title: Characterizing Non-Tuberculous Mycobacteria Infection in Bronchiectasis.
abstract: Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease. This was a prospective, observational study enrolling 261 adult bronchiectasis patients during the stable state at the San Gerardo Hospital, Monza, Italy, from 2012 to 2015. Three groups were identified: pNTM disease; chronicP. aeruginosainfection; chronic infection due to bacteria other thanP. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronicP. aeruginosainfection, patients with pNTM were more likely to have cylindrical bronchiectasis and a "tree-in-bud" pattern, a history of weight loss, a lower disease severity and a lower number of pulmonary exacerbations. Among pNTM patients who started treatment, 68% showed a radiological improvement, and 37% achieved culture conversion without recurrence, while 21% showed NTM isolation recurrence. NTM isolation seems to be a frequent event in bronchiectasis patients, and few parameters might help to suspect NTM infection. Treatment indications and monitoring still remain an important area for future research.
authors.affiliation: Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy. paola.faverio@gmail.com.
authors.forename: Paola
authors.initials: P
authors.lastname: Faverio
authors.affiliation: Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy. annetta.stainer@gmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Stainer
authors.affiliation: Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy. giu28686@hotmail.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bonaiti
authors.affiliation: Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy. s.zucchetti2@campus.unimib.it.
authors.forename: Stefano C
authors.initials: SC
authors.lastname: Zucchetti
authors.affiliation: Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy. edo.simonetta@gmail.com.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Simonetta
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy. giuseppe.lapadula@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lapadula
authors.affiliation: Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy. almx@libero.it.
authors.forename: Almerico
authors.initials: A
authors.lastname: Marruchella
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy. andrea.gori@unimib.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gori
authors.affiliation: Department of Pathophysiology and Transplantation, University of Milan, Cardio-Thoracic Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy. francesco.blasi@unimi.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasi
authors.affiliation: Villa Marelli Institute, Niguarda Ca' Granda Hospital, 20122 Milan, Italy. luigiruffo.codecasa@ospedaleniguarda.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Codecasa
authors.affiliation: Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy. alberto.pesci@unimib.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Pesci
authors.affiliation: Scottish Centre for Respiratory Research, University of Dundee, Dundee DD1 9SY, UK. j.chalmers@dundee.ac.uk.
authors.forename: James D
authors.initials: JD
authors.lastname: Chalmers
authors.affiliation: Host Defence Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK Imperial College London, London SW3 6NP, UK. M.Loebinger@rbht.nhs.uk.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Loebinger
authors.affiliation: Department of Pathophysiology and Transplantation, University of Milan, Cardio-Thoracic Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy. stefano.aliberti@unimi.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Aliberti
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001987:Bronchiectasis / Q000150:complications* / Q000188:drug therapy / Q000821:virology*; D005260:Female; D006801:Humans; D008168:Lung / Q000821:virology; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000188:drug therapy / Q000821:virology*; D009170:Nontuberculous Mycobacteria / Q000187:drug effects / Q000821:virology*; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy / Q000821:virology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents
keywords: non-cystic fibrosis bronchiectasis; non-tuberculous mycobacteria; pulmonary infection