A Rough Colony Morphology of Mycobacterium abscessus Is Associated With Cavitary Pulmonary Disease and Poor Clinical Outcome.


Journal

The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675

Informations de publication

Date de publication:
28 03 2023
Historique:
received: 13 10 2022
accepted: 11 01 2023
medline: 29 3 2023
pubmed: 14 1 2023
entrez: 13 1 2023
Statut: ppublish

Résumé

The Mycobacterium abscessus complex (MABC) is a difficult to treat mycobacterium with two distinct morphologies: smooth and rough. As the clinical implications are unclear, we explored the morphology of MABC in relation to disease and outcome. We performed a retrospective multicenter cohort study including patients with confirmed MABC in Sweden, 2009-2020, with treatment outcome as the primary outcome. MABC colony morphology was determined by light microscopy on Middlebrook 7H10 agar plates. Of the 71 MABC isolates, a defined morphology could be determined for 63 isolates, of which 40 were smooth (56%) and 23 were rough (32%). Immunosuppression, pulmonary disease, and cavitary lesion on chest radiographs were significantly associated with a rough isolate morphology. Participants with smooth isolates had more favorable treatment outcomes (12/14, 86%) compared to those with rough isolates (3/10, 30%). In an age-adjusted logistic regression, rough morphology of MABC was associated to lower odds of clinical cure compared to smooth morphology (adjusted odds ratio, 0.12; P = .049). Study participants with rough MABC colony morphology of isolates had a worse clinical outcome compared to those with smooth isolates. The biological mechanisms should be further characterized and colony morphology of MABC taken into account during clinical management.

Sections du résumé

BACKGROUND
The Mycobacterium abscessus complex (MABC) is a difficult to treat mycobacterium with two distinct morphologies: smooth and rough. As the clinical implications are unclear, we explored the morphology of MABC in relation to disease and outcome.
METHODS
We performed a retrospective multicenter cohort study including patients with confirmed MABC in Sweden, 2009-2020, with treatment outcome as the primary outcome. MABC colony morphology was determined by light microscopy on Middlebrook 7H10 agar plates.
RESULTS
Of the 71 MABC isolates, a defined morphology could be determined for 63 isolates, of which 40 were smooth (56%) and 23 were rough (32%). Immunosuppression, pulmonary disease, and cavitary lesion on chest radiographs were significantly associated with a rough isolate morphology. Participants with smooth isolates had more favorable treatment outcomes (12/14, 86%) compared to those with rough isolates (3/10, 30%). In an age-adjusted logistic regression, rough morphology of MABC was associated to lower odds of clinical cure compared to smooth morphology (adjusted odds ratio, 0.12; P = .049).
CONCLUSIONS
Study participants with rough MABC colony morphology of isolates had a worse clinical outcome compared to those with smooth isolates. The biological mechanisms should be further characterized and colony morphology of MABC taken into account during clinical management.

Identifiants

pubmed: 36637124
pii: 6986912
doi: 10.1093/infdis/jiad007
pmc: PMC10043986
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Multicenter Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

820-827

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Déclaration de conflit d'intérêts

Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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Auteurs

Wilhelm Hedin (W)

Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.

Gabrielle Fröberg (G)

Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
Department of Medicine, Division of Infectious Diseases, Karolinska Institutet, Solna, Sweden.

Kalle Fredman (K)

Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Erja Chryssanthou (E)

Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.

Ingrid Selmeryd (I)

Department of Infectious Diseases, Västmanland Hospital, Västerås, Sweden.

Anna Gillman (A)

Department of Medical Sciences, Section for Infectious Diseases, Uppsala University, Uppsala, Sweden.

Letizia Orsini (L)

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.

Michael Runold (M)

Department of Medicine, Division of Respiratory Medicine and Allergology, Karolinska Institutet, Solna, Sweden.

Bodil Jönsson (B)

Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden.

Thomas Schön (T)

Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Department of Infectious Diseases, Region Östergötland and Kalmar County Hospital, Sweden.

Lina Davies Forsman (L)

Department of Medicine, Division of Infectious Diseases, Karolinska Institutet, Solna, Sweden.
Department of Infectious Diseases, Karolinska University Hospital, Solna, Sweden.

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Classifications MeSH