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01-08-2010

Nontuberculous Mycobacterial Lung Infections in Ontario, Canada: Clinical and Microbiological Characteristics

Authors: Theodore K. Marras, Mauli Mehta, Pamela Chedore, Kevin May, Mohammed Al Houqani, Frances Jamieson

Published in: Lung | Issue 4/2010

Abstract

Study Objectives The aim of this study was to determine gender and clinical phenotype frequencies in pulmonary nontuberculous mycobacterial (NTM) infection and the frequency of disease in NTM isolates. Design The study is a retrospective observational cohort study of two overlapping cohorts: population cohort and clinical cohort. Setting The study was conducted at the University Health Network and Ontario Mycobacteriology Laboratory in Toronto, Ontario, Canada. Patients or Participants The population cohort consisted of all patients with one or more pulmonary NTM isolates in Ontario in 2003. The clinical cohort consisted of all patients with one or more pulmonary NTM isolates at our hospital in 2002–2003. Interventions The study entailed the review of laboratory records and demographics (both cohorts) and detailed clinical records (clinical cohort). Measurements and Results In the population cohort (N = 1651), females comprised 48% overall and 51% with microbiological disease criteria. In the clinical cohort (N = 552), females comprised 48% overall and 55% with NTM disease. In the population cohort, 45% fulfilled microbiological disease criteria, and in the clinical cohort 46% of patients had disease. Patients with MAC isolates fulfilled microbiological disease criteria in 51% of population cohort cases and all disease criteria in 52% of clinical cohort cases. Women more commonly fulfilled microbiological disease criteria in the population cohort (51 vs. 45%, P = 0.02) and all disease criteria in the clinical cohort (53 vs. 40%, P = 0.03). Among clinical cohort patients, 26% (13 women, 44 men) had fibrocavitation, while 62% (101 women, 37 men) had nodular bronchiectasis. Conclusions Women comprised a small majority with disease. Nodular bronchiectasis in women was most common, but significant proportions of each gender with each radiographic type were observed. NTM isolation, particularly MAC, was frequently associated with disease.

Marras TK, Chedore P, Ying AM, Jamieson F (2007) Isolation prevalence of pulmonary non-tuberculous mycobacteria in Ontario 1997–2003. Thorax 62:661–666CrossRefPubMed

Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, Holland SM, Horsburgh R, Huitt G, Iademarco F, Iseman M, Olivier K, Ruoss S, von Reyn CF, Wallace RJ Jr, Winthrop K (2007) Diagnosis, treatment and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 175:367–416CrossRefPubMed

Prince DS, Peterson DD, Steiner RM, Gottlieb JE, Scott R, Israel HL, Figueroa WG, Fish JE (1989) Infection with Mycobacterium avium complex in patients without predisposing conditions. New Engl J Med 321:863–868PubMedCrossRef

Huang JH, Kao PN, Adi V, Ruoss SJ (1999) Mycobacterium avium-intracellulare pulmonary infection in HIV-negative patients without preexisting lung disease: diagnostic and management limitations. Chest 115:1033–1040CrossRefPubMed

Hanna BA, Ebrahimzadeh A, Elliott LB, Morgan MA, Novak SM, Rusch-Gerdes S, Acio M, Dunbar DF, Holmes TM, Rexer CH, Savthyakumar C, Vannier AM (1999) Multicenter evaluation of the BACTEC MGIT 960 system for recovery of mycobacteria. J Clin Microbiol 37:748–752PubMed

Butler WR, Guthertz LS (2001) Mycolic acid analysis by high-performance liquid chromatography for identification of Mycobacterium species. Clin Microbiol Rev 14:704–726CrossRefPubMed

Arnow PM, Bakir M, Thompson K, Bova JL (2000) Endemic contamination of clinical specimens by Mycobacterium gordonae. Clin Infect Dis 31:472–476CrossRefPubMed

Kim RD, Greenberg DE, Ehrmantraut ME, Guide SV, Ding L, Shea Y, Brown MR, Chernick M, Steagall WK, Glasgow CG, Lin JP, Jolley C, Sorbara L, Raffeld M, Hill S, Avila N, Sachdev V, Barnhart LA, Anderson VL, Claypool L, Hilligoss DM, Garofalo M, Fitzgerald A, Anaya-O’Brien S, Darnell D, DeCastro R, Menning HM, Ricklefs SM, Porcella SF, Olivier KN, Moss J, Holland SM (2008) Pulmonary nontuberculous mycobacterial disease: prospective study of a distinct preexisting syndrome. Am J Respir Crit Care Med 178:1066–1074CrossRefPubMed

Fogan L (1970) Atypical mycobacteria. Medicine 49:243–255CrossRefPubMed

10.

Ahn CH, Lowell JR, Onstad GD, Shuford EH, Hurst GA (1979) A demographic study of disease due to Mycobacterium kansasii or M intracellulare-avium in Texas. Chest 75:120–125CrossRefPubMed

11.

