Nontuberculous mycobacteria in bronchiectasis: Prevalence and patient characteristics.
The aim of the current study was to investigate the prevalence and clinical associations of nontuberculous mycobacteria (NTM) in a well-characterised cohort of patients with adult-onset bronchiectasis. The sputum of all patients attending a tertiary referral bronchiectasis clinic between April 2002 and August 2003 was examined for mycobacteria as part of an extensive diagnostic work-up. NTM-positive patients subsequently had further sputa examined. A modified bronchiectasis scoring system was applied to all high-resolution computed tomography (HRCT) scans from NTM-positive patients, and a matched cohort without NTM. Out of 98 patients attending the clinic, 10 had NTM in their sputum on first culture; of those, eight provided multiple positive cultures. Three patients were treated for NTM infection. A higher proportion of NTM-positive than -negative patients were subsequently diagnosed with cystic fibrosis (two out of nine versus two out of 75). On HRCT scoring, more patients in the NTM-positive group had peripheral mucus plugging than in the NTM-negative group. In the current prospective study of a large cohort of patients with bronchiectasis, 10% cultured positive for nontuberculous mycobacteria in a random clinic sputum sample. Few clinical parameters were helpful in discriminating between groups, except for a higher prevalence of previously undiagnosed cystic fibrosis and of peripheral mucus plugging on high-resolution computed tomography in the nontuberculous mycobacteria group.
Fowler
S J
SJ
Lung Defence Clinic, Cambridge, UK. stephen.fowler@lthtr.nhs.uk
French
J
J
Screaton
N J
NJ
Foweraker
J
J
Condliffe
A
A
Haworth
C S
CS
Exley
A R
AR
Bilton
D
D
D000368:Aged; D000369:Aged, 80 and over; D001987:Bronchiectasis / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology*; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000235:genetics; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D009164:Mycobacterium Infections / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000503:physiopathology; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D015995:Prevalence; D011446:Prospective Studies; D013183:Sputum / Q000382:microbiology; D036542:Tomography, Spiral Computed / Q000379:methods; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology
D019005:Cystic Fibrosis Transmembrane Conductance Regulator