Implication of species change of Nontuberculous Mycobacteria during or after treatment
Abstract Background Co-existence or subsequent isolation of multiple nontuberculous mycobacteria (NTM) species in same patient has been reported. However, clinical significance of these observations is unclear. The aim of this study was to determine clinical implications of changes of NTM species du...
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doaj-f37138ad76374ea2a5eb3dfa58d4dbcc2020-11-24T22:01:47ZengBMCBMC Pulmonary Medicine1471-24662017-12-011711710.1186/s12890-017-0539-7Implication of species change of Nontuberculous Mycobacteria during or after treatmentJong Sik Lee0Jong Hyuk Lee1Soon Ho Yoon2Taek Soo Kim3Moon-Woo Seong4Sung Koo Han5Jae-Joon Yim6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of MedicineDepartment of Radiology, Seoul National University College of MedicineDepartment of Radiology, Seoul National University College of MedicineDepartment of Laboratory Medicine, Seoul National University HospitalDepartment of Laboratory Medicine, Seoul National University HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of MedicineAbstract Background Co-existence or subsequent isolation of multiple nontuberculous mycobacteria (NTM) species in same patient has been reported. However, clinical significance of these observations is unclear. The aim of this study was to determine clinical implications of changes of NTM species during or after treatment in patients with NTM lung disease. Methods Patients with NTM lung disease, who experienced changes of NTM species during treatment or within 2 years of treatment completion between January 1, 2009 and December 31, 2015, were included in the analysis. Demographic, clinical, microbiological, and radiographic data were reviewed and analyzed. Results During the study period, 473 patients were newly diagnosed with NTM lung disease. Treatment was started in 164 patients (34.6%). Among these 164 patients, 16 experienced changes of NTM species during or within 2 years of treatment completion. Seven showed changes from M. avium complex (MAC) to M. abscessus subspecies abscessus (MAA) and five patients displayed changes from M. abscessus subspecies massiliense (MAM) to MAC. With isolation of new NTM species, 6 out of 7 patients with change from MAC to MAA reported worsening of symptoms, whereas none of the five patients with change from MAM to MAC reported worsening of symptoms. All MAA isolated during or after treatment for MAC lung diseases showed inducible resistance to clarithromycin. Conclusions Change of NTM species may occur during or after treatment for NTM lung disease. Especially, changes from MAC to MAA is accompanied by symptomatic and radiographic worsening as well as inducible resistance to clarithromycin.http://link.springer.com/article/10.1186/s12890-017-0539-7Nontuberculous mycobacteria species changeMycobacterium avium ComplexMycobacterium abscessus subspecies abscessusClarithromcycin resistance |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jong Sik Lee Jong Hyuk Lee Soon Ho Yoon Taek Soo Kim Moon-Woo Seong Sung Koo Han Jae-Joon Yim |
spellingShingle |
Jong Sik Lee Jong Hyuk Lee Soon Ho Yoon Taek Soo Kim Moon-Woo Seong Sung Koo Han Jae-Joon Yim Implication of species change of Nontuberculous Mycobacteria during or after treatment BMC Pulmonary Medicine Nontuberculous mycobacteria species change Mycobacterium avium Complex Mycobacterium abscessus subspecies abscessus Clarithromcycin resistance |
author_facet |
Jong Sik Lee Jong Hyuk Lee Soon Ho Yoon Taek Soo Kim Moon-Woo Seong Sung Koo Han Jae-Joon Yim |
author_sort |
Jong Sik Lee |
title |
Implication of species change of Nontuberculous Mycobacteria during or after treatment |
title_short |
Implication of species change of Nontuberculous Mycobacteria during or after treatment |
title_full |
Implication of species change of Nontuberculous Mycobacteria during or after treatment |
title_fullStr |
Implication of species change of Nontuberculous Mycobacteria during or after treatment |
title_full_unstemmed |
Implication of species change of Nontuberculous Mycobacteria during or after treatment |
title_sort |
implication of species change of nontuberculous mycobacteria during or after treatment |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2017-12-01 |
description |
Abstract Background Co-existence or subsequent isolation of multiple nontuberculous mycobacteria (NTM) species in same patient has been reported. However, clinical significance of these observations is unclear. The aim of this study was to determine clinical implications of changes of NTM species during or after treatment in patients with NTM lung disease. Methods Patients with NTM lung disease, who experienced changes of NTM species during treatment or within 2 years of treatment completion between January 1, 2009 and December 31, 2015, were included in the analysis. Demographic, clinical, microbiological, and radiographic data were reviewed and analyzed. Results During the study period, 473 patients were newly diagnosed with NTM lung disease. Treatment was started in 164 patients (34.6%). Among these 164 patients, 16 experienced changes of NTM species during or within 2 years of treatment completion. Seven showed changes from M. avium complex (MAC) to M. abscessus subspecies abscessus (MAA) and five patients displayed changes from M. abscessus subspecies massiliense (MAM) to MAC. With isolation of new NTM species, 6 out of 7 patients with change from MAC to MAA reported worsening of symptoms, whereas none of the five patients with change from MAM to MAC reported worsening of symptoms. All MAA isolated during or after treatment for MAC lung diseases showed inducible resistance to clarithromycin. Conclusions Change of NTM species may occur during or after treatment for NTM lung disease. Especially, changes from MAC to MAA is accompanied by symptomatic and radiographic worsening as well as inducible resistance to clarithromycin. |
topic |
Nontuberculous mycobacteria species change Mycobacterium avium Complex Mycobacterium abscessus subspecies abscessus Clarithromcycin resistance |
url |
http://link.springer.com/article/10.1186/s12890-017-0539-7 |
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