O’Brien RJ, Geiter LJ, Snider DE Jr (1987) The epidemiology of nontuberculous mycobacterial diseases in the United States. Results from a national survey. Am Rev Respir Dis 135:1007–1014PubMed

12.

Butler W, Crawford J, Shutt K (1999) Nontuberculous mycobacteria reported to the Public Health Laboratory Information System by state public health laboratories, United States, 1993–1996. Centers for Disease Control and Prevention, Atlanta.

13.

Donnabella V, Salazar-Schicchi J, Bonk S, Hanna B, Rom WN (2000) Increasing incidence of Mycobacterium xenopi at Bellevue Hospital: an emerging pathogen or a product of improved laboratory methods? Chest 118:1365–1370CrossRefPubMed

14.

Gale GL (1976) Atypical mycobacteria in a tuberculosis hospital. Can Med Assoc J 114:612–614PubMed

15.

Warring FC Jr (1968) Mycobacteria in a New England Hospital. Am Rev Respir Dis 98:965–977PubMed

16.

Gorse GJ, Fairshter RD, Friedly G, Dela Maza L, Greene GR, Cesario TC (1983) Nontuberculous mycobacterial disease: experience in a Southern California hospital. Arch Intern Med 143:225–228CrossRefPubMed

17.

Reich JM, Johnson RE (1991) Mycobacterium avium complex pulmonary disease: incidence, presentation, and response to therapy in a community setting. Am Rev Respir Dis 143:1381–1385PubMed

18.

Bodle EE, Cunningham JA, Della-Latta P, Schluger N, Saiman L (2008) Epidemiology of nontuberculous mycobacteria in patients without HIV infection, New York City. Emerg Infect Dis 14:390–396CrossRefPubMed

19.

Cassidy PM, Hedberg K, Saulson A, McNelly E, Winthrop KL (2009) Nontuberculous mycobacterial disease prevalence and risk factors: a changing epidemiology. Clin Infect Dis 49(12):e124–e129CrossRefPubMed

20.

Jenkins PA (1981) The epidemiology of opportunist mycobacterial infections in Wales, 1952–1978. Rev Infect Dis 3:1021–1023PubMed

21.

Gerogianni I, Papala M, Kostikas K, Petinaki E, Gourgoulianis KI (2008) Epidemiology and clinical significance of mycobacterial respiratory infections in Central Greece. Int J Tuberc Lung Dis 12:807–812PubMed

22.

Van Ingen J, Bendien SA, de Lange WCM, Hoefsloot W, Dekhuijzen PNR, Boeree MJ, van Soolingen D (2009) Clinical relevance of nontuberculous mycobacteria isolated in Nijmegen-Arnhem region, The Netherlands. Thorax 64:502–506CrossRefPubMed

23.

Kubin M, Svandova E, Medek B, Chobot S, Olsovsky Z (1980) Mycobacterium kansasii infection in an endemic area of Czechoslovakia. Tubercle 61:207–212CrossRefPubMed

24.

Kaustova J, Chmelik M, Ettlova D, Hudec V, Lazarova H, Richtrova S (1995) Disease due to Mycobacterium kansasii in the Czech Republic: 1984–1989. Tuber Lung Dis 76:205–209CrossRefPubMed

25.

Leal Arranz MV, Gaafar A, Unzaga Barañano MJ, Crespo Notario JA, Cisterna Cáncer R, Garcia Cebrián F (2005) Clinical and epidemiological study of disease caused by Mycobacterium kansasii in the metropolitan area of Bilbao, Spain. Arch Bronconeumol 41:189–196PubMed

26.

Van Ingen J, Boeree MJ, de Lange WCM, Hoefsloot W, Bendien SA, Magis-Escurra C, Dekhuijzen PNR, van Soolingen D (2008) Mycobacterium xenopi clinical relevance and determinants, the Netherlands. Emerg Infect Dis 14:385–389CrossRefPubMed

27.

Marusic A, Katalinic-Jankovic V, Popovic-Grle S, Jankovic M, Mazuranic I, Puljic I, Seric Milic H (2009) Mycobacterium xenopi pulmonary disease—epidemiology and clinical features in non-immunocompromised patients. J Infect 58:108–112CrossRefPubMed

28.

Dailloux M, Abalain ML, Laurain C, Lebrun L, Loos-Ayav C, Lozniewski A, Maugein J (2006) Respiratory infections associated with nontuberculous mycobacteria in non-HIV patients. Eur Respir J 28:1211–1215CrossRefPubMed

29.

Tsukamura M, Kita N, Shimoide H, Arakawa H, Kuze A (1988) Studies on the epidemiology of nontuberculous mycobacteriosis in Japan. Am Rev Respir Dis 137:1280–1284PubMed

30.

Hosker HSR, Lam CW, Ng TK, Ma HK, Chan SL (1995) The prevalence and clinical significance of pulmonary infection due to non-tuberculous mycobacteria in Hong Kong. Respir Med 89:3–8CrossRefPubMed

31.

Shih JY, Hsueh PR, Lee LN, Wang HC, Yang PC, Kuo SH, Luh KT (1997) Nontuberculous mycobacteria isolates: clinical significance and disease spectrum. J Formos Med Assoc 96:621–626PubMed

32.

Koh WJ, Kwon OJ, Jeon K, Kim TS, Lee KS, Park YK, Bai GH (2006) Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens in Korea. Chest 129:341–348CrossRefPubMed

33.

Okumura M, Iwai K, Ogata H, Ueyama M, Kubota M, Aoki M, Kokuto H, Tadokoro E, Uchiyama T, Saotome M, Yoshiyama T, Yoshimori K, Yoshida N, Azuma A, Kudoh S (2008) Clinical factors on cavitary and nodular bronchiectatic types in pulmonary Mycobacterium avium complex disease. Intern Med 47:1465–1472CrossRefPubMed

34.

O’Brien DP, Currie BJ, Krause VL (2000) Nontuberculous mycobacterial disease in Northern Australia: a case series and review of the literature. Clin Infect Dis 31:958–968CrossRefPubMed

35.

Freeman J, Morris A, Blackmore T, Hammer D, Munroe S, McKnight L (2007) Incidence of nontuberculous mycobacterial disease in New Zealand, 2004. N Z Med J 120(1256):U2580PubMed

36.

Khan K, Wang J, Marras TK (2007) Nontuberculous mycobacterial sensitization in the United States: national trends over three decades. Am J Respir Crit Care Med 176:306–313CrossRefPubMed

37.

Reich JM, Johnson RE (1992) Mycobacterium avium complex pulmonary disease presenting as an isolated lingular or middle lobe pattern: the Lady Windermere Syndrome. Chest 101:1605–1609CrossRefPubMed

38.

Choudhri S, Manfreda J, Wolfe J, Parker S, Long R (1995) Clinical significance of nontuberculous mycobacteria isolates in a Canadian tertiary care center. Clin Infect Dis 21:128–133PubMed

39.

Robinson BL, Grzybowski S, Bowmer EJ, McDiarmid J, Whittaker EI, Tanner K (1969) Atypical mycobacterial disease in British Columbia, 1960–1967. Can Med Assoc J 101:17–24PubMed

40.

Schaefer WB, Birn KJ, Jenkins PA, Marks J (1969) Infection with the avian-Battey group of mycobacteria in England and Wales. Br Med J 2:412–415CrossRefPubMed

41.

Marras TK, Daley CL (2002) Epidemiology of human pulmonary infection with nontuberculous mycobacteria. Clin Chest Med 23:553–567CrossRefPubMed

42.

Varadi RG, Marras TK (2009) Pulmonary Mycobacterium xenopi infection in non-HIV-infected patients: a systematic review. Int J Tuberc Lung Dis 13:1210–1218PubMed

43.

Han XY, Tarrand JT, Infante R, Jacobson KL, Truong M (2005) Clinical significance and epidemiologic amalyses of Mycobacterium avium and Mycobacterium intracellulare among patients without AIDS. J Clin Microbiol 43:4407–4412CrossRefPubMed

44.

Maesaki S, Kohno S, Koga H, Miyazaki Y, Kaku M (1993) A clinical comparison between Mycobacterium avium and Mycobacterium intracellulare. Chest 104:1408–1411CrossRefPubMed

45.

Toyoda T, Aoyagi T, Saito H (1993) Clinical features of the lung diseases due to Mycobacterium avium and M. intracellulare. Kekkaku 68:63–69PubMed

46.

Tortoli E, Rindi L, Garcia MJ, Chiaradonna P, Dei R, Garzelli C, Kroppenstedt RM, Lari N, Mattei R, Mariottini A, Mazzarelli G, Murcia MI, Nanetti A, Piccoli P, Scarparo C (2004) Proposal to elevate the genetic variant MAC-A, included in the Mycobacterium avium complex, to species rank as Mycobacterium chimaera sp. nov. Int J Syst Evol Microbiol 54:1277–1285CrossRefPubMed

47.

Turenne CY, Thibert L, Williams K, Burdz TV, Cook VJ, Wolfe JN, Cockcroft DW, Kabani A (2004) Mycobacterium saskatchewanense sp. nov., a novel slowly growing scotochromogenic species from human clinical isolates related to Mycobacterium interjectum and Accuprobe positive for Mycobacterium avium complex. Int J Syst Evol Microbiol 54:659–667CrossRefPubMed

Title: Nontuberculous Mycobacterial Lung Infections in Ontario, Canada: Clinical and Microbiological Characteristics
Authors: Theodore K. Marras
Mauli Mehta
Pamela Chedore
Kevin May
Mohammed Al Houqani
Frances Jamieson
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: Lung / Issue 4/2010
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI: https://doi.org/10.1007/s00408-010-9241-8

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