The Impact of Nontuberculous Mycobacteria Species on Mortality in Patients With Nontuberculous Mycobacterial Lung Disease

Abstract

Patients with nontuberculous mycobacterial lung disease (NTM-LD) have increased mortality. The impact of NTM species on the risk of mortality remains unclear, especially that of death by non-cancer causes. We conducted a retrospective cohort study from 2006 to 2018 in a tertiary-care hospital in Taiwan. We enrolled patients who fulfilled the microbiological diagnostic criteria of NTM-LD. The mortality causes within 8 years after diagnosis were identified, and the Cox proportional hazard regression was performed for risk factors of mortality. A total of 1,652 subjects with NTM-LD were included. Among them, 723 (43.8%) were infected by Mycobacterium avium complex (MAC), 408 (24.7%) by M. abscessus complex (MABC), 120 (7.3%) by Mycobacterium kansasii (MK), 304 (18.4%) by other rapid-growing mycobacteria (RGM), and 97 (5.9%) by other slow-growing mycobacteria (SGM) groups. The 8-year all-cause mortality was 45.2% for all and the highest in the MK-LD group (59.2%), followed by the MABC-LD and MAC-LD groups. The adjusted hazard ratios were 2.20 (95% confidence interval: 1.40–3.46) in the MK-LD, 1.85 (1.54–2.22) in the MABC-LD, and 1.65 (1.12–2.41) in the MAC-LD groups for all-cause mortality, compared with the SGM group. Kaplan–Meier survival curves showed that all-cause mortality, non-cancer mortality, and mortality due to chronic airway diseases were significantly correlated with NTM species (log-rank p = 0.0031, < 0.001, and 0.001, respectively). High 8-year mortality rates were found in patients with NTM-LDs according to different NTM species. Notably, the difference was significant in non-cancer mortality causes, especially in chronic airway diseases.

PulmonaryMycobacterium abscessusinfection treated in combination with inhaled tigecycline

“…More than 190 non-tuberculous mycobacteria (NTM) species have been identified and the incidence is increasing globally, ranging from 15.2/100 000 to 41.3/100 000 (USA and Canada) 1 2. The mortality is high (35.3%),3 and the morbidity is significant 4. The microbiological cure rate is as low as 45% 5…”

Presence of indicator bacteria, Shiga toxin-producing Escherichia coli, and nontuberculous mycobacteria in oregano

“…The incidence of NTM diseases is increasing worldwide (Kendall & Winthrop, 2013); for example, in the United States, the prevalence of NTM diseases has been rising from 8.2 per 100,000 persons in 1994 to 16 per 100,000 persons in 2014 (Donohue, 2018). Moreover, recently, Wang et al (2022) reported that patients with NTM lung disease in Taiwan have increased mortality. While it has long been known that aquatic environments are a source of NTM that can infect people and animals, there is still insufficient knowledge of the ecology and sources of human exposure to many NTM species (Pavlik et al, 2022b).…”

Rapid and Accurate Discrimination of Mycobacterium abscessus Subspecies Based on Matrix-Assisted Laser Desorption Ionization-Time of Flight Spectrum and Machine Learning Algorithms

“…Nontuberculous mycobacterial (NTM) infection has become an emerging crisis worldwide due to its rising mortality rates of up to 45% [1][2][3]. In most countries, M. abscessus complex (MABC) is one of the predominant NTM species in Taiwan, secondary to Mycobacterium avium complex [4,5].…”