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Int J Mol Sci ; 17(11)2016 Nov 16.
Article in English | MEDLINE | ID: mdl-27854334

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; chronic P. aeruginosa infection; chronic infection due to bacteria other than P. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronic P. aeruginosa infection, 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.


Subject(s)
Bronchiectasis/complications , Bronchiectasis/virology , Mycobacterium Infections, Nontuberculous/complications , Mycobacterium Infections, Nontuberculous/virology , Nontuberculous Mycobacteria/virology , Aged , Anti-Bacterial Agents/therapeutic use , Bronchiectasis/drug therapy , Female , Humans , Lung/virology , Male , Middle Aged , Mycobacterium Infections, Nontuberculous/drug therapy , Nontuberculous Mycobacteria/drug effects , Prospective Studies , Pseudomonas Infections/complications , Pseudomonas Infections/drug therapy , Pseudomonas Infections/virology , Pseudomonas aeruginosa/isolation & purification
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