title: Non-tuberculous mycobacterial bloodstream infections in patients with indwelling vascular catheters - the role of sickle cell anaemia.
abstract: BACKGROUND
  Few studies have examined risk factors for nontuberculous mycobacteria (NTM) bloodstream infections (BSI) involving indwelling vascular catheters (IDVC). Sickle cell anaemia (HbSS/SC) is known to affect several aspects of the immune system leading to relative immune deficiency. The purpose of this retrospective nested case-control study was to determine if HbSS/SC is a risk factor for NTM BSI among individuals with IDVCs.
  
  
  METHODS
  All NTM IDVC infections (cases) at two tertiary hospitals from 2008 to 2014 were reviewed. Cases were matched 2:1 with controls who had IDVC infections due to organisms other than NTM. Matching criteria included age within 10 years and IDVC infection within three months of index case. Logistic regression was used to identify risk factors for IDVC infection due to NTM.
  
  
  RESULTS
  Nineteen NTM BSIs were identified. Three cases were excluded because they did not have IDVCs at the time their BSI was identified. Sixteen cases of NTM IDVC infection were matched to 32 controls with IDVC infections due to other organisms. The mean age of patients with IDVC infections was 48.5 years and 28 (58%) were male. Compared to the control group those with NTM BSI were more likely to have HbSS/SC 38% (6/16) versus 6% (2/32) (p = .006).
  
  
  CONCLUSIONS
  IDVCs are a risk factor for NTM BSI. Sickle cell anaemia appears to be a risk factor for IDVC infections due to NTM. This study is limited by the small sample size. A larger study is needed to further investigate the association between HbSS/SC and NTM IDVC infections.
authors.affiliation: a Department of Medicine, Division of Infectious Diseases , University of South Carolina , Columbia , SC , USA.
authors.forename: Babatunde
authors.initials: B
authors.lastname: Edun
authors.affiliation: a Department of Medicine, Division of Infectious Diseases , University of South Carolina , Columbia , SC , USA.
authors.forename: Ansal
authors.initials: A
authors.lastname: Shah
authors.affiliation: b Department of Medicine, Palmetto Health Richland Hospital , Columbia , SC , USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Durkin
authors.affiliation: c Department of Internal Medicine , University of South Carolina School of Medicine , Columbia , SC , USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Whitmire
authors.affiliation: b Department of Medicine, Palmetto Health Richland Hospital , Columbia , SC , USA.
authors.forename: Shanetta Patterson
authors.initials: SP
authors.lastname: Williams
authors.affiliation: a Department of Medicine, Division of Infectious Diseases , University of South Carolina , Columbia , SC , USA.
authors.forename: Helmut
authors.initials: H
authors.lastname: Albrecht
authors.affiliation: a Department of Medicine, Division of Infectious Diseases , University of South Carolina , Columbia , SC , USA.
authors.forename: Majdi
authors.initials: M
authors.lastname: Al-Hasan
authors.affiliation: a Department of Medicine, Division of Infectious Diseases , University of South Carolina , Columbia , SC , USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Weissman
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications*; D016470:Bacteremia / Q000453:epidemiology*; D016022:Case-Control Studies; D055499:Catheter-Related Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D012189:Retrospective Studies; D018570:Risk Assessment; D062666:Vascular Access Devices / Q000009:adverse effects*
keywords: Bloodstream infection; nontuberculous mycobacteria; sickle cell anaemia