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Management of nontuberculous mycobacteria in lung transplant cases: an international Delphi study

RATIONALE: Nontuberculous mycobacterial (NTM) diseases are difficult-to-treat infections, especially in lung transplant (LTx) candidates. Currently, there is a paucity of recommendations on the management of NTM infections in LTx, focusing on Mycobacterium avium complex (MAC), M. abscessus and M. ka...

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Autores principales: Asif, Huda, Rahaghi, Franck F., Ohsumi, Akihiro, Philley, Julie, Emtiazjoo, Amir, Hirama, Takashi, Baker, Arthur W., Shu, Chin-Chung, Silveira, Fernanda, Poulin, Vincent, Rizzuto, Pete, Nagao, Miki, Burgel, Pierre-Régis, Hays, Steve, Aksamit, Timothy, Kawasaki, Takeshi, Dela Cruz, Charles, Aliberti, Stefano, Nakajima, Takahiro, Ruoss, Stephen, Marras, Theodore K., Snell, Gregory I., Winthrop, Kevin, Mirsaeidi, Mehdi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052461/
https://www.ncbi.nlm.nih.gov/pubmed/37009016
http://dx.doi.org/10.1183/23120541.00377-2022
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author Asif, Huda
Rahaghi, Franck F.
Ohsumi, Akihiro
Philley, Julie
Emtiazjoo, Amir
Hirama, Takashi
Baker, Arthur W.
Shu, Chin-Chung
Silveira, Fernanda
Poulin, Vincent
Rizzuto, Pete
Nagao, Miki
Burgel, Pierre-Régis
Hays, Steve
Aksamit, Timothy
Kawasaki, Takeshi
Dela Cruz, Charles
Aliberti, Stefano
Nakajima, Takahiro
Ruoss, Stephen
Marras, Theodore K.
Snell, Gregory I.
Winthrop, Kevin
Mirsaeidi, Mehdi
author_facet Asif, Huda
Rahaghi, Franck F.
Ohsumi, Akihiro
Philley, Julie
Emtiazjoo, Amir
Hirama, Takashi
Baker, Arthur W.
Shu, Chin-Chung
Silveira, Fernanda
Poulin, Vincent
Rizzuto, Pete
Nagao, Miki
Burgel, Pierre-Régis
Hays, Steve
Aksamit, Timothy
Kawasaki, Takeshi
Dela Cruz, Charles
Aliberti, Stefano
Nakajima, Takahiro
Ruoss, Stephen
Marras, Theodore K.
Snell, Gregory I.
Winthrop, Kevin
Mirsaeidi, Mehdi
author_sort Asif, Huda
collection PubMed
description RATIONALE: Nontuberculous mycobacterial (NTM) diseases are difficult-to-treat infections, especially in lung transplant (LTx) candidates. Currently, there is a paucity of recommendations on the management of NTM infections in LTx, focusing on Mycobacterium avium complex (MAC), M. abscessus and M. kansasii. METHODS: Pulmonologists, infectious disease specialists, LTx surgeons and Delphi experts with expertise in NTM were recruited. A patient representative was also invited. Three questionnaires comprising questions with multiple response statements were distributed to panellists. Delphi methodology with a Likert scale of 11 points (5 to −5) was applied to define the agreement between experts. Responses from the first two questionnaires were collated to develop a final questionnaire. The consensus was described as a median rating >4 or <−4 indicating for or against the given statement. After the last round of questionnaires, a cumulative report was generated. RESULTS: Panellists recommend performing sputum cultures and a chest computed tomography scan for NTM screening in LTx candidates. Panellists recommend against absolute contraindication to LTx even with multiple positive sputum cultures for MAC, M. abscessus or M. kansasii. Panellists recommend MAC patients on antimicrobial treatment and culture negative can be listed for LTx without further delay. Panellists recommend 6 months of culture-negative for M. kansasii, but 12 months of further treatment from the time of culture-negative for M. abscessus before listing for LTx. CONCLUSION: This NTM LTx study consensus statement provides essential recommendations for NTM management in LTx and can be utilised as an expert opinion while awaiting evidence-based contributions.
