Management of patients with pulmonary mycobacteriosis in France: a multicenter retrospective cohort study.
Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Female
France
/ epidemiology
Guideline Adherence
/ statistics & numerical data
Humans
Lung Diseases
/ diagnostic imaging
Male
Middle Aged
Mycobacterium
/ isolation & purification
Mycobacterium Infections
/ diagnostic imaging
Prognosis
Retrospective Studies
Sex Distribution
Young Adult
Management
Mycobacterium avium complex
Mycobacterium xenopi
Nontuberculous mycobacteria
Prognosis
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
26 Oct 2021
26 Oct 2021
Historique:
received:
26
07
2021
accepted:
13
10
2021
entrez:
27
10
2021
pubmed:
28
10
2021
medline:
3
2
2022
Statut:
epublish
Résumé
Recent studies report very low adherence of practitioners to ATS/IDSA recommendations for the treatment of nontuberculous mycobacteria pulmonary disease (NTM-PD), as well as a great variability of practices. Type of management could impact prognosis. To evaluate management and prognosis of patients with NTM-PD cases with respect to ATS recommendations, we conducted a multicenter retrospective cohort study (18 sentinel sites distributed throughout France), over a period of six years. We collected clinical, radiological, microbiological characteristics, management and outcome of the patients (especially death or not). 477 patients with NTM-PD were included. Respiratory comorbidities were found in 68% of cases, tuberculosis sequelae in 31.4% of patients, and immunosuppression in 16.8% of cases. The three most common NTM species were Mycobacterium avium complex (60%), M. xenopi (20%) and M. kansasii (5.7%). Smear-positive was found in one third of NTM-PD. Nodulobronchiectatic forms were observed in 54.3% of cases, and cavitary forms in 19.1% of patients. Sixty-three percent of patients were treated, 72.4% of patients with smear-positive samples, and 57.5% of patients with smear-negative samples. Treatment was in adequacy with ATS guidelines in 73.5%. The 2-year mortality was 14.4%. In the Cox regression, treatment (HR = 0.51), age (HR = 1.02), and M. abscessus (3.19) appeared as the 3 significant independent prognostic factors. These findings highlight the adequacy between French practices and the ATS/IDSA guidelines. Treatment was associated with a better survival.
Sections du résumé
BACKGROUND
BACKGROUND
Recent studies report very low adherence of practitioners to ATS/IDSA recommendations for the treatment of nontuberculous mycobacteria pulmonary disease (NTM-PD), as well as a great variability of practices. Type of management could impact prognosis.
METHODS
METHODS
To evaluate management and prognosis of patients with NTM-PD cases with respect to ATS recommendations, we conducted a multicenter retrospective cohort study (18 sentinel sites distributed throughout France), over a period of six years. We collected clinical, radiological, microbiological characteristics, management and outcome of the patients (especially death or not).
RESULTS
RESULTS
477 patients with NTM-PD were included. Respiratory comorbidities were found in 68% of cases, tuberculosis sequelae in 31.4% of patients, and immunosuppression in 16.8% of cases. The three most common NTM species were Mycobacterium avium complex (60%), M. xenopi (20%) and M. kansasii (5.7%). Smear-positive was found in one third of NTM-PD. Nodulobronchiectatic forms were observed in 54.3% of cases, and cavitary forms in 19.1% of patients. Sixty-three percent of patients were treated, 72.4% of patients with smear-positive samples, and 57.5% of patients with smear-negative samples. Treatment was in adequacy with ATS guidelines in 73.5%. The 2-year mortality was 14.4%. In the Cox regression, treatment (HR = 0.51), age (HR = 1.02), and M. abscessus (3.19) appeared as the 3 significant independent prognostic factors.
CONCLUSION
CONCLUSIONS
These findings highlight the adequacy between French practices and the ATS/IDSA guidelines. Treatment was associated with a better survival.
Identifiants
pubmed: 34702233
doi: 10.1186/s12890-021-01701-5
pii: 10.1186/s12890-021-01701-5
pmc: PMC8549171
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
333Informations de copyright
© 2021. The Author(s).
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