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Progression and Treatment Outcomes of Lung Disease Caused by Mycobacterium abscessus and Mycobacterium massiliense
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Progression and Treatment Outcomes of Lung Disease Caused by Mycobacterium abscessus and Mycobacterium massiliense
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Journal Article
Progression and Treatment Outcomes of Lung Disease Caused by Mycobacterium abscessus and Mycobacterium massiliense
2017
Overview
Background. Mycobacterium abscessus and Mycobacterium massiliense are grouped as the Mycobacterium abscessus complex. The aim of this study was to elucidate the differences between M. abscessus and M. massiliense lung diseases in terms of progression rate, treatment outcome, and the predictors thereof. Methods. Between 1 January 2006 and 30 June 2015, 56 patients and patients were diagnosed with M. abscessus and M. massiliense lung diseases, respectively. The time to progression requiring treatment and treatment outcomes were compared between the 2 groups of patients, and predictors of progression and sustained culture conversion with treatment were analyzed. In addition, mediation analysis was performed to evaluate the effect of susceptibility to clarithromycin on treatment outcomes. Results. During follow-up, 21 of 56 patients with M. abscessus lung diseases and 21 of 54 patients with M. massiliense lung diseases progressed, requiring treatment. No difference was detected in the time to progression between the 2 patient groups. Lower body mass index, bilateral lung involvement, and fibrocavitary-type disease were identified as predictors of disease progression. Among the patients who began treatment, infection with M. massiliense rather than M. abscessus and the use of azithromycin rather than clarithromycin were associated with sustained culture conversion. The difference in treatment outcomes was partly mediated by the organism's susceptibility to clarithromycin. Conclusions. Progression rates were similar but treatment outcomes differed significantly between patients with lung disease caused by M. abscessus and M. massiliense. This difference in treatment outcomes was partly explained by the susceptibility of these organisms to clarithromycin.
Publisher
Oxford University Press
Subject
/ Anti-Bacterial Agents - therapeutic use
/ Azithromycin - therapeutic use
/ Bacteria
/ Clarithromycin - pharmacology
/ Clarithromycin - therapeutic use
/ Female
/ Humans
/ Lung Diseases - drug therapy
/ Lung Diseases - microbiology
/ Male
/ Mycobacterium Infections, Nontuberculous - diagnosis
/ Mycobacterium Infections, Nontuberculous - drug therapy
/ Mycobacterium Infections, Nontuberculous - microbiology
/ Nontuberculous Mycobacteria - drug effects
