Non-tuberculous micobacteria in the elderly. Multicentric study

Area of Science:

• Infectious Diseases
• Pulmonology
• Geriatrics

Background:

• Nontuberculous mycobacterial (NTM) pulmonary disease is a growing concern, especially in individuals with compromised lung health, weakened immune systems, and older age.
• Understanding the specific impact on the elderly population is crucial for public health initiatives.

Purpose of the Study:

• To investigate the incidence of NTM isolation and NTM pulmonary disease (NTM-PD) in adults aged 75 years and older.
• To characterize the clinical and radiological features of NTM-PD in this demographic.
• To evaluate treatment outcomes and compare them with younger patient groups.

Main Methods:

• A multicenter observational study combining retrospective (2012-2017) and prospective (2018-2020) data from five tertiary hospitals in northern Spain.
• Inclusion criteria encompassed all adult patients (≥18 years) with NTM isolated from respiratory samples, followed for two years.
• Data analysis focused on comparing incidence, clinical presentation, diagnostic methods, treatment patterns, and outcomes between older adults (>75 years) and younger individuals.

Main Results:

• Older adults (>75 years) represented 37% of the 594 patients studied, with 32% of NTM-PD cases occurring in this group.
• The incidence of NTM isolation (13.8/100,000) and NTM-PD (3.82/100,000) was significantly higher in older adults compared to younger individuals.
• Despite meeting disease criteria, older patients were less likely to undergo bronchoscopy, receive treatment, or present with cavitated forms, yet achieved similar cure rates.

Conclusions:

• Older adults demonstrate a higher incidence of NTM isolation and NTM pulmonary disease.
• Current diagnostic and therapeutic strategies for NTM-PD in the elderly appear less aggressive.
• Despite differences in management, cure rates for NTM-PD in older adults are not significantly compromised compared to younger patients.