Clinical Presentation, Microbiological Profile, Treatment Outcome, and Predictors of Outcome in Patients with Nontuberculous Mycobacteria Bloodstream Infection.

IF 1.5 Q4 INFECTIOUS DISEASES
International Journal of Mycobacteriology Pub Date : 2025-07-01 Epub Date: 2025-09-15 DOI:10.4103/ijmy.ijmy_107_25
Adarsh Joseph Philip, Joy Sarojini Michael, Amith Balachandran, Tina George, Nalini Newbigging, Anuka Alena Abraham, Thomas Isiah Sudarsan, Uday Kulkarni, Ramya Iyadurai
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Abstract

Background: Nontuberculous mycobacteria (NTM) are ubiquitous organisms with varied clinical syndromes. We conducted this study to identify the clinical spectrum, microbiological diagnosis, outcomes, and predictors of outcome in patients with NTM bloodstream infections (NTM BSIs).

Methods: This is a retrospective study of patients diagnosed with NTM BSI from January 2005 to December 2024. Poor outcomes were defined as patients who either expired or were lost to follow-up after being discharged against medical advice, subsequent to a poor prognosis.

Results: A total of 40 patients with NTM BSI were included. The median age was 43 years with male predominance (n = 25, 62.5%). Associated risk factors included human immunodeficiency virus (HIV) infection (n = 18, 45%) with a median CD4 count of 18 cells/mm3, diabetes mellitus (n = 7, 31.8%), and immunosuppressive medication use (n = 6, 27.3%). The spectrum of infections among HIV-negative patients (n = 22) were disseminated infection (n = 6), coronary stent infection (n = 5), infective endocarditis (n = 4), catheter-related BSI (n = 4), pacemaker lead infection (n = 1), aortic stent infection (n = 1), thecoperitoneal shunt infection (n = 1), and infected bedsore (n = 1). All HIV-positive patients presented with disseminated NTM infection. Poor outcome for NTM BSI was seen in 64.9% of patients. Among the rapid growers, Mycobacterium abscessus complex had the worst prognosis with a poor outcome in 71.4% of patients.

Conclusion: The spectrum of diseases associated with NTM BSI was either disseminated disease in an immunosuppressed host or infection secondary to nosocomial contamination of a catheter, implant, or stent. NTM BSI is associated with poor prognosis. This underscores the need for early diagnosis, appropriate antibiotic therapy, and adequate source control to improve clinical outcomes.

非结核分枝杆菌血流感染患者的临床表现、微生物学特征、治疗结果和预后预测因素。
背景:非结核分枝杆菌(NTM)是一种普遍存在的生物,具有多种临床症状。我们进行了这项研究,以确定NTM血流感染(NTM bsi)患者的临床谱、微生物学诊断、结局和结局预测因素。方法:回顾性研究2005年1月至2024年12月诊断为NTM BSI的患者。不良预后被定义为患者在不遵医嘱出院后,因预后不良而死亡或失去随访。结果:共纳入40例NTM BSI患者。中位年龄为43岁,男性为主(n = 25,占62.5%)。相关危险因素包括人类免疫缺陷病毒(HIV)感染(n = 18, 45%), CD4细胞中位数为18个/mm3,糖尿病(n = 7, 31.8%)和使用免疫抑制药物(n = 6, 27.3%)。hiv阴性患者(n = 22)的感染类型为弥散性感染(n = 6)、冠状动脉支架感染(n = 5)、感染性心内膜炎(n = 4)、导管相关性BSI (n = 4)、起搏器导联感染(n = 1)、主动脉支架感染(n = 1)、腹腔分流感染(n = 1)和感染性褥疮(n = 1)。所有hiv阳性患者均出现播散性NTM感染。64.9%的NTM BSI患者预后不良。在快速生长的患者中,71.4%的患者预后最差,预后不良。结论:与NTM BSI相关的疾病谱系要么是免疫抑制宿主的播散性疾病,要么是继发于医院导管、植入物或支架污染的感染。NTM BSI与预后不良相关。这强调了早期诊断、适当的抗生素治疗和充分的传染源控制的必要性,以改善临床结果。
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
2.20
自引率
25.00%
发文量
62
审稿时长
7 weeks
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