Anne-Laure Roux1, Emilie Catherinot2, Nathalie Soismier3, Beate Heym3, Gil Bellis4, Lydie Lemonnier5, Raphaël Chiron6, Brigitte Fauroux7, Muriel Le Bourgeois8, Anne Munck9, Isabelle Pin10, Isabelle Sermet8, Cristina Gutierrez11, Nicolas Véziris12, Vincent Jarlier12, Emmanuelle Cambau13, Jean-Louis Herrmann14, Didier Guillemot15, Jean-Louis Gaillard16. 1. EA3647, UFR des Sciences de la Santé Simone Veil, Université de Versailles Saint Quentin en Yvelines (UVSQ), Guyancourt, France; Laboratoire de Microbiologie, Hôpital Raymond Poincaré, Assistance Publique Hôpitaux de Paris (AP-HP), Garches, France. Electronic address: anne-laure.roux@rpc.aphp.fr. 2. EA3647, UFR des Sciences de la Santé Simone Veil, Université de Versailles Saint Quentin en Yvelines (UVSQ), Guyancourt, France; Service de Pneumologie, Hôpital Foch, Suresnes, France. 3. EA3647, UFR des Sciences de la Santé Simone Veil, Université de Versailles Saint Quentin en Yvelines (UVSQ), Guyancourt, France; Laboratoire de Microbiologie, Hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France. 4. Institut National d'Etudes Démographiques, Paris, France. 5. Association Vaincre La Mucoviscidose, Paris, France. 6. Centre de Ressources et de Compétences en Mucoviscidose, Hôpital Arnaud de Villeneuve, Montpellier, France. 7. Service de Pneumologie Pédiatrique, Hôpital Armand Trousseau, AP-HP et INSERM U955, Paris, France. 8. Service de Pneumologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France. 9. Service de Gastro-entérologie-mucoviscidose et nutrition pédiatriques, Hôpital Robert Debré, AP-HP, Paris, France. 10. Service de Pneumologie Pédiatrique, CHU Grenoble, Grenoble, France. 11. Département Infection et Epidémiologie, Institut Pasteur, Paris, France. 12. Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France; Laboratoire de Bactériologie, UPMC, Paris, France. 13. Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France; Laboratoire de Bactériologie, Hôpitaux universitaires Lariboisière-Saint Louis, AP-HP, Paris, France. 14. EA3647, UFR des Sciences de la Santé Simone Veil, Université de Versailles Saint Quentin en Yvelines (UVSQ), Guyancourt, France; Laboratoire de Microbiologie, Hôpital Raymond Poincaré, Assistance Publique Hôpitaux de Paris (AP-HP), Garches, France. 15. INSERM U 657, Paris, France; PhEMI, Institut Pasteur, Paris, France; RISE, UFR des Sciences de la Santé Simone Veil, Université de Versailles Saint Quentin en Yvelines (UVSQ), Guyancourt, France. 16. EA3647, UFR des Sciences de la Santé Simone Veil, Université de Versailles Saint Quentin en Yvelines (UVSQ), Guyancourt, France; Laboratoire de Microbiologie, Hôpital Raymond Poincaré, Assistance Publique Hôpitaux de Paris (AP-HP), Garches, France; Laboratoire de Microbiologie, Hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France.
Abstract
BACKGROUND: Mycobacterium massiliense is closely related to Mycobacterium abscessus and is also a frequent cause of mycobacterial lung disease in patients with cystic fibrosis (CF). There has been no previous investigation of possible differences between M. massiliense and M. abscessus infections in the setting of CF. METHODS: We studied a prospective cohort of 16 M. massiliense and 27 M. abscessus lung infection cases with CF, with a mean follow-up of 6 years. RESULTS: M. massiliense cases were younger than M. abscessus cases (mean age: 12.8 vs 17.1 years; p=0.02) at the time of the first mycobacterial isolation and also had lower body mass index values (mean: 16.4 vs 19.3 kg/m(2), p=0.002). All M. massiliense cases, except one, had negative BMI Z-score values at the time of the first mycobacterial isolation (11/12 vs 16/23 M. abscessus cases, p=0.04). Clarithromycin-based combination therapies led to mycobacterial eradication in 100% of M. massiliense cases but only in 27% of M. abscessus cases (p=0.009). CONCLUSION: Our data show a particular link between M. massiliense and malnutrition specifically in CF patients. Unlike M. abscessus, the bacteriological response of M. massiliense to combination antibiotic therapies containing clarithromycin was excellent. Distinguishing between M. massiliense and M. abscessus has major clinical implications for CF patients.
BACKGROUND:Mycobacterium massiliense is closely related to Mycobacterium abscessus and is also a frequent cause of mycobacterial lung disease in patients with cystic fibrosis (CF). There has been no previous investigation of possible differences between M. massiliense and M. abscessus infections in the setting of CF. METHODS: We studied a prospective cohort of 16 M. massiliense and 27 M. abscessus lung infection cases with CF, with a mean follow-up of 6 years. RESULTS:M. massiliense cases were younger than M. abscessus cases (mean age: 12.8 vs 17.1 years; p=0.02) at the time of the first mycobacterial isolation and also had lower body mass index values (mean: 16.4 vs 19.3 kg/m(2), p=0.002). All M. massiliense cases, except one, had negative BMI Z-score values at the time of the first mycobacterial isolation (11/12 vs 16/23 M. abscessus cases, p=0.04). Clarithromycin-based combination therapies led to mycobacterial eradication in 100% of M. massiliense cases but only in 27% of M. abscessus cases (p=0.009). CONCLUSION: Our data show a particular link between M. massiliense and malnutrition specifically in CFpatients. Unlike M. abscessus, the bacteriological response of M. massiliense to combination antibiotic therapies containing clarithromycin was excellent. Distinguishing between M. massiliense and M. abscessus has major clinical implications for CFpatients.