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Implication of species change of Nontuberculous Mycobacteria during or after treatment

BACKGROUND: Co-existence or subsequent isolation of multiple nontuberculous mycobacteria (NTM) species in same patient has been reported. However, clinical significance of these observations is unclear. The aim of this study was to determine clinical implications of changes of NTM species during or...

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Autores principales: Lee, Jong Sik, Lee, Jong Hyuk, Yoon, Soon Ho, Kim, Taek Soo, Seong, Moon-Woo, Han, Sung Koo, Yim, Jae-Joon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738815/
https://www.ncbi.nlm.nih.gov/pubmed/29262802
http://dx.doi.org/10.1186/s12890-017-0539-7
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author Lee, Jong Sik
Lee, Jong Hyuk
Yoon, Soon Ho
Kim, Taek Soo
Seong, Moon-Woo
Han, Sung Koo
Yim, Jae-Joon
author_facet Lee, Jong Sik
Lee, Jong Hyuk
Yoon, Soon Ho
Kim, Taek Soo
Seong, Moon-Woo
Han, Sung Koo
Yim, Jae-Joon
author_sort Lee, Jong Sik
collection PubMed
description BACKGROUND: Co-existence or subsequent isolation of multiple nontuberculous mycobacteria (NTM) species in same patient has been reported. However, clinical significance of these observations is unclear. The aim of this study was to determine clinical implications of changes of NTM species during or after treatment in patients with NTM lung disease. METHODS: Patients with NTM lung disease, who experienced changes of NTM species during treatment or within 2 years of treatment completion between January 1, 2009 and December 31, 2015, were included in the analysis. Demographic, clinical, microbiological, and radiographic data were reviewed and analyzed. RESULTS: During the study period, 473 patients were newly diagnosed with NTM lung disease. Treatment was started in 164 patients (34.6%). Among these 164 patients, 16 experienced changes of NTM species during or within 2 years of treatment completion. Seven showed changes from M. avium complex (MAC) to M. abscessus subspecies abscessus (MAA) and five patients displayed changes from M. abscessus subspecies massiliense (MAM) to MAC. With isolation of new NTM species, 6 out of 7 patients with change from MAC to MAA reported worsening of symptoms, whereas none of the five patients with change from MAM to MAC reported worsening of symptoms. All MAA isolated during or after treatment for MAC lung diseases showed inducible resistance to clarithromycin. CONCLUSIONS: Change of NTM species may occur during or after treatment for NTM lung disease. Especially, changes from MAC to MAA is accompanied by symptomatic and radiographic worsening as well as inducible resistance to clarithromycin.
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spelling pubmed-57388152018-01-02 Implication of species change of Nontuberculous Mycobacteria during or after treatment Lee, Jong Sik Lee, Jong Hyuk Yoon, Soon Ho Kim, Taek Soo Seong, Moon-Woo Han, Sung Koo Yim, Jae-Joon BMC Pulm Med Research Article BACKGROUND: Co-existence or subsequent isolation of multiple nontuberculous mycobacteria (NTM) species in same patient has been reported. However, clinical significance of these observations is unclear. The aim of this study was to determine clinical implications of changes of NTM species during or after treatment in patients with NTM lung disease. METHODS: Patients with NTM lung disease, who experienced changes of NTM species during treatment or within 2 years of treatment completion between January 1, 2009 and December 31, 2015, were included in the analysis. Demographic, clinical, microbiological, and radiographic data were reviewed and analyzed. RESULTS: During the study period, 473 patients were newly diagnosed with NTM lung disease. Treatment was started in 164 patients (34.6%). Among these 164 patients, 16 experienced changes of NTM species during or within 2 years of treatment completion. Seven showed changes from M. avium complex (MAC) to M. abscessus subspecies abscessus (MAA) and five patients displayed changes from M. abscessus subspecies massiliense (MAM) to MAC. With isolation of new NTM species, 6 out of 7 patients with change from MAC to MAA reported worsening of symptoms, whereas none of the five patients with change from MAM to MAC reported worsening of symptoms. All MAA isolated during or after treatment for MAC lung diseases showed inducible resistance to clarithromycin. CONCLUSIONS: Change of NTM species may occur during or after treatment for NTM lung disease. Especially, changes from MAC to MAA is accompanied by symptomatic and radiographic worsening as well as inducible resistance to clarithromycin. BioMed Central 2017-12-20 /pmc/articles/PMC5738815/ /pubmed/29262802 http://dx.doi.org/10.1186/s12890-017-0539-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Lee, Jong Sik
Lee, Jong Hyuk
Yoon, Soon Ho
Kim, Taek Soo
Seong, Moon-Woo
Han, Sung Koo
Yim, Jae-Joon
Implication of species change of Nontuberculous Mycobacteria during or after treatment
title Implication of species change of Nontuberculous Mycobacteria during or after treatment
title_full Implication of species change of Nontuberculous Mycobacteria during or after treatment
title_fullStr Implication of species change of Nontuberculous Mycobacteria during or after treatment
title_full_unstemmed Implication of species change of Nontuberculous Mycobacteria during or after treatment
title_short Implication of species change of Nontuberculous Mycobacteria during or after treatment
title_sort implication of species change of nontuberculous mycobacteria during or after treatment
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738815/
https://www.ncbi.nlm.nih.gov/pubmed/29262802
http://dx.doi.org/10.1186/s12890-017-0539-7
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