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Long-Term Outcomes in a Population-based Cohort with Respiratory Nontuberculous Mycobacteria Isolation
Emily Henkle1,2, Shannon A Novosad1, Sean Shafer2
11 OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon.
Annals of the American Thoracic Society
|April 14, 2017
Summary
Nontuberculous mycobacteria (NTM) respiratory infections often show persistent disease, with over half of patients exhibiting radiographic or microbiologic evidence of NTM at least two years post-isolation. Long-term outcomes remain poorly understood in the general population.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Microbiology
Background:
- The natural history of nontuberculous mycobacteria (NTM) respiratory infections in the general population is not well-characterized.
- Understanding long-term outcomes is crucial for managing NTM infections.
Purpose of the Study:
- To describe the long-term clinical, microbiologic, and radiographic outcomes of patients with respiratory NTM isolates.
- To assess the proportion of patients who develop persistent NTM disease.
Main Methods:
- A population-based cohort of patients with respiratory NTM isolation (2005-2006) was identified.
- Medical charts of patients alive in 2007 were reviewed for outcomes at 2-5 and 5+ years post-isolation.
- Disease persistence was defined by radiographic findings (infiltrate, nodules, cavities) or positive cultures.
Main Results:
- Of 172 included patients, 102 met NTM case criteria at baseline.
- Among baseline noncases, only 5.7% later met case criteria.
- At least 2 years post-isolation, 89% of cases alive had radiographic evidence and 49% had microbiologic evidence of persistent disease.
Conclusions:
- Long-term follow-up data for respiratory NTM isolation in the general population is limited.
- A significant proportion of patients with NTM isolation show persistent disease, evidenced by radiographic or microbiologic findings, even after two years.