suggestive of milder disease and were less often treated. Among treated patients, outcomes did not differ by radiologic pattern.

Keywords

Mycobacterium xenopi Nontuberculous mycobacteria Chest CT Nodular bronchiectasis 

Notes

Acknowledgement

This work is supported in part by Kurozumi Medical Foundation and Tokyo-Hokenkai Byotai-Seiri Laboratory.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was reviewed by the University Health Network-Research Ethics Board (Research Ethics Board number 18-5104).

Informed consent

In light of the retrospective design, the requirement of informed consent was waived.

Supplementary material

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References

  1. 1.
    Prevots DR, Marras TK (2015) Epidemiology of human pulmonary infection with nontuberculous mycobacteria: a review. Clin Chest Med 36:13–34.  https://doi.org/10.1016/j.ccm.2014.10.002 CrossRefGoogle Scholar
  2. 2.
    Marras TK, Mendelson D, Marchand-Austin A et al (2013) Pulmonary nontuberculous mycobacterial disease, Ontario, Canada, 1998-2010. Emerg Infect Dis 19:1889–1891.  https://doi.org/10.3201/eid1911.130737 CrossRefGoogle Scholar
  3. 3.
    Hoefsloot W, Van Ingen J, Andrejak C et al (2013) The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples: an NTM-NET collaborative study. Eur Respir J 42:1604–1613.  https://doi.org/10.1183/09031936.00149212 CrossRefGoogle Scholar
  4. 4.
    van Ingen J, Boeree MJ, de Lange WCM et al (2008) Mycobacterium xenopi clinical relevance and determinants, the Netherlands. Emerg Infect Dis 14:385–389.  https://doi.org/10.3201/eid1403.061393 CrossRefGoogle Scholar
  5. 5.
    Andrejak C, Lescure F-X, Pukenyte E et al (2009) Mycobacterium xenopi pulmonary infections: a multicentric retrospective study of 136 cases in north-east France. Thorax 64:291–296.  https://doi.org/10.1136/thx.2008.096842 CrossRefGoogle Scholar
  6. 6.
    Griffith DE, Aksamit T, Brown-Elliott BA et al (2007) An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 175:367–416.  https://doi.org/10.1164/rccm.200604-571ST CrossRefGoogle Scholar
  7. 7.
    Hayashi M, Takayanagi N, Kanauchi T et al (2012) Prognostic factors of 634 HIV-negative patients with Mycobacterium avium complex lung disease. Am J Respir Crit Care Med 185:575–583.  https://doi.org/10.1164/rccm.201107-1203OC CrossRefGoogle Scholar
  8. 8.
    Ito Y, Hirai T, Maekawa K et al (2012) Predictors of 5-year mortality in pulmonary Mycobacterium avium-intracellulare complex disease. Int J Tuberc Lung Dis 16:408–414.  https://doi.org/10.5588/ijtld.11.0148 CrossRefGoogle Scholar
  9. 9.
    Hirama T, Marchand-Austin A, Ma J et al (2018) Mycobacterium xenopi genotype associated with clinical phenotype in lung disease. Lung 196:213–217.  https://doi.org/10.1007/s00408-018-0087-9 CrossRefGoogle Scholar
  10. 10.
    Hirama T, Brode SK, Beswick J et al (2018) Characteristics, treatment and outcomes of nontuberculous mycobacterial pulmonary disease after allogeneic hematopoietic stem cell transplant. Eur Respir J 51:1702330.  https://doi.org/10.1183/13993003.02330-2017 CrossRefGoogle Scholar
  11. 11.
    Lam PK, Griffith DE, Aksamit TR et al (2006) Factors related to response to intermittent treatment of Mycobacterium avium complex lung disease. Am J Respir Crit Care Med 173:1283–1289.  https://doi.org/10.1164/rccm.200509-1531OC CrossRefGoogle Scholar
  12. 12.
    van Ingen J, Aksamit T, Andrejak C et al (2018) Treatment outcome definitions in nontuberculous mycobacterial pulmonary disease: an NTM-NET consensus statement. Eur Respir J 51:1800170.  https://doi.org/10.1183/13993003.00170-2018 CrossRefGoogle Scholar
  13. 13.
    Marras TK, Wagnetz U, Jamieson FB, Patsios DA (2013) Chest computed tomography predicts microbiological burden and symptoms in pulmonary Mycobacterium xenopi. Respirology 18:92–101.  https://doi.org/10.1111/j.1440-1843.2012.02277.x CrossRefGoogle Scholar
  14. 14.
    Carrillo MC, Patsios D, Wagnetz U et al (2014) Comparison of the spectrum of radiologic and clinical manifestations of pulmonary disease caused by mycobacterium avium complex and mycobacterium xenopi. Can Assoc Radiol J 65:207–213.  https://doi.org/10.1016/j.carj.2013.05.006 CrossRefGoogle Scholar
  15. 15.
    Park SW, Song JW, Shim TS et al (2012) Mycobacterial pulmonary infections in patients with idiopathic pulmonary fibrosis. J Korean Med Sci 27:896–900.  https://doi.org/10.3346/jkms.2012.27.8.896 CrossRefGoogle Scholar
  16. 16.
    Jo K-W, Kim S, Lee JY et al (2014) Treatment outcomes of refractory MAC pulmonary disease treated with drugs with unclear efficacy. J Infect Chemother 20:602–606.  https://doi.org/10.1016/j.jiac.2014.05.010 CrossRefGoogle Scholar
  17. 17.
    Varadi RG, Marras TK (2009) Pulmonary Mycobacterium xenopi infection in non-HIV-infected patients: a systematic review. Int J Tuberc Lung Dis 13:1210–1218Google Scholar
  18. 18.
    Wallace RJ, Brown-Elliott BA, McNulty S et al (2014) Macrolide/azalide therapy for nodular/bronchiectatic Mycobacterium avium complex lung disease. Chest 146:276–282.  https://doi.org/10.1378/chest.13-2538 CrossRefGoogle Scholar
  19. 19.
    Koh W-J, Moon SM, Kim S-Y et al (2017) Outcomes of Mycobacterium avium complex lung disease based on clinical phenotype. Eur Respir J 50:1602503.  https://doi.org/10.1183/13993003.02503-2016 CrossRefGoogle Scholar
  20. 20.
    Haworth CS, Banks J, Capstick T et al (2017) British Thoracic Society guidelines for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD). Thorax 72:ii1–ii64.  https://doi.org/10.1136/thoraxjnl-2017-210927 CrossRefGoogle Scholar
  21. 21.
    Research Committee of the British Thoracic Society (2001) First randomised trial of treatments for pulmonary disease caused by M avium intracellulare, M malmoense, and M xenopi in HIV negative patients: rifampicin, ethambutol and isoniazid versus rifampicin and ethambutol. Thorax 56:167–172CrossRefGoogle Scholar
  22. 22.
    Diel R, Ringshausen F, Richter E et al (2017) Microbiological and clinical outcomes of treating non-Mycobacterium avium complex nontuberculous mycobacterial pulmonary disease: a systematic review and meta-analysis. Chest 152:120–142.  https://doi.org/10.1016/j.chest.2017.04.166 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Respirology, Department of MedicineUniversity of TorontoTorontoCanada
  2. 2.Department of Respiratory MedicineWest Park Healthcare CentreTorontoCanada
  3. 3.Division of Respirology, Department of MedicineToronto Western HospitalTorontoCanada
  4. 4.Department of Thoracic Surgery, Institute of Development, Aging and CancerTohoku UniversitySendaiJapan

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