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Implication of species change of Nontuberculous Mycobacteria during or after treatment

Cited 6 time in Web of Science Cited 6 time in Scopus
Authors
Lee, Jong Sik; Lee, Jong Hyuk; Yoon, Soon Ho; Kim, Taek Soo; Seong, Moon-Woo; Han, Sung Koo; Yim, Jae-Joon
Issue Date
2017-12-20
Publisher
BioMed Central
Citation
BMC Pulmonary Medicine, 17(1):213
Keywords
Nontuberculous mycobacteria species changeMycobacterium avium ComplexMycobacterium abscessus subspecies abscessusClarithromcycin resistance
Abstract
Background
Co-existence or subsequent isolation of multiple nontuberculous mycobacteria (NTM) species in same patient has been reported. However, clinical significance of these observations is unclear. The aim of this study was to determine clinical implications of changes of NTM species during or after treatment in patients with NTM lung disease.

Methods
Patients with NTM lung disease, who experienced changes of NTM species during treatment or within 2 years of treatment completion between January 1, 2009 and December 31, 2015, were included in the analysis. Demographic, clinical, microbiological, and radiographic data were reviewed and analyzed.

Results
During the study period, 473 patients were newly diagnosed with NTM lung disease. Treatment was started in 164 patients (34.6%). Among these 164 patients, 16 experienced changes of NTM species during or within 2 years of treatment completion. Seven showed changes from M. avium complex (MAC) to M. abscessus subspecies abscessus (MAA) and five patients displayed changes from M. abscessus subspecies massiliense (MAM) to MAC. With isolation of new NTM species, 6 out of 7 patients with change from MAC to MAA reported worsening of symptoms, whereas none of the five patients with change from MAM to MAC reported worsening of symptoms. All MAA isolated during or after treatment for MAC lung diseases showed inducible resistance to clarithromycin.

Conclusions
Change of NTM species may occur during or after treatment for NTM lung disease. Especially, changes from MAC to MAA is accompanied by symptomatic and radiographic worsening as well as inducible resistance to clarithromycin.
ISSN
1471-2466
Language
English
URI
https://hdl.handle.net/10371/138455
DOI
https://doi.org/10.1186/s12890-017-0539-7
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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