Lung infection with nontuberculous mycobacteria

C. Cano Rodríguez , E. Castañer González , M. Andreu Magarolas , X. Gallardo Cistare , A. González López , Ó. Cuevas Lobato , M. Gallego Díaz
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Abstract

Objective

To describe the epidemiology and CT findings for nontuberculous mycobacterial lung infections and outcomes depending on the treatment.

Material and methods

We retrospectively studied 131 consecutive patients with positive cultures for nontuberculous mycobacteria between 2005 and 2016. We selected those who met the criteria for nontuberculous mycobacterial lung infection. We analysed the epidemiologic data; clinical, microbiological, and radiological findings; treatment; and outcome according to treatment.

Results

We included 34 patients (mean age, 55 y; 67.6% men); 50% were immunodepressed (58.8% of these were HIV+), 20.6% had COPD, 5.9% had known tumors, 5.9% had cystic fibrosis, and 29.4% had no comorbidities. We found that 20.6% had a history of tuberculosis and 20.6% were also infected with other microorganisms. Mycobacterium avium complex was the most frequently isolated germ (52.9%); 7 (20.6%) were also infected with other organisms. The most common CT findings were nodules (64.7%), tree-in-bud pattern (61.8%), centrilobular nodules (44.1 %), consolidations (41.2%), bronchiectasis (35.3%), and cavities (32.4%). We compared findings between men and women and between immunodepressed and immunocompetent patients. Treatment was antituberculosis drugs in 67.6% of patients (72% of whom showed improvement) and conventional antibiotics in 20.6% (all of whom showed radiologic improvement).

Conclusion

The diagnosis of nontuberculous mycobacterial lung infections is complex. The clinical and radiologic findings are nonspecific and a significant percentage of pateints can have other, concomitant infections.

肺部感染非结核分枝杆菌。
目的:描述非结核分枝杆菌肺部感染的流行病学和CT表现以及根据治疗的结果。材料和方法:我们回顾性研究了2005年至2016年间131例非结核分枝杆菌培养呈阳性的连续患者。我们选择了符合非结核分枝杆菌肺部感染标准的患者。我们分析了流行病学数据;临床、微生物学和放射学检查结果;治疗以及根据治疗的结果。结果:我们包括34名患者(平均年龄55岁;67.6%为男性);50%的患者患有免疫抑制(其中58.8%为HIV/),20.6%患有COPD,5.9%患有已知肿瘤,5.9%具有囊性纤维化,29.4%没有合并症。我们发现20.6%的患者有肺结核病史,20.6%的人也感染了其他微生物。鸟分枝杆菌复合体是最常见的分离细菌(52.9%);7例(20.6%)也感染了其他生物。最常见的CT表现为结节(64.7%)、树芽型(61.8%)、小叶中心结节(44.1%)、实变(41.2%)、支气管扩张(35.3%)和空洞(32.4%)。67.6%的患者使用抗结核药物治疗(其中72%的患者病情好转),20.6%的患者使用常规抗生素治疗(所有患者的放射学表现均好转)。结论:非结核分枝杆菌肺部感染的诊断是复杂的。临床和放射学检查结果是非特异性的,很大一部分患者可能有其他伴随感染。
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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