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spelling pubmed-100524612023-03-30 Management of nontuberculous mycobacteria in lung transplant cases: an international Delphi study Asif, Huda Rahaghi, Franck F. Ohsumi, Akihiro Philley, Julie Emtiazjoo, Amir Hirama, Takashi Baker, Arthur W. Shu, Chin-Chung Silveira, Fernanda Poulin, Vincent Rizzuto, Pete Nagao, Miki Burgel, Pierre-Régis Hays, Steve Aksamit, Timothy Kawasaki, Takeshi Dela Cruz, Charles Aliberti, Stefano Nakajima, Takahiro Ruoss, Stephen Marras, Theodore K. Snell, Gregory I. Winthrop, Kevin Mirsaeidi, Mehdi ERJ Open Res Original Research Articles RATIONALE: Nontuberculous mycobacterial (NTM) diseases are difficult-to-treat infections, especially in lung transplant (LTx) candidates. Currently, there is a paucity of recommendations on the management of NTM infections in LTx, focusing on Mycobacterium avium complex (MAC), M. abscessus and M. kansasii. METHODS: Pulmonologists, infectious disease specialists, LTx surgeons and Delphi experts with expertise in NTM were recruited. A patient representative was also invited. Three questionnaires comprising questions with multiple response statements were distributed to panellists. Delphi methodology with a Likert scale of 11 points (5 to −5) was applied to define the agreement between experts. Responses from the first two questionnaires were collated to develop a final questionnaire. The consensus was described as a median rating >4 or <−4 indicating for or against the given statement. After the last round of questionnaires, a cumulative report was generated. RESULTS: Panellists recommend performing sputum cultures and a chest computed tomography scan for NTM screening in LTx candidates. Panellists recommend against absolute contraindication to LTx even with multiple positive sputum cultures for MAC, M. abscessus or M. kansasii. Panellists recommend MAC patients on antimicrobial treatment and culture negative can be listed for LTx without further delay. Panellists recommend 6 months of culture-negative for M. kansasii, but 12 months of further treatment from the time of culture-negative for M. abscessus before listing for LTx. CONCLUSION: This NTM LTx study consensus statement provides essential recommendations for NTM management in LTx and can be utilised as an expert opinion while awaiting evidence-based contributions. European Respiratory Society 2023-03-27 /pmc/articles/PMC10052461/ /pubmed/37009016 http://dx.doi.org/10.1183/23120541.00377-2022 Text en Copyright ©The authors 2023 https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org)
spellingShingle Original Research Articles
Asif, Huda
Rahaghi, Franck F.
Ohsumi, Akihiro
Philley, Julie
Emtiazjoo, Amir
Hirama, Takashi
Baker, Arthur W.
Shu, Chin-Chung
Silveira, Fernanda
Poulin, Vincent
Rizzuto, Pete
Nagao, Miki
Burgel, Pierre-Régis
Hays, Steve
Aksamit, Timothy
Kawasaki, Takeshi
Dela Cruz, Charles
Aliberti, Stefano
Nakajima, Takahiro
Ruoss, Stephen
Marras, Theodore K.
Snell, Gregory I.
Winthrop, Kevin
Mirsaeidi, Mehdi
Management of nontuberculous mycobacteria in lung transplant cases: an international Delphi study
title Management of nontuberculous mycobacteria in lung transplant cases: an international Delphi study
title_full Management of nontuberculous mycobacteria in lung transplant cases: an international Delphi study
title_fullStr Management of nontuberculous mycobacteria in lung transplant cases: an international Delphi study
title_full_unstemmed Management of nontuberculous mycobacteria in lung transplant cases: an international Delphi study
title_short Management of nontuberculous mycobacteria in lung transplant cases: an international Delphi study
title_sort management of nontuberculous mycobacteria in lung transplant cases: an international delphi study
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052461/
https://www.ncbi.nlm.nih.gov/pubmed/37009016
http://dx.doi.org/10.1183/23120541.00377-2022
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