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. 2020 Mar;19(2):232-235.
doi: 10.1016/j.jcf.2019.07.007. Epub 2019 Aug 6.

Distribution and outcomes of infection of Mycobacterium avium complex species in cystic fibrosis

Michelle Azar  1 , Madsen Zimbric  1 , Kerby Shedden  2 , Lindsay J Caverly  3
Affiliations

Distribution and outcomes of infection of Mycobacterium avium complex species in cystic fibrosis

Michelle Azar et al. J Cyst Fibros. 2020 Mar.

Abstract

Background: The majority of nontuberculous mycobacterial (NTM) pulmonary infections in people with cystic fibrosis (CF) are caused by Mycobacterium avium complex (MAC) species. Data on MAC species distribution and outcomes of infection in CF are lacking.

Methods: This was a single center, retrospective study. MAC isolates had species identification with MLSA of rpoB and the 16S23S ITS region. Clinical data were compared between species.

Results: Twenty-three people with CF and 57 MAC isolates were included. Infection with M. avium was the most common (65.2%). M. intracellulare was associated with higher rates of NTM disease, younger age, and steeper decline in lung function prior to infection.

Conclusions: We observed worse clinical outcomes in people with M. intracellulare infection relative to other MAC species. Further investigation of clinical outcomes of MAC infection among CF patients is warranted to better define the utility of species-level identification of MAC isolates in CF.

Keywords: Mycobacterium avium complex; Mycobacterium intracellulare; Nontuberculous mycobacteria.

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Conflict of interest statement

Declaration of Competing Interest The authors have no conflicts of interest.

Figures

Figure 1:
Figure 1:. Distribution of MAC species.
Dendrogram of clinical MAC isolates (n=57) with reference strains (n=6) based on rpoB and 16S–23S ITS MLSA. Clinical isolates are labelled by a patient identifier (A-W), and serial isolates within patients are numbered sequentially (1–10). Patients in red (patients B, D, and F) had more than one MAC species identified among serial isolates.
Figure 2:
Figure 2:. Lung function trends before and after infection based on MAC species.
Shown are linear regression lines of longitudinal lung function measurements (ppFEV1) in relation to time of MAC acquisition (time 0). Lung function changes before and after acquisition of M. intracellulare (dotted line) were significantly different from zero (p=0.02 and p=0.002, respectively, linear mixed effects model).
See this image and copyright information in PMC

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