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Pulmonary infection with nontuberculous mycobacteria
M A Contreras1, O T Cheung, D E Sanders
1Department of Medicine, University of Toronto, West Park Hospital, Ontario, Canada.
The American Review of Respiratory Disease
|January 1, 1988
Summary
Nontuberculous mycobacterial (NTM) infections cause chronic lung disease. This study highlights Mycobacterium xenopi as a significant pathogen in Ontario, despite treatment challenges and a notable mortality rate.
Area of Science:
- Pulmonology
- Infectious Diseases
- Microbiology
Background:
- Nontuberculous mycobacterial (NTM) infections are an emerging cause of chronic pulmonary disease.
- Preexisting lung conditions and alcohol abuse are common comorbidities in patients with NTM.
Purpose of the Study:
- To review the clinical, radiologic, and bacteriologic presentation of hospitalized NTM patients.
- To assess the prevalence of different NTM species and treatment outcomes.
- To identify the significance of Mycobacterium xenopi as a pulmonary pathogen.
Main Methods:
- Retrospective review of 89 adult patients hospitalized with NTM between 1981 and 1985.
- Analysis of clinical, radiologic, and bacteriologic data.
- Evaluation of treatment efficacy and patient outcomes.
Main Results:
- Mycobacterium avium complex was the most common NTM (51%), followed by Mycobacterium xenopi (38%) and Mycobacterium kansasii (9%).
- High rates of comorbidities, drug resistance, and toxicity limited treatment effectiveness.
- Mortality rate was 32% within 18 months; however, 29% of treated patients achieved bacteriologic conversion.
- Mycobacterium xenopi demonstrated distinct in vitro drug resistance patterns compared to other NTM.
Conclusions:
- Mycobacterium xenopi is an important cause of pulmonary NTM disease in southern Ontario.
- Treatment outcomes for NTM infections are often poor due to comorbidities and drug resistance.
- Despite challenges, bacteriologic conversion is achievable in a subset of treated patients.