Non-tuberculous mycobacteria pulmonary infection: management and follow-up of 31 infected patients.
BACKGROUND
The global number of non-tuberculous mycobacteria (NTM) pulmonary infections is increasing. Treatment decisions and management are difficult and the prognosis of these infections has been rarely evaluated.


METHODS
The aim of this study was to evaluate management and prognosis of patients with NTM pulmonary infection in a French teaching hospital. In this study, we evaluated management of patients satisfying the ATS (American Thoracic Society) criteria for NTM pulmonary infection in Amiens hospital from 1992 to 2002 and retrospectively compared this management to ATS guidelines. Short-term and long-term survival was also described.


RESULTS
Thirty-one patients satisfying the ATS criteria for NTM pulmonary infection were included: 15 patients were infected with Mycobacterium xenopi, nine with Mycobacterium avium intracellulare, four with Mycobacterium kansasii and three patients were infected with rapidly growing mycobacteria. Twenty-seven patients had past or concomitant diseases responsible for local or systemic immunosuppression. Eleven patients were not treated. In the 20 treated patients, 13 different antibiotic combinations were used, often comprising three or more drugs. The median survival was 15 months. Twenty-one patients (67%) died before 5 years of follow-up. Thirty per cent of deaths were attributed to NTM pulmonary infection. Adjusting treatment to the results of susceptibility tests or ATS guidelines was not associated with any significant difference in survival.


CONCLUSIONS
As the high mortality rate may be related to concomitant diseases, management of NTM pulmonary infection also depends on comorbidities, and should be defined according to the severity of underlying diseases.
Andréjak
Claire
C
Pneumology Department, University Hospital, Amiens, 80054 Amiens Cedex 1, France. claire_ski2002@yahoo.fr
Lescure
François-Xavier
FX
Douadi
Youcef
Y
Laurans
Geneviève
G
Smail
Amar
A
Duhaut
Pierre
P
Jounieaux
Vincent
V
Schmit
Jean-Luc
JL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D005602:France; D006784:Hospitals, Teaching; D006801:Humans; D008168:Lung; D008297:Male; D008875:Middle Aged; D009161:Mycobacterium / Q000302:isolation & purification; D009164:Mycobacterium Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D015269:Mycobacterium avium Complex / Q000302:isolation & purification*; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D019909:Mycobacterium kansasii / Q000302:isolation & purification*; D019912:Mycobacterium xenopi / Q000302:isolation & purification*; D011379:Prognosis; D015996:Survival Rate; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality
D000995:Antitubercular Agents