Bronchial Brushing and Diagnosis of Pulmonary Nontuberculous Mycobacteria Infection

Urabe, Naohisa; Sakamoto, Susumu; Ito, Atsushi; Sekiguchi, Ryo; Shimanuki, Yui; Kanokogi, Takumi; Motohashi, Takumi; Anzai, Nanami; Homma, Sakae; Kishi, Kazuma

doi:10.1159/000515605

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…Fourth, this study included patients with suspected NTM-PD for analysis. Several studies have revealed cases wherein bronchial brushing or washing and repeated culture failed to confirm NTM microbiologically; in some cases, physicians do not proceed with biopsy upon considering the associated risks [ 33 , 34 ]. Therefore, in this study, we included patients with suspected NTM based on CT findings.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis

Kim,

Lee,

Kim

et al. 2024

Korean J Intern Med

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Background/Aims: This study aimed to identify the clinical characteristics of patients with concurrent rheumatoid arthritis (RA) and suspected non-tuberculous mycobacterial (NTM) infections as well as determine their prognostic factors.Methods: We retrospectively reviewed the medical records of 91 patients with RA whose computed tomography (CT) findings suggested NTM infection. Subsequently, we compared the clinical characteristics between patients with and without clinical or radiological exacerbation of NTM-pulmonary disease (PD) and investigated the risk factors for the exacerbation and associated mortality.Results: The mean age of patients with RA and suspected NTM-PD was 65.0 ± 10.2 years. The nodular/bronchiectatic (NB) form of NTM-PD was the predominant radiographic feature (78.0%). During follow-up, 36 patients (41.9%) experienced a radiological or clinical exacerbation of NTM-PD, whereas 12 patients (13.2%) died. Combined interstitial lung disease (ILD), microbiologically confirmed NTM-PD, and NB with the fibrocavitary (FC) form on chest CT were identified as risk factors for the clinical or radiological exacerbation of NTM-PD. Hydroxychloroquine use was identified as a good prognostic factor. Conversely, history of tuberculosis, ILD, smoking, microbiologically confirmed NTM-PD, and NB with the FC form on chest CT were identified as poor prognostic factors for mortality in suspected NTM-PD.Conclusions: ILD and NB with the FC form on chest CT were associated with NTM-PD exacerbation and mortality. Hydroxychloroquine use may lower the risk of NTM-PD exacerbation. Therefore, radiographic features and presence of ILD should be considered when predicting the prognosis of patients with RA and suspected NTM-PD.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis

Kim,

Lee,

Kim

et al. 2024

Korean J Intern Med

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“…Chest high-resolution computed tomography (HRCT) score was reviewed as previously described [ 8 , 9 ]. We divided the lungs into 6 zones at the levels of the carina and inferior pulmonary vein.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease

et al. 2023

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Background In Mycobacterium avium complex pulmonary disease (MAC-PD), diagnosis requires a positive culture from at least two separate expectorated sputum specimens. The optimal number of sputum examinations remains unclear. Objective This study sought to elucidate the diagnostic yield of acid-fast bacilli in MAC-PD using 3 sputum specimens and to clarify the clinical characteristics of patients with MAC-PD diagnosed using 3 sputum specimens. Furthermore, we investigated the correlation between increased number of sputum specimens and diagnostic yield. Methods We reviewed the medical records of 139 patients with MAC-PD diagnosed at Toho University Omori Medical Center for whom at least three sputum specimens were examined before treatment from November 2014 through June 2021. Patients were classified into the 3-sputum diagnosed and the non-3 sputum diagnosed groups based on diagnostic procedure; clinical and radiological characteristics were compared. We also assessed diagnostic yield with the increased number of sputum specimens. Results Diagnostic yield with 3 sputum specimens was 16.5% (23/139). The 3-sputum diagnosed group had a lower body mass index [18.6(17–19.5) vs. 19.5(18–21.5); p = 0.014], and higher chest CT score [9(6.5–13) vs. 6(4–9); p = 0.011] including cavitary lesions (39.1% vs. 19%; p = 0.037) compared with the non-3 sputum diagnosed group. When the number of sputum specimens was increased to 6, the diagnostic yield increased to 23.7% (33/139). Conclusion Diagnostic yield with 3 sputum specimens was 16.5%. Patients diagnosed using 3 sputum specimens had more severe chest CT findings including cavitary lesions. Increasing the number of sputum specimens to 6 improved diagnostic yield by 7.2%.

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“…Table 1 shows the characteristics of all 153 patients. The 3-sputum diagnosed, and non-3 sputum diagnosed groups showed signi cant differences in vs. 19.4(18-21.4); p = 0.002], proportion of patients with MAC treatment history (20.7% vs. 6.5%; p = 0.028), CAT score [11.5(7-18) Chest high-resolution computed tomography (HRCT) score was reviewed as previously described [8,9].…”

Section: Clinical Characteristicsmentioning

confidence: 99%

Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease

Urabe

Sakamoto

Masuoka

et al. 2022

Preprint

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Background: In Mycobacterium avium complex pulmonary disease (MAC-PD), diagnosis requires a positive culture from at least two separate expectorated sputum specimens. The optimal number of sputum examinations remains unclear. Objective: This study sought to elucidate the diagnostic yield of acid-fast bacilli in MAC-PD using 3 sputum specimens and to clarify the clinical characteristics of patients with MAC-PD diagnosed using 3 sputum specimens. Furthermore, we investigated the correlation between increased number of sputum specimens and diagnostic yield. Methods: We reviewed the medical records of 153 patients with MAC-PD diagnosed at Toho University Omori Medical Center for whom at least three sputum specimens were examined before treatment from November 2014 through June 2021. Patients were classified into the 3-sputum diagnosed and the non-3 sputum diagnosed groups based on diagnostic procedure; clinical and radiological characteristics were compared. We also assessed diagnostic yield with the increased number of sputum specimens. Results: Diagnostic yield with 3 sputum specimens was 19% (29/153). The 3-sputum diagnosed group had a lower body mass index (18.0±2.3 vs. 19.7±3.0 kg/m2; p=0.002) and higher chest CT score (10.7±4.9 vs. 7.2±4.0; p=0.001) including cavitary lesions (51.7% vs 20.2%; p=0.002) compared with the non-3 sputum diagnosed group. When the number of sputum specimens was increased to 6, the diagnostic yield increased to 26.1% (40/153). Conclusion: Diagnostic yield with 3 sputum specimens was 19%. Patients diagnosed using 3 sputum specimens had more severe chest CT findings including cavitary lesions. Increasing the number of sputum specimens to 6 improved diagnostic yield by 7.1%.

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Bronchial Brushing and Diagnosis of Pulmonary Nontuberculous Mycobacteria Infection

Cited by 8 publications

References 22 publications

Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis

Clinical characteristics and prognostic factors of non-tuberculous mycobacterial disease in patients with rheumatoid arthritis

Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease

Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease

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