Long-term clinical course of Mycobacterium avium complex pulmonary disease patients with treatment failure.

IF 4.1 2区 医学 Q2 MICROBIOLOGY
Antimicrobial Agents and Chemotherapy Pub Date : 2024-12-05 Epub Date: 2024-10-29 DOI:10.1128/aac.01055-24
Sungmin Zo, Junsu Choe, Dae Hun Kim, Su-Young Kim, Byung Woo Jhun
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引用次数: 0

Abstract

Despite guideline-based therapy, some patients with Mycobacterium avium complex pulmonary disease (MAC-PD) experience treatment failure. We analyzed the clinical courses of 271 patients with treatment-refractory MAC-PD who discontinued therapy after at least 12 months. Patients were categorized into two groups-the retreatment group, who resumed antibiotics due to clinical or radiological deterioration, and the stable group, who did not require antibiotics. Of the study patients, 138 (51%) were in the retreatment group, whereas 133 (49%) were in the stable group. In the multivariate analysis models, an elevated erythrocyte sedimentation rate (adjusted hazard ratio [aHR] =1.01), the presence of a cavity (aHR = 1.75), and the number of lobes affected by bronchiectasis (aHR = 1.21) were associated with the need for retreatment. Our data indicated that approximately 50% of the patients with refractory MAC-PD who discontinued antibiotics eventually required retreatment, which was influenced by the extent of lung destruction or inflammation. These findings can aid in determining treatment strategies for patients with refractory diseases.

治疗失败的复合分枝杆菌肺病患者的长期临床病程。
尽管按照指南进行了治疗,但仍有一些复合分枝杆菌肺病(MAC-PD)患者治疗失败。我们分析了 271 例至少在 12 个月后停止治疗的难治性 MAC-PD 患者的临床病程。患者被分为两组--因临床或放射学恶化而重新使用抗生素的再治疗组和无需使用抗生素的稳定组。在研究患者中,138 人(51%)属于再治疗组,133 人(49%)属于稳定组。在多变量分析模型中,红细胞沉降率升高(调整后危险比 [aHR] =1.01)、存在空洞(aHR =1.75)和受支气管扩张影响的肺叶数(aHR =1.21)与需要再治疗有关。我们的数据表明,在停用抗生素的难治性 MAC-PD 患者中,约有 50% 最终需要进行再治疗,这与肺部破坏或炎症的程度有关。这些发现有助于确定难治性疾病患者的治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
10.00
自引率
8.20%
发文量
762
审稿时长
3 months
期刊介绍: Antimicrobial Agents and Chemotherapy (AAC) features interdisciplinary studies that build our understanding of the underlying mechanisms and therapeutic applications of antimicrobial and antiparasitic agents and chemotherapy.
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