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1365. Profiling Extrapulmonary Nontuberculous Mycobacteria Infections and Predictors for rapid-growing Species: A Multi-Center Retrospective Study
BACKGROUND: Nontuberculous mycobacteria (NTM) disease is increasing worldwide and is an important cause of morbidity and mortality. It is found that 20 to 30% of NTM isolates are of extrapulmonary origin. However, Studies about extrapulmonary NTM infections have been limited. Thus, we aim to describ...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809325/ http://dx.doi.org/10.1093/ofid/ofz360.1229 |
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author | Ho Kim, Jung Ji Lee, Woon Seong, Hye Young Jung, In Jin Kim, Eun Eun Song, Je young Ahn, Jin Jin Jeong, Su su Ku, Nam yong Choi, Jun Yeom, Joon-Sup Goo Song, Young |
author_facet | Ho Kim, Jung Ji Lee, Woon Seong, Hye Young Jung, In Jin Kim, Eun Eun Song, Je young Ahn, Jin Jin Jeong, Su su Ku, Nam yong Choi, Jun Yeom, Joon-Sup Goo Song, Young |
author_sort | Ho Kim, Jung |
collection | PubMed |
description | BACKGROUND: Nontuberculous mycobacteria (NTM) disease is increasing worldwide and is an important cause of morbidity and mortality. It is found that 20 to 30% of NTM isolates are of extrapulmonary origin. However, Studies about extrapulmonary NTM infections have been limited. Thus, we aim to describe the diversity of NTM infections and correlate these observations with clinical data. METHODS: We analyzed all symptomatic patients with positive NTM cultures in sterile extrapulmonary sites at three tertiary care centers in South Korea between January 2006 and June 2018. We collected patient information including predisposing factors, diversity of NTM isolates, antimicrobial susceptibility testing, treatment regimens, and outcomes. RESULTS: A total of 117 patients (46 males vs. 71 females) were included. The median age of the patients was 54 years. There are a lot of infections associated with medical procedures like surgery, but about half of cases (54.7%) are unknown origin. Skin and soft-tissue infections predominated (34.2%), followed by bone and joint infections (28.2%). Of 117 NTM isolates, 66 NTM subspecies were identified. Mycobacterium intracellulare (34.8%) was the most common species identified, followed rapid-growing NTM (RGM) species such as M. fortuitum complex (21.2%), M. abscessus (15.2%), M. massiliense (10.6%), and M. chelonae (9.1%). In skin and soft-tissue infections, RGM species were predominantly identified (26/28, 92.9%), whereas slow-growing NTM (SGM) species were mainly identified in bone and joint infections (18/26, 69.2%). The difference of isolated sites was verified by post hoc test and female sex (OR 4.72; P < 0.001) and skin and soft-tissue infections (OR 25.33; P < 0.001) were identified as predictors of RGM by logistic regression analysis. Based on antimicrobial susceptibility testing, fluoroquinolone and macrolide were mainly used for RGM treatment, and rifamycin-ethambutol-macrolide-based regimen was predominantly used for SGM treatment. CONCLUSION: Skin and soft-tissue infection were predominantly caused by RGM, whereas bone and joint infection is mainly caused by SGM. Species-specific and region-specific data that integrate clinical and microbiologic information is crucial in determining treatment direction. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6809325 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-68093252019-10-28 1365. Profiling Extrapulmonary Nontuberculous Mycobacteria Infections and Predictors for rapid-growing Species: A Multi-Center Retrospective Study Ho Kim, Jung Ji Lee, Woon Seong, Hye Young Jung, In Jin Kim, Eun Eun Song, Je young Ahn, Jin Jin Jeong, Su su Ku, Nam yong Choi, Jun Yeom, Joon-Sup Goo Song, Young Open Forum Infect Dis Abstracts BACKGROUND: Nontuberculous mycobacteria (NTM) disease is increasing worldwide and is an important cause of morbidity and mortality. It is found that 20 to 30% of NTM isolates are of extrapulmonary origin. However, Studies about extrapulmonary NTM infections have been limited. Thus, we aim to describe the diversity of NTM infections and correlate these observations with clinical data. METHODS: We analyzed all symptomatic patients with positive NTM cultures in sterile extrapulmonary sites at three tertiary care centers in South Korea between January 2006 and June 2018. We collected patient information including predisposing factors, diversity of NTM isolates, antimicrobial susceptibility testing, treatment regimens, and outcomes. RESULTS: A total of 117 patients (46 males vs. 71 females) were included. The median age of the patients was 54 years. There are a lot of infections associated with medical procedures like surgery, but about half of cases (54.7%) are unknown origin. Skin and soft-tissue infections predominated (34.2%), followed by bone and joint infections (28.2%). Of 117 NTM isolates, 66 NTM subspecies were identified. Mycobacterium intracellulare (34.8%) was the most common species identified, followed rapid-growing NTM (RGM) species such as M. fortuitum complex (21.2%), M. abscessus (15.2%), M. massiliense (10.6%), and M. chelonae (9.1%). In skin and soft-tissue infections, RGM species were predominantly identified (26/28, 92.9%), whereas slow-growing NTM (SGM) species were mainly identified in bone and joint infections (18/26, 69.2%). The difference of isolated sites was verified by post hoc test and female sex (OR 4.72; P < 0.001) and skin and soft-tissue infections (OR 25.33; P < 0.001) were identified as predictors of RGM by logistic regression analysis. Based on antimicrobial susceptibility testing, fluoroquinolone and macrolide were mainly used for RGM treatment, and rifamycin-ethambutol-macrolide-based regimen was predominantly used for SGM treatment. CONCLUSION: Skin and soft-tissue infection were predominantly caused by RGM, whereas bone and joint infection is mainly caused by SGM. Species-specific and region-specific data that integrate clinical and microbiologic information is crucial in determining treatment direction. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809325/ http://dx.doi.org/10.1093/ofid/ofz360.1229 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Ho Kim, Jung Ji Lee, Woon Seong, Hye Young Jung, In Jin Kim, Eun Eun Song, Je young Ahn, Jin Jin Jeong, Su su Ku, Nam yong Choi, Jun Yeom, Joon-Sup Goo Song, Young 1365. Profiling Extrapulmonary Nontuberculous Mycobacteria Infections and Predictors for rapid-growing Species: A Multi-Center Retrospective Study |
title | 1365. Profiling Extrapulmonary Nontuberculous Mycobacteria Infections and Predictors for rapid-growing Species: A Multi-Center Retrospective Study |
title_full | 1365. Profiling Extrapulmonary Nontuberculous Mycobacteria Infections and Predictors for rapid-growing Species: A Multi-Center Retrospective Study |
title_fullStr | 1365. Profiling Extrapulmonary Nontuberculous Mycobacteria Infections and Predictors for rapid-growing Species: A Multi-Center Retrospective Study |
title_full_unstemmed | 1365. Profiling Extrapulmonary Nontuberculous Mycobacteria Infections and Predictors for rapid-growing Species: A Multi-Center Retrospective Study |
title_short | 1365. Profiling Extrapulmonary Nontuberculous Mycobacteria Infections and Predictors for rapid-growing Species: A Multi-Center Retrospective Study |
title_sort | 1365. profiling extrapulmonary nontuberculous mycobacteria infections and predictors for rapid-growing species: a multi-center retrospective study |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809325/ http://dx.doi.org/10.1093/ofid/ofz360.1229 |
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