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. 2022 Feb 15;7(2):27.
doi: 10.3390/tropicalmed7020027.

Factors Associated with Treatment Outcome in Patients with Nontuberculous Mycobacterial Pulmonary Disease: A Large Population-Based Retrospective Cohort Study in Shanghai

Li-Ping Cheng  1 , Shan-Hao Chen  1 , Hai Lou  1 , Xu-Wei Gui  1 , Xiao-Na Shen  1 , Jie Cao  1 , Wei Sha  1 , Qin Sun  1
Affiliations

Factors Associated with Treatment Outcome in Patients with Nontuberculous Mycobacterial Pulmonary Disease: A Large Population-Based Retrospective Cohort Study in Shanghai

Li-Ping Cheng et al. Trop Med Infect Dis. .

Abstract

Infectious diseases caused by nontuberculous mycobacteria (NTM) are increasingly common. This retrospective cohort study examined factors associated with outcomes in patients from Shanghai who had NTM pulmonary disease (NTMPD) from January 2014 to December 2018. The causative bacterial species, drug susceptibility test results, treatment outcomes, sputum culture conversion rate, and risk factors associated with treatment failure were determined. The most common species were Mycobacterium avium complex (MAC) (50%), M. abscessus (28%), and M. kansasii (15%). Over five years, the proportions of M. kansasii and M. abscessus increased, and that of MAC decreased. The treatment success rate was significantly greater for patients infected with M. kansasii (89.9%) than MAC (65.0%, p < 0.001) and M. abscessus (36.1%, p < 0.001). Multivariate analysis indicated the risk factors for treatment failure were pathogenic NTM species (M. abscessus: aOR = 9.355, p < 0.001; MAC: aOR = 2.970, p < 0.001), elevated ESR (>60 mm/h: aOR = 2.658, p < 0.001), receipt of retreatment (aOR = 2.074, p < 0.001), and being middle-aged or elderly (>60 years-old: aOR = 1.739, p = 0.021; 45-60 years-old: aOR = 1.661, p = 0.034). The main bacterial species responsible for NTMPD were MAC, M. abscessus, and M. kansasii. Patients who were infected by M. abscessus or MAC, with elevated ESR, received retreatment, and were middle-aged or elderly had an increased risk of treatment failure.

Keywords: lung disease; nontuberculous mycobacteria; risk factors; treatment outcome.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Identification and disposition of patients with NTMPD. NTMPD: nontuberculous mycobacterial pulmonary disease, and NTM: nontuberculous mycobacteria.
Figure 2
Figure 2
Abundances of different NTM species in patients diagnosed with NTMPD. NTM: nontuberculous Mycobacteria, and NTMPD: nontuberculous mycobacterial pulmonary disease.
Figure 3
Figure 3
Changes in the abundances of major NTM species in patients with NTMPD from 2014 to 2018. NTM: nontuberculous mycobacteria, MAC: Mycobacterium avium complex.
Figure 4
Figure 4
Sputum culture conversion rates of patients infected by M. Kansasii, MAC, and M. abscessus. NTM: nontuberculous mycobacteria, and MAC: Mycobacterium avium complex.
See this image and copyright information in PMC

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