High mortality in patients with Mycobacterium avium complex lung disease: a systematic review

Published on May 3, 2018in BMC Infectious Diseases3.09
· DOI :10.1186/S12879-018-3113-X
Roland Diel60
Estimated H-index: 60
,
Marc Lipman62
Estimated H-index: 62
(UCL: University College London),
Wouter Hoefsloot20
Estimated H-index: 20
Sources
Abstract
The incidence of nontuberculous mycobacterial (NTM) pulmonary disease caused by Mycobacterium avium complex (MAC) in apparently immune-competent people is increasing worldwide. We performed a systematic review of the published literature on five-year all-cause mortality in patients with MAC lung disease, and pooled the mortality rates to give an overall estimate of five-year mortality from these studies. We systematically reviewed the literature up to 1st August 2017 using PubMed® and ProQuest Dialog™ to search Medline® and Embase® databases, respectively. Eligible studies contained > 10 patients with MAC, and numerical five-year mortality data or a treatment evaluation for this patient group. Mortality data were extracted and analysed to determine a pooled estimate of all-cause mortality. Fourteen of 1035 identified studies, comprising 17 data sets with data from a total of 9035 patients, were eligible. The pooled estimate of five-year all-cause mortality was 27% (95% CI 21.3–37.8%). A high degree of heterogeneity was observed (I2 = 96%). The mortality in the data sets varied between 10 and 48%. Studies predominantly including patients with cavitary disease or greater comorbidity reported a higher risk of death. Patients in Asian studies tended to have a lower mortality risk. Predictors of mortality consistent across studies included male sex, presence of comorbidities and advanced patient age. Despite high heterogeneity, most studies in patients with MAC pulmonary disease document a five-year all-cause mortality exceeding 25%, indicating poor prognosis. These findings emphasise the need for more effective management and additional prospective mortality data collection.
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References31
Newest
#1Takanori Asakura (Keio: Keio University)H-Index: 14
#2Nobutaka HayakawaH-Index: 1
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view all 10 authors...
Background: Pulmonary resection along with multiple antimicrobial therapy has produced favorable outcomes at a few centers. However, little is known regarding the risk factors for long-term survival and microbiological recurrence after pulmonary resection for nontuberculous mycobacterial pulmonary disease (NTMPD). We evaluated the long-term outcomes of pulmonary resection, including microbiological recurrence and survival. Methods: This retrospective cohort study included 125 patients (median ag...
Source
#1Emily Henkle (OHSU: Oregon Health & Science University)H-Index: 12
#2Shannon A. Novosad (OHSU: Oregon Health & Science University)H-Index: 10
Last. Kevin L. Winthrop (OHSU: Oregon Health & Science University)H-Index: 72
view all 10 authors...
Rationale: The natural history of nontuberculous mycobacteria (NTM) respiratory infection in the general population is poorly understood.Objectives: To describe the long-term clinical, microbiologic, and radiographic outcomes of patients with respiratory NTM isolates.Methods: We previously identified a population-based cohort of patients with respiratory NTM isolation during 2005–2006 and categorized patients as cases or noncases using the American Thoracic Society/Infectious Diseases Society of...
Source
#1Shannon A. NovosadH-Index: 10
#2Emily HenkleH-Index: 12
Last. Kevin L. Winthrop (OHSU: Oregon Health & Science University)H-Index: 72
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Rationale: The mortality of patients with respiratory tract isolates of nontuberculous mycobacteria (NTM) and their risk factors for death are not well described.Objectives: To determine age-adjusted mortality rates for patients with respiratory NTM isolates and their causes of death and to examine whether American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) diagnostic criteria identify those at higher risk of death after NTM isolation.Methods: We linked vital records regi...
Source
Patients with Mycobacterium avium complex (MAC) lung disease (LD) have a heterogeneous prognosis. This study aimed to develop and validate a prognostic scoring model for these patients using independent risk factors for survival. We retrospectively analyzed the data of patients with MAC-LD from two hospitals (cohort 1, n = 368; cohort 2, n = 118). Cohort 1 was evaluated using a multivariate Cox proportional hazards model to identify independent risk factors for overall survival (OS). A prognosti...
Source
#1Roland DielH-Index: 60
#2Josephine Jacob (Elsevier)H-Index: 7
Last. Felix C. Ringshausen (MHH: Hannover Medical School)H-Index: 25
view all 7 authors...
The objective of this study was to estimate the burden of disease in incident patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD). A sample of 7 073 357 anonymised persons covered by German public statutory health insurances was used to identify patients with NTM-PD. In total, 125 patients with newly diagnosed NTM-PD in 2010 and 2011 were matched with 1250 control patients by age, sex and Charlson Comorbidity Index, and followed for 39 months. The incidence rate for NTM-PD was...
Source
#1Theodore K. Marras (U of T: University of Toronto)H-Index: 23
Last. Frances B. Jamieson (OHSU: Oregon Health & Science University)H-Index: 40
view all 10 authors...
: Survival implications of nontuberculous mycobacterial pulmonary disease (NTM-PD) and NTM pulmonary isolation without disease (NTM-PI) are unclear. To study deaths associated with NTM-PD and NTM-PI and differences in survival between them, we conducted a population-based cohort study of persons with microbiologically defined NTM-PD or NTM-PI diagnosed during 2001-2013 in Ontario, Canada. We used propensity score matching and Cox proportional hazards models to compare survival. Among 9,681 NTM-P...
Source
#1Jakko van Ingen (Radboud University Nijmegen)H-Index: 50
#2Dirk Wagner (University of Freiburg)H-Index: 40
Last. David E. Griffith (University of Texas Health Science Center at San Antonio)H-Index: 61
view all 10 authors...
