title: Non-tuberculous mycobacteria pulmonary infection: management and follow-up of 31 infected patients.
abstract: 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.
authors.affiliation: Pneumology Department, University Hospital, Amiens, 80054 Amiens Cedex 1, France. claire_ski2002@yahoo.fr
authors.forename: Claire
authors.initials: C
authors.lastname: Andréjak
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Lescure
authors.forename: Youcef
authors.initials: Y
authors.lastname: Douadi
authors.forename: Geneviève
authors.initials: G
authors.lastname: Laurans
authors.forename: Amar
authors.initials: A
authors.lastname: Smail
authors.forename: Pierre
authors.initials: P
authors.lastname: Duhaut
authors.forename: Vincent
authors.initials: V
authors.lastname: Jounieaux
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Schmit
mesh_terms: 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
chemical_list: D000995:Antitubercular Agents