The Impact of the 2007 ATS/IDSA Diagnostic Criteria for Nontuberculous Mycobacterial Disease on the Diagnosis of Nontuberculous Mycobacterial Lung Disease

Chae, Dong-Ryeol; Kim, Yu-Il; Kee, Seung‐Jung; Kim, Chongam; Chi, Su-Young; Ban, Hee Jung; Kwon, Yong Soo; Oh, In Jae; Kim, Kyu‐Sik; Soo-ock, Kim; Kim, Young‐Chul; Lim, Sung‐Chul

doi:10.1159/000320254

Cited by 17 publications

(8 citation statements)

References 31 publications

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“…The diagnostic rate may increase and time to diagnosis may shorten [16]. The diagnosis of pulmonary RGM disease in the present study was based on the latest guidelines of the ATS.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Disease Caused by Rapidly Growing Mycobacteria: A Retrospective Study of 44 Cases in Japan

Yano

Kitada²,

Mori³

et al. 2012

Respiration

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Background: The features of pulmonary disease caused by rapidly growing mycobacteria (RGM) have not been sufficiently documented. Objectives: To establish these features, we retrospectively evaluated 44 patients. Methods: We screened respiratory isolates at the National Toneyama Hospital (Osaka, Japan) between 2003 and 2007. Diagnosis was based on the latest guidelines of the American Thoracic Society. The patients were classified into 3 types according to their radiographic findings: fibrocavitary, nodular bronchiectatic and unclassified variant. Results: We obtained 1,348 nontuberculous mycobacteria respiratory isolates from 1,187 patients, including 119 RGM isolates from 100 patients. Forty-four of these 100 patients were definitively diagnosed with respiratory disease due to RGM. The most common pathogen was Mycobacteriumabscessus, which accounted for 65.9% of cases, followed by Mycobacterium fortuitum at 20.5%. There was a statistically significant difference in smoking history between patients infected with these 4 RGM species (excluding those with an unknown smoking history; p = 0.039). The overall evaluation of radiographic findings revealed 18.2% as fibrocavitary, 43.2% as nodular bronchiectatic and 38.6% as unclassified variants in these 44 patients. There was a significant difference in radiographic findings between the 4 RGM species (p = 0.002). There was also a significant difference in radiographic findings between M. abscessus and M. fortuitum infected patients (p = 0.022). Conclusions: Patients with M. abscessus seem to have less of a smoking history and more frequent nodular bronchiectatic radiographic patterns than patients with M. fortuitum. In contrast, fibrocavitary patterns might be more frequent with M. fortuitum infection.

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“…The diagnostic rate may increase and time to diagnosis may shorten [16]. The diagnosis of pulmonary RGM disease in the present study was based on the latest guidelines of the ATS.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Disease Caused by Rapidly Growing Mycobacteria: A Retrospective Study of 44 Cases in Japan

Yano

Kitada²,

Mori³

et al. 2012

Respiration

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“…In this most recent definition, the bacteriological criteria have been simplified from the 1997 ATS criteria, allowing a shorter period for the diagnosis of NTM lung disease and simplified diagnosis (8). The diagnosis of NTM lung disease required the presence of: 1) compatible respiratory symptoms; 2) compatible radiographic findings, nodular or cavity opacities on chest radiography, or multifocal bronchiectasis with or without multiple small nodules on high-resolution computed tomography; and 3) 2 positive sputum cultures or a single positive bronchial washing fluid culture.…”

Section: Methodsmentioning

confidence: 99%

Recovery Rates of Non-Tuberculous Mycobacteria from Clinical Specimens Are Increasing in Korean Tertiary-Care Hospitals

Kim

Chang

2017

J Korean Med Sci

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Non-tuberculous mycobacteria (NTM) are being recognized increasingly as the causative agents of opportunistic infections in humans. This study investigated the epidemiologic trends of NTM recovery from various clinical specimens in 2 Korean tertiary-care hospitals. We reviewed the laboratory records of patient samples cultured for mycobacteria between 2009 and 2015 at 2 tertiary-care hospitals in Korea. The medical records for patients with positive NTM samples were also reviewed. During the study period, 144,540 specimens were cultured for mycobacteria. The proportion of NTM-positive samples increased from 23.3% in 2009 to 48.2% in 2015. The 2 most frequently isolated NTM were Mycobacterium intracellulare (38.3%) and M. avium (23.1%). The number of clinically significant diseases caused by NTM in inpatients and outpatients increased from 6.8 to 12.9 per 100,000 patients over the same period. The rates of recovery of NTM from clinical specimens and the number of patients with NTM infections increased significantly (P < 0.001, testing for trend) between 2009 and 2015.

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“…Reported NTM disease prevalence in CF ranges from 4 [12] to 14 % [14] (Table 1). However, this may not be a true representation, as studies differed in NTM disease definition (i.e., some used the 1997 ATS criteria which required three positive respiratory cultures) [21] and none considered radiographic findings.…”

Section: Ntm Epidemiologymentioning

confidence: 99%

Nontuberculous Mycobacteria in Cystic Fibrosis

Skolnik

Kirkpatrick

Quon

2016

Curr Treat Options Infect Dis

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Opinion statementNontuberculous mycobacteria (NTM) are found in approximately 10 % of cystic fibrosis (CF) patients, but only a portion will develop NTM disease. The management of CF lung disease should be optimized, including antibiotic therapy targeted to the individual’s usual airway bacteria, prior to considering treatment for NTM lung disease. Those who meet criteria for NTM lung disease may not necessarily require treatment and could be monitored expectantly if symptoms and radiographic findings are minimal. However, the presence of Mycobacterium abscessus complex (MABSC), severe lung disease, and/or anticipated lung transplant should prompt NTM therapy initiation. For CF patients with Mycobacterium avium complex (MAC), recommended treatment includes triple antibiotic therapy with a macrolide, rifampin, and ethambutol. Azithromycin is generally our preferred macrolide in CF as it is better tolerated and has fewer drug-drug interactions. MABSC treatment is more complex and requires an induction phase (oral macrolide and two IV agents including amikacin) as well as a maintenance phase (nebulized amikacin and two to three oral antibiotics including a macrolide). The induction phase may range from one to three months (depending on infection severity, treatment response, and medication tolerability). For both MAC and MABSC, treatment duration is extended 1-year post-culture conversion. However, in patients who do not achieve culture negative status but tolerate therapy, we consider ongoing treatment for mycobacterial suppression and prevention of disease progression.

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The Impact of the 2007 ATS/IDSA Diagnostic Criteria for Nontuberculous Mycobacterial Disease on the Diagnosis of Nontuberculous Mycobacterial Lung Disease

Cited by 17 publications

References 31 publications

Pulmonary Disease Caused by Rapidly Growing Mycobacteria: A Retrospective Study of 44 Cases in Japan

Pulmonary Disease Caused by Rapidly Growing Mycobacteria: A Retrospective Study of 44 Cases in Japan

Recovery Rates of Non-Tuberculous Mycobacteria from Clinical Specimens Are Increasing in Korean Tertiary-Care Hospitals

Nontuberculous Mycobacteria in Cystic Fibrosis

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