Nontuberculous Mycobacteria Isolates at a Cancer Center: A 5-year Experience at H. Lee Moffitt Cancer Center in Tampa, Florida

BACKGROUND: Nontuberculous Mycobacteriae (NTM) are widely distributed in natural environments and are known to cause human diseases distinct from tuberculous mycobacteria. NTM caused diseases may lead to significant morbidity and mortality, particularly in immunocompromised hosts such as cancer patients. We present here a 5-year experience of NTM isolates at the Moffitt Cancer Center and research institute in Tampa, Florida. METHODS: We conducted a single center, retrospective study of patients with NTM from January 2011 to February 2016. Records were searched to identify patients with NTM. Specimens included bronchial lavage, swabs, blood, body fluids and biopsy or excised surgical specimens. Basic demographics of patients, clinical attributes, presentation and sites from which the NTM were isolated and associated neoplastic pathologies were evaluated for each NTM type and compared. RESULTS: There were a total of 208 isolates of NTM during the 5-year study period. 86/208 (41%) of the isolates were Mycobacterium avium complex (MAC). Mycobacterium abscessus, gordonae and fortuitum accounted for 26%, 11% and 6% of the top four isolates respectively. There was no significant difference in types of NTM isolated based on the type of underlying neoplasm. Over half of the cases were from the respiratory tract, majority with lung nodule referred to rule out cancer. Skin/wound isolates accounted for 13% (majority from breast lesions) and blood/serologic diagnosis accounted for 7 % of the isolates. Average age of patients was 68 ± 11 years, 92% were US born and over 70% had smoking history. CONCLUSION: NTM isolated in a referral cancer center setting are likely to be from the work up of PET positive pulmonary nodules and the majority isolates were MAC, followed closely by M. abscessus. With high level of resistance and few therapeutic options, the rise of M. abscessus pulmonary diseases is cause for concern. Even though the respiratory tract was the most common site of NTM isolation, we did’nt find association between types of NTM and a given neoplasm. Our finding may have been confounded by referral pattern to our center and the retrospective design. Future studies that lead to improved testing and scoring algorithms for NTM could reduce the rate of surgical excision of pulmonary nodules. DISCLOSURES: All authors: No reported disclosures.