title: Clinical features and outcomes of disseminated infections caused by non-tuberculous mycobacteria in a university hospital in Taiwan, 2004-2008.
abstract: This retrospective study investigated the clinical characteristics and prognostic factors of patients with disseminated infections caused by non-tuberculous mycobacteria (NTM) in Taiwan. Forty patients who fulfilled the criteria for disseminated NTM infection at a medical centre from January 2004 to December 2008 were analyzed. More than half of the patients (n = 22, 55%) were HIV-infected and fever was the most common initial presentation (n = 21, 52.5%). There were 13 episodes of co-infection with other bacterial pathogens in 11 patients (30%). The most common site of NTM isolation from culture was blood (62.5%), followed by respiratory tract (52.5%). Mycobacterium avium complex was the most common species (70%). The overall mortality rate due to disseminated NTM infection was 30%. Univariate survival analysis showed significantly higher mortality rates in female patients, patients without anti-NTM treatment and patients co-infected with other bacterial pathogens. Multivariate analysis showed that lack of anti-NTM treatment was the only prognostic factor for a poor outcome (p = 0.001). In conclusion, maintaining a high level of suspicion and starting appropriate anti-NTM treatment promptly after diagnosis are crucial to improve outcome in patients with disseminated NTM infection.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan.
authors.forename: Chien-Hong
authors.initials: CH
authors.lastname: Chou
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Chen
authors.forename: Chung-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Huang
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Lai
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001769:Blood / Q000382:microbiology; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000150:complications; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology*; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D012137:Respiratory System / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents