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Published in: Lung 4/2020

01-08-2020 | Computed Tomography | BRONCHIECTASIS AND NON-TUBERCULOUS MYCOBACTERIAL INFECTION

Radiologic Characteristics of Non-tuberculous Mycobacteria Infection in Patients with Bronchiectasis

Authors: Iya Eisenberg, Alaa Yasin, Leonardo Fuks, Nili Stein, Walid Saliba, Mordechai R. Kramer, Yochai Adir, Michal Shteinberg

Published in: Lung | Issue 4/2020

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Abstract

Introduction

Non-tuberculous mycobacteria pulmonary disease (NTM-pd) commonly complicates bronchiectasis. However, clinical and radiological features of NTM-pd and bronchiectasis are very similar. We aimed to develop a radiologic prediction tool for bronchiectasis to identify NTM-pd.

Methods

We reviewed clinical, laboratory and radiological data in patients with bronchiectasis. Radiologic features on CT scans and the individual components of the Bhalla scoring system were compared between people with and without NTM-pd. Logistic regression and receiver-operating curve (ROC) analysis were performed to predict NTM-pd.

Results

People with NTM-pd had more pulmonary segments with bronchiectasis (13 ± 5 vs. 11 ± 5, p = 0.03), presence of mucus plugging (47% vs. 19%, p < 0.0001) and tree in bud infiltrates (53% vs. 28%, p = 0.004). The total modified- Bhalla score was worse among people with NTM-pd (median [IQR] 11[9,13] vs. 9[8,12], p = 0.03). Logistic regression identified the number of pulmonary segments involved, presence of bullae, consolidations, and a total score of 10 or more to be independently associated with presence of NTM-pd. ROC analysis with radiographic variables only identified an AUC of 0.706 (95% CI 0.644–0.762). When people with chronic Pseudomonas infection were excluded from the ROC analysis, prediction for NTM was improved: AUC = 0.87 (95% CI 0.796–0.945).

Discussion and Conclusions

Radiological features together with advanced age and female gender may predict NTM-pd among people with bronchiectasis. Infection with Pseudomonas aeruginosa may resemble NTM radiographically, and this prediction rule may better differentiate people with and without NTM-pd when Pseudomonas infection is not present.
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Metadata
Title
Radiologic Characteristics of Non-tuberculous Mycobacteria Infection in Patients with Bronchiectasis
Authors
Iya Eisenberg
Alaa Yasin
Leonardo Fuks
Nili Stein
Walid Saliba
Mordechai R. Kramer
Yochai Adir
Michal Shteinberg
Publication date
01-08-2020
Publisher
Springer US
Published in
Lung / Issue 4/2020
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-020-00371-0

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