Won-Jung Koh1, Byeong-Ho Jeong2, Kyeongman Jeon2, Nam Yong Lee3, Kyung Soo Lee4, Sook Young Woo5, Sung Jae Shin6, O Jung Kwon2. 1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Seoul, South Korea. Electronic address: wjkoh@skku.edu. 2. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Seoul, South Korea. 3. Department of Laboratory Medicine, Seoul, South Korea. 4. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 5. Biostatistics Team, Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, South Korea. 6. Department of Microbiology, Yonsei University College of Medicine, Seoul, South Korea.
Abstract
BACKGROUND: Mycobacterium avium and Mycobacterium intracellulare are grouped together as the M avium complex; however, little is known about the clinical impact of this species differentiation. This study compared the clinical features and prognoses of patients with M avium and M intracellulare lung disease. METHODS: From 2000 to 2009, 590 patients were given a new diagnosis of M avium complex lung disease; 323 (55%) had M avium lung disease, and 267 (45%) had M intracellulare lung disease. RESULTS: Compared with the patients with M avium lung disease, the patients with M intracellulare lung disease were more likely to have the following characteristics: older age (64 vs 59 years, P = .002), a lower BMI (19.5 kg/m² vs 20.6 kg/m², P < .001), respiratory symptoms such as cough (84% vs 74%, P = .005), a history of previous treatment for TB (51% vs 31%, P < .001), the fibrocavitary form of the disease (26% vs 13%, P < .001), smear-positive sputum (56% vs 38%, P < .001), antibiotic therapy during the 24 months of follow-up (58% vs 42%, P < .001), and an unfavorable microbiologic response after combination antibiotic treatment (56% vs 74%, P = .001). CONCLUSIONS: Patients with M intracellulare lung disease exhibited a more severe presentation and had a worse prognosis than patients with M avium lung disease in terms of disease progression and treatment response. Therefore, species differentiation between M avium and M intracellulare may have prognostic and therapeutic implications.
BACKGROUND:Mycobacterium avium and Mycobacterium intracellulare are grouped together as the M avium complex; however, little is known about the clinical impact of this species differentiation. This study compared the clinical features and prognoses of patients with M avium and M intracellularelung disease. METHODS: From 2000 to 2009, 590 patients were given a new diagnosis of M avium complexlung disease; 323 (55%) had M aviumlung disease, and 267 (45%) had M intracellularelung disease. RESULTS: Compared with the patients with M aviumlung disease, the patients with M intracellularelung disease were more likely to have the following characteristics: older age (64 vs 59 years, P = .002), a lower BMI (19.5 kg/m² vs 20.6 kg/m², P < .001), respiratory symptoms such as cough (84% vs 74%, P = .005), a history of previous treatment for TB (51% vs 31%, P < .001), the fibrocavitary form of the disease (26% vs 13%, P < .001), smear-positive sputum (56% vs 38%, P < .001), antibiotic therapy during the 24 months of follow-up (58% vs 42%, P < .001), and an unfavorable microbiologic response after combination antibiotic treatment (56% vs 74%, P = .001). CONCLUSIONS:Patients with M intracellularelung disease exhibited a more severe presentation and had a worse prognosis than patients with M aviumlung disease in terms of disease progression and treatment response. Therefore, species differentiation between M avium and M intracellulare may have prognostic and therapeutic implications.
Authors: Richard J Wallace; Elena Iakhiaeva; Myra D Williams; Barbara A Brown-Elliott; Sruthi Vasireddy; Ravikiran Vasireddy; Leah Lande; Donald D Peterson; Janet Sawicki; Rebecca Kwait; Wellington S Tichenor; Christine Turenne; Joseph O Falkinham Journal: J Clin Microbiol Date: 2013-03-27 Impact factor: 5.948