title: Risk factors for nontuberculous mycobacterial infections in solid organ transplant recipients: a case-control study.
abstract: BACKGROUND
  The epidemiology of nontuberculous mycobacteria (NTM) disease in solid organ transplant recipients is poorly defined.
  
  
  METHODS
  We identified all solid organ transplant recipients with NTM disease at a single center over a 7.5-year period, and collected data on patient demographics, co-morbidities, immunosuppressive medications, and rejection. We conducted a case-control study to identify risk factors for disease, matching 3 control patients to each case patient by date of transplantation.
  
  
  RESULTS
  A total of 34 cases of NTM disease occurred during the study period, involving 6 single lung, 13 bilateral lung, 8 heart, 4 liver, 2 kidney, and 1 pancreas-kidney recipients. Cases were predominantly male (24/34), with a median age of 55 years (interquartile range [IQR]: 46-61 years), and developed after a median of 8 months post transplantation (IQR: 2-87 months). Mycobacterium abscessus and Mycobacterium avium complex were the most common pathogens, and the lung (including pleura) was the most common site of disease. In the adjusted case-control analysis, lung transplant recipients had the highest risk of NTM disease.
  
  
  CONCLUSIONS
  Additional studies are needed to evaluate the role of targeted surveillance measures for NTM disease in high-risk patients, particularly lung transplant recipients, and to characterize the mechanisms of disease acquisition.
authors.affiliation: Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Longworth
authors.forename: C
authors.initials: C
authors.lastname: Vinnard
authors.forename: I
authors.initials: I
authors.lastname: Lee
authors.forename: K D
authors.initials: KD
authors.lastname: Sims
authors.forename: T D
authors.initials: TD
authors.lastname: Barton
authors.forename: E A
authors.initials: EA
authors.lastname: Blumberg
mesh_terms: D000367:Age Factors; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D016031:Liver Transplantation; D016015:Logistic Models; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000453:epidemiology* / Q000276:immunology; D019909:Mycobacterium kansasii / Q000302:isolation & purification; D019910:Mycobacterium marinum / Q000302:isolation & purification; D016377:Organ Transplantation; D016035:Pancreas Transplantation; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology
chemical_list: D007166:Immunosuppressive Agents
keywords: NTM; epidemiology; mycobacteria; nontuberculous; risk factors; solid organ transplant