Risk factors of pulmonary non-tuberculous mycobacterial infection in 489 patients with sputum acid-fast bacilli positive and/or mycobacteria culture positive / 中华传染病杂志

ABSTRACT

Objective To analyze the risk factors of pulmonary non-tuberculous mycobacterial (NTM) infection in sputum acid-fast bacilli positive and/or mycobacteria culture positive patients.Methods One hundred and sixty-three patients with pulmonary NTM infection were recruited from Jan 2006 to Jun 2011 in Shanghai Pulmonary Hospital and 326 patients with sputum positive pulmonary tuberculosis who were selected by random systemic sampling method in the same period were recruited as control.The data were retrospectively analyzed.The related factors were compared between groups by chi-square test.The risk factors of pulmonary NTM infection were analyzed by binary Logistic regression model.Results There were statistically significant differences of age,history of smoking,chronic obstructive pulmonary disease (COPD),bronchiectasis,thin walled cavities focus,purified protein derivative (PPD) test between patients with pulmonary NTM infection and patients with pulmonary tuberculosis (all P＜0.05).Univariate analysis showed that age [45-60year (OR=2.637,95％CI1.631-4.264; P＜0.001); ＞60 year (OR=4.194,95％CI2.581-6,813 ; P＜0.001)],history of smoking [10-20 year (OR=1.842,95％CI1.0843.070; P=0.024),＞20 year (OR=2.040,95％CI1.167-3.567; P=0.012)],COPD (OR=2.698,95％CI1.588-4.583; P＜0.001),bronchiectasis (OR=3.566,95％CI2.343-5.427;P＜0.001),thin walled cavities focus (OR=2.592,95％CI1.581-4.250; P＜0.001) and a weak-positive reaction of PPD test (OR=2.389,95％CI1.276-4.472; P=0.006) were all risk factors of pulmonary NTM infection.Multivariate analysis showed that age＞60 year (OR=3.961,95％CI2.183-7.189 ; P＜0.001),bronchiectasis (OR =3.880,95 ％ CI2.342-6.487 ; P＜0.001),thin walled cavities focus (OR=2.898,95％CI1.567-5.360; P＜0.001),COPD (OR=2.503,95％ CI1.289-4.857; P=0.007),age45-60 year (OR=2.452,95％CI1.391 4.325; P=0.002)anda weak-positive reaction of PPD test (OR=2.295,95％CI..1.132-4.652; P=0.021) were independent risk factors of pulmonary NTM infection.Conclusion In sputum acid-fast bacilli positive and/or mycobacteria culture positive patients,age≥ 45 year,COPD,bronchiectasis,thin walled cavities focus and a weak-positive reaction of PPD test are risk factors of pulmonary NTM infection.The clinicians should pay close attention to the results of species identification.