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Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease

BACKGROUND: In Mycobacterium avium complex pulmonary disease (MAC-PD), diagnosis requires a positive culture from at least two separate expectorated sputum specimens. The optimal number of sputum examinations remains unclear. OBJECTIVE: This study sought to elucidate the diagnostic yield of acid-fas...

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Autores principales: Urabe, Naohisa, Sakamoto, Susumu, Masuoka, Marie, Kato, Chiaki, Yamaguchi, Asuka, Tokita, Nozomi, Homma, Sakae, Kishi, Kazuma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850505/
https://www.ncbi.nlm.nih.gov/pubmed/36658536
http://dx.doi.org/10.1186/s12890-023-02327-5
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author Urabe, Naohisa
Sakamoto, Susumu
Masuoka, Marie
Kato, Chiaki
Yamaguchi, Asuka
Tokita, Nozomi
Homma, Sakae
Kishi, Kazuma
author_facet Urabe, Naohisa
Sakamoto, Susumu
Masuoka, Marie
Kato, Chiaki
Yamaguchi, Asuka
Tokita, Nozomi
Homma, Sakae
Kishi, Kazuma
author_sort Urabe, Naohisa
collection PubMed
description BACKGROUND: In Mycobacterium avium complex pulmonary disease (MAC-PD), diagnosis requires a positive culture from at least two separate expectorated sputum specimens. The optimal number of sputum examinations remains unclear. OBJECTIVE: This study sought to elucidate the diagnostic yield of acid-fast bacilli in MAC-PD using 3 sputum specimens and to clarify the clinical characteristics of patients with MAC-PD diagnosed using 3 sputum specimens. Furthermore, we investigated the correlation between increased number of sputum specimens and diagnostic yield. METHODS: We reviewed the medical records of 139 patients with MAC-PD diagnosed at Toho University Omori Medical Center for whom at least three sputum specimens were examined before treatment from November 2014 through June 2021. Patients were classified into the 3-sputum diagnosed and the non-3 sputum diagnosed groups based on diagnostic procedure; clinical and radiological characteristics were compared. We also assessed diagnostic yield with the increased number of sputum specimens. RESULTS: Diagnostic yield with 3 sputum specimens was 16.5% (23/139). The 3-sputum diagnosed group had a lower body mass index [18.6(17–19.5) vs. 19.5(18–21.5); p = 0.014], and higher chest CT score [9(6.5–13) vs. 6(4–9); p = 0.011] including cavitary lesions (39.1% vs. 19%; p = 0.037) compared with the non-3 sputum diagnosed group. When the number of sputum specimens was increased to 6, the diagnostic yield increased to 23.7% (33/139). CONCLUSION: Diagnostic yield with 3 sputum specimens was 16.5%. Patients diagnosed using 3 sputum specimens had more severe chest CT findings including cavitary lesions. Increasing the number of sputum specimens to 6 improved diagnostic yield by 7.2%. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-023-02327-5.
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spelling pubmed-98505052023-01-20 Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease Urabe, Naohisa Sakamoto, Susumu Masuoka, Marie Kato, Chiaki Yamaguchi, Asuka Tokita, Nozomi Homma, Sakae Kishi, Kazuma BMC Pulm Med Research BACKGROUND: In Mycobacterium avium complex pulmonary disease (MAC-PD), diagnosis requires a positive culture from at least two separate expectorated sputum specimens. The optimal number of sputum examinations remains unclear. OBJECTIVE: This study sought to elucidate the diagnostic yield of acid-fast bacilli in MAC-PD using 3 sputum specimens and to clarify the clinical characteristics of patients with MAC-PD diagnosed using 3 sputum specimens. Furthermore, we investigated the correlation between increased number of sputum specimens and diagnostic yield. METHODS: We reviewed the medical records of 139 patients with MAC-PD diagnosed at Toho University Omori Medical Center for whom at least three sputum specimens were examined before treatment from November 2014 through June 2021. Patients were classified into the 3-sputum diagnosed and the non-3 sputum diagnosed groups based on diagnostic procedure; clinical and radiological characteristics were compared. We also assessed diagnostic yield with the increased number of sputum specimens. RESULTS: Diagnostic yield with 3 sputum specimens was 16.5% (23/139). The 3-sputum diagnosed group had a lower body mass index [18.6(17–19.5) vs. 19.5(18–21.5); p = 0.014], and higher chest CT score [9(6.5–13) vs. 6(4–9); p = 0.011] including cavitary lesions (39.1% vs. 19%; p = 0.037) compared with the non-3 sputum diagnosed group. When the number of sputum specimens was increased to 6, the diagnostic yield increased to 23.7% (33/139). CONCLUSION: Diagnostic yield with 3 sputum specimens was 16.5%. Patients diagnosed using 3 sputum specimens had more severe chest CT findings including cavitary lesions. Increasing the number of sputum specimens to 6 improved diagnostic yield by 7.2%. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-023-02327-5. BioMed Central 2023-01-19 /pmc/articles/PMC9850505/ /pubmed/36658536 http://dx.doi.org/10.1186/s12890-023-02327-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Urabe, Naohisa
Sakamoto, Susumu
Masuoka, Marie
Kato, Chiaki
Yamaguchi, Asuka
Tokita, Nozomi
Homma, Sakae
Kishi, Kazuma
Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease
title Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease
title_full Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease
title_fullStr Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease
title_full_unstemmed Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease
title_short Efficacy of three sputum specimens for the diagnosis of Mycobacterium avium complex pulmonary disease
title_sort efficacy of three sputum specimens for the diagnosis of mycobacterium avium complex pulmonary disease
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850505/
https://www.ncbi.nlm.nih.gov/pubmed/36658536
http://dx.doi.org/10.1186/s12890-023-02327-5
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