Poor adherence to diagnosis and treatment guidelines for nontuberculous mycobacterial lung disease in EU and Japan http://ow.ly/EVYl306vVcN
Source
ABSTRACT Macrolide antibiotics are key components of the multidrug treatment regimen for treating lung disease (LD) due to Mycobacterium avium complex (MAC). Despite the emergence of macrolide resistance, limited data are available on macrolide-resistant MAC-LD. This study evaluated the clinical features and treatment outcomes of patients with macrolide-resistant MAC-LD and the molecular characteristics of the macrolide-resistant isolates. A retrospective review of the medical records of 34 pati...
Source
#1Man Wah YeungH-Index: 3
#2Edwin KhooH-Index: 6
Last. Beate SanderH-Index: 23
view all 10 authors...
Nontuberculous mycobacterial (NTM) infections are increasing in disease frequency worldwide. This systematic review examines health-related quality of life (HRQOL), comorbidities and mortality associated with pulmonary NTM disease. We searched MEDLINE, EMBASE, CINAHL, Scopus Life Sciences, conference proceedings and Google (earliest date available to February 2015) for primary studies. Eligible studies compared populations with and without pulmonary NTM disease in high-income jurisdictions. We e...
Source
#1Monika Fleshner (NIH: National Institutes of Health)H-Index: 85
#2Kenneth N. OlivierH-Index: 67
Last. D. R. Prevots (NIH: National Institutes of Health)H-Index: 2
view all 10 authors...
Tertiary referral center, National Institutes of Health (NIH), USA.To estimate the mortality rate and its correlates among persons with pulmonary non-tuberculous mycobacteria (PNTM) disease.A retrospective review of 106 patients who were treated at the NIH Clinical Center and met American Thoracic Society/Infectious Diseases Society of America criteria for PNTM. Eligible patients were aged ⩾18 years and did not have cystic fibrosis or human immunodeficiency virus (HIV) infection.Of 106 patients ...
Source
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Source
#1Eric C. Keen (WashU: Washington University in St. Louis)H-Index: 7
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Source
#1Jakko van Ingen (Radboud University Nijmegen)H-Index: 50
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Source
Nontuberculous mycobacterial (NTM) pulmonary disease is a chronic respiratory infection associated with declining lung function, radiological deterioration and significantly increased morbidity and mortality. Patients often have underlying lung conditions, particularly bronchiectasis and COPD. NTM pulmonary disease is difficult to treat because mycobacteria can evade host defences and antimicrobial therapy through extracellular persistence in biofilms and sequestration into macrophages. Manageme...
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BACKGROUND The incidence of nontuberculous mycobacterial (NTM) infections has been increasing worldwide, becoming a significant healthcare burden especially among elderly people. This study aimed to evaluate the trends in NTM-associated mortality in Japan. METHODS This study used vital statistics data and data on all NTM-associated deaths (N=18,814) among individuals aged ≥40 years in Japan from 1997 to 2016. We calculated the crude and age-adjusted mortality rates by age and sex and used joinpo...
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#1Rohini Mattoo (IISc: Indian Institute of Science)H-Index: 4
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#1Rosenbloom R (BU: Boston University)
#2Gavrish I (BU: Boston University)
Last. Nicholas A. Crossland (BU: Boston University)H-Index: 8
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Pulmonary infections caused by the group of nontuberculosis mycobacteria (NTM), Mycobacterium avium complex (MAC), are increasing worldwide and a growing public health concern. Pulmonary granulomas are the hallmark of MAC lung infection, yet reliable correlates of granuloma progression and susceptibility in immunocompetent hosts are poorly defined. The development of mouse models that recapitulate the diversity of granulomas seen in MAC pulmonary disease in humans is crucial to study mechanisms ...
Source
#1Yang Zhang (Edin.: University of Edinburgh)
#2Adam T. Hill (Edin.: University of Edinburgh)H-Index: 57
Introduction: Amikacin liposome inhalation suspension (ALIS) contains amikacin sulfate, an aminoglycoside antibacterial drug. It has been approved in the US as a combined antibiotic treatment for refractory MAC lung disease patients. ALIS, as an inhaled antibiotic, can deliver amikacin to the infected site effectively and reduce systemic toxicity.Areas covered: This article gives a summated review of the pharmacodynamics, pharmacokinetics, therapeutic efficacy, post-marketing surveillance, and r...
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#1Hyewon Lee (SCH: Soonchunhyang University)H-Index: 3
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BACKGROUND Population-based studies on the mortality burden of nontuberculous mycobacteria (NTM) infection are lacking. We compared the long-term mortality of NTM-infected patients with tuberculosis (TB)-patients and the general population, and investigated mortality-associated factors. METHODS We analyzed nationwide-data from the Korean National Health Insurance and Korea-Statistical Office between 2002 and 2017. NTM infection was identified using the International Classification of Disease, Te...
Source
#1Ahmad Mourad (Duke University)H-Index: 8
#2Arthur W Baker (Duke University)H-Index: 11
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Background Nontuberculous mycobacteria (NTM) are opportunistically pathogenic bacteria that are found abundantly in the soil and water. Susceptible individuals exposed to NTM-containing aerosols from environmental sources may develop NTM pulmonary disease (NTM-PD). Reported survival after NTM-PD diagnosis varies widely among existing studies. Prior work has suggested that mortality among persons with NTM-PD is primarily driven by comorbidities rather than NTM-PD. Methods We retrospectively ident...
Source
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