Cargando…

Management of patients with pulmonary mycobacteriosis in France: a multicenter retrospective cohort study

BACKGROUND: Recent studies report very low adherence of practitioners to ATS/IDSA recommendations for the treatment of nontuberculous mycobacteria pulmonary disease (NTM-PD), as well as a great variability of practices. Type of management could impact prognosis. METHODS: To evaluate management and p...

Descripción completa

Detalles Bibliográficos
Autores principales: Bemer, Pascale, Peuchant, Olivia, Guet-Revillet, Hélène, Bador, Julien, Balavoine, Charlotte, Basille, Damien, Beltramo, Guillaume, Blanc, François-Xavier, Blanchard, Elodie, Boulanger, Sarah, Bourgoin, Anne, Boutoille, David, Cambau, Emmanuelle, Canis, Frédérique, Caparros, Didier, Carricajo, Anne, Carrière, Christian, Couetdic, Gérard, Couturaud, Francis, Dalphin, Jean-Charles, Degot, Tristan, Desquiens, Marion, Devouassoux, Gilles, Duez, Jean-Marie, Dumitrescu, Oana, Dupuy-Grasset, Magali, Gaudart, Alice, Georges, Marjolaine, Godet, Cendrine, Godreuil, Sylvain, Guillouzouic, Aurélie, Hamdad-Daoudi, Farida, Héry-Arnaud, Geneviève, Koebel, Christelle, Lagrange, Aurore, Lanotte, Philippe, Marchand-Adam, Sylvain, Mougari, Faïza, Murris, Marlène, Patry, Isabelle, Pérouse de Montclos, Michèle, Raskine, Laurent, Risso, Karine, Segonds, Christine, Sicard, Dominique, Terru, Dominique, Vachée, Anne, Vergnon, Jean-Michel, Martin, Christian, Schramm, Frédéric, Andrejak, Claire
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8549171/
https://www.ncbi.nlm.nih.gov/pubmed/34702233
http://dx.doi.org/10.1186/s12890-021-01701-5
Descripción
Sumario:BACKGROUND: Recent studies report very low adherence of practitioners to ATS/IDSA recommendations for the treatment of nontuberculous mycobacteria pulmonary disease (NTM-PD), as well as a great variability of practices. Type of management could impact prognosis. METHODS: To evaluate management and prognosis of patients with NTM-PD cases with respect to ATS recommendations, we conducted a multicenter retrospective cohort study (18 sentinel sites distributed throughout France), over a period of six years. We collected clinical, radiological, microbiological characteristics, management and outcome of the patients (especially death or not). RESULTS: 477 patients with NTM-PD were included. Respiratory comorbidities were found in 68% of cases, tuberculosis sequelae in 31.4% of patients, and immunosuppression in 16.8% of cases. The three most common NTM species were Mycobacterium avium complex (60%), M. xenopi (20%) and M. kansasii (5.7%). Smear-positive was found in one third of NTM-PD. Nodulobronchiectatic forms were observed in 54.3% of cases, and cavitary forms in 19.1% of patients. Sixty-three percent of patients were treated, 72.4% of patients with smear-positive samples, and 57.5% of patients with smear-negative samples. Treatment was in adequacy with ATS guidelines in 73.5%. The 2-year mortality was 14.4%. In the Cox regression, treatment (HR = 0.51), age (HR = 1.02), and M. abscessus (3.19) appeared as the 3 significant independent prognostic factors. CONCLUSION: These findings highlight the adequacy between French practices and the ATS/IDSA guidelines. Treatment was associated with a better survival. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-021-01701-5.