Mycobacterium abscessus complex infection is associated with poor treatment outcome

This study aimed to evaluate the factors associated with poor outcomes and the impact of Mycobacterium abscessus complex (MABC) infection in patients with pulmonary mycobacteriosis in Brazil.

This retrospective longitudinal study evaluated risk factors for death, treatment failure, or treatment default using multivariable logistic regression, and analyzed survival using Kaplan - Meier method.

MABC was identified as a major predictor of unfavorable results. The Kaplan-Meier analysis revealed that patients with MABC infection had a significantly lower probability of a successful outcome compared to those with other nontuberculous mycobacteria (NTM) species (p < 0.01), especially due to a considerably higher rate of treatment failure (p < 0.01). The multivariable regression confirmed that infection by MABC (OR 1.16, 95% CI 1.09-1.23), HIV infection (OR 1.13, 95% CI 1.05-1.21), having only 1 to 3 years of schooling (OR 1.17, 95% CI 1.08-1.26), renal disease (OR 1.32, 95% CI 1.08-1.62), alcohol abuse (OR 1.14, 95% CI 1.03-1.26), and illicit drug use (OR 1.21, 95% CI 1.03-1.41) were independent risk factors for a poor outcome.

The evidence shows that pulmonary infection by MABC, HIV co-infection, fewer years of schooling, renal disease, alcohol abuse and the use of illicit drugs are associated with poor outcomes.