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Nontuberculous mycobacterial pulmonary disease diagnosed by two methods: a prospective cohort study
BACKGROUND: Microbiological criteria for diagnosing nontuberculous mycobacterial pulmonary disease (NTM-PD) include positive culture results from at least two separately expectorated sputum specimens or one bronchial washing or lavage. However, the clinical similarities and differences between patie...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534935/ https://www.ncbi.nlm.nih.gov/pubmed/31126235 http://dx.doi.org/10.1186/s12879-019-4078-0 |
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author | Kim, Hyung-Jun Lee, Jong Hyuk Yoon, Soon Ho Kim, Sung A. Kim, Myoung Sil Choi, Sun Mi Lee, Jinwoo Lee, Chang-Hoon Han, Sung Koo Yim, Jae-Joon |
author_facet | Kim, Hyung-Jun Lee, Jong Hyuk Yoon, Soon Ho Kim, Sung A. Kim, Myoung Sil Choi, Sun Mi Lee, Jinwoo Lee, Chang-Hoon Han, Sung Koo Yim, Jae-Joon |
author_sort | Kim, Hyung-Jun |
collection | PubMed |
description | BACKGROUND: Microbiological criteria for diagnosing nontuberculous mycobacterial pulmonary disease (NTM-PD) include positive culture results from at least two separately expectorated sputum specimens or one bronchial washing or lavage. However, the clinical similarities and differences between patients diagnosed by these two methods remain unclear. We compared clinical features and prognoses of patients with NTM-PD diagnosed from both specimen types. METHODS: We analysed data from patients who participated in the Seoul National University Hospital NTM-PD cohort (ClinicalTrials.gov identifier: NCT01616745). Baseline demographics, symptoms, radiographic findings, disease progression, and treatment responses were summarized and compared between patients diagnosed from sputum specimens and patients diagnosed from bronchoscopic specimens. RESULTS: Three hundred forty-seven patients were included in the analyses. Of these, 279 (80.4%) were diagnosed from two separately expectorated sputum specimens, and 68 (19.6%) were diagnosed from bronchoscopic specimens. Patients diagnosed from sputum specimens had more frequent and severe cough, sputum, postnasal drip, and high St. George’s Respiratory Questionnaire scores. However, the extent and severity of the radiographic lesions, disease progression, and treatment responses were similar for both groups. Further analysis based on the following three groups (sputum culture positive, sputum culture negative/bronchoscopy, and scanty sputum/bronchoscopy groups) suggested that the scanty sputum/bronchoscopy group appeared to have the worst prognosis in terms of both time to progression and time to culture conversion. CONCLUSIONS: Although some symptoms and quality of life were worse in patients with NTM-PD diagnosed from sputum specimens, their prognoses were similar to those of patients diagnosed by bronchoscopic specimen. We recommend bronchoscopic sampling for patients in whom NTM-PD is suspected clinically or radiographically, especially those who have no or scanty sputum. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12879-019-4078-0) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6534935 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65349352019-05-30 Nontuberculous mycobacterial pulmonary disease diagnosed by two methods: a prospective cohort study Kim, Hyung-Jun Lee, Jong Hyuk Yoon, Soon Ho Kim, Sung A. Kim, Myoung Sil Choi, Sun Mi Lee, Jinwoo Lee, Chang-Hoon Han, Sung Koo Yim, Jae-Joon BMC Infect Dis Research Article BACKGROUND: Microbiological criteria for diagnosing nontuberculous mycobacterial pulmonary disease (NTM-PD) include positive culture results from at least two separately expectorated sputum specimens or one bronchial washing or lavage. However, the clinical similarities and differences between patients diagnosed by these two methods remain unclear. We compared clinical features and prognoses of patients with NTM-PD diagnosed from both specimen types. METHODS: We analysed data from patients who participated in the Seoul National University Hospital NTM-PD cohort (ClinicalTrials.gov identifier: NCT01616745). Baseline demographics, symptoms, radiographic findings, disease progression, and treatment responses were summarized and compared between patients diagnosed from sputum specimens and patients diagnosed from bronchoscopic specimens. RESULTS: Three hundred forty-seven patients were included in the analyses. Of these, 279 (80.4%) were diagnosed from two separately expectorated sputum specimens, and 68 (19.6%) were diagnosed from bronchoscopic specimens. Patients diagnosed from sputum specimens had more frequent and severe cough, sputum, postnasal drip, and high St. George’s Respiratory Questionnaire scores. However, the extent and severity of the radiographic lesions, disease progression, and treatment responses were similar for both groups. Further analysis based on the following three groups (sputum culture positive, sputum culture negative/bronchoscopy, and scanty sputum/bronchoscopy groups) suggested that the scanty sputum/bronchoscopy group appeared to have the worst prognosis in terms of both time to progression and time to culture conversion. CONCLUSIONS: Although some symptoms and quality of life were worse in patients with NTM-PD diagnosed from sputum specimens, their prognoses were similar to those of patients diagnosed by bronchoscopic specimen. We recommend bronchoscopic sampling for patients in whom NTM-PD is suspected clinically or radiographically, especially those who have no or scanty sputum. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12879-019-4078-0) contains supplementary material, which is available to authorized users. BioMed Central 2019-05-24 /pmc/articles/PMC6534935/ /pubmed/31126235 http://dx.doi.org/10.1186/s12879-019-4078-0 Text en © The Author(s). 2019 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 Kim, Hyung-Jun Lee, Jong Hyuk Yoon, Soon Ho Kim, Sung A. Kim, Myoung Sil Choi, Sun Mi Lee, Jinwoo Lee, Chang-Hoon Han, Sung Koo Yim, Jae-Joon Nontuberculous mycobacterial pulmonary disease diagnosed by two methods: a prospective cohort study |
title | Nontuberculous mycobacterial pulmonary disease diagnosed by two methods: a prospective cohort study |
title_full | Nontuberculous mycobacterial pulmonary disease diagnosed by two methods: a prospective cohort study |
title_fullStr | Nontuberculous mycobacterial pulmonary disease diagnosed by two methods: a prospective cohort study |
title_full_unstemmed | Nontuberculous mycobacterial pulmonary disease diagnosed by two methods: a prospective cohort study |
title_short | Nontuberculous mycobacterial pulmonary disease diagnosed by two methods: a prospective cohort study |
title_sort | nontuberculous mycobacterial pulmonary disease diagnosed by two methods: a prospective cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534935/ https://www.ncbi.nlm.nih.gov/pubmed/31126235 http://dx.doi.org/10.1186/s12879-019-4078-0 |
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