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

Autor: Bemer P; Department of Bacteriology, CHU Nantes, Nantes, France., Peuchant O; Department of Bacteriology, CHU Bordeaux, Bordeaux, France., Guet-Revillet H; Department of Bacteriology, CHU Toulouse, Toulouse, France., Bador J; Department of Bacteriology, CHU Dijon, Dijon, France., Balavoine C; Department of Respiratory Diseases, CHU Tours, Tours, France., Basille D; Department of Respiratory Diseases, Amiens University Hospital, CHU Amiens, 80054, Amiens Cedex 1, France.; EA 4294 AGIR, Picardie Jules Verne University, Amiens, France., Beltramo G; Department of Respiratory Diseases, CHU Dijon, Dijon, France., Blanc FX; Department of Respiratory Diseases, CHU Nantes, Nantes, France., Blanchard E; Department of Respiratory Diseases, CHU Bordeaux, Bordeaux, France., Boulanger S; Department of Respiratory Diseases, CH Roubaix, Bordeaux, France., Bourgoin A; Department of Bacteriology, CHU Poitiers, Poitiers, France., Boutoille D; Department of Infectious Disease, CHU Nantes, Nantes, France., Cambau E; Department of Bacteriology, AP-HP, Paris, France.; Laboratoire Associé du Centre National de Référence des Mycobactéries et Résistance des Mycobactéries aux Antibiotiques (CNR-MyRMA), Paris, France., Canis F; Department of Bacteriology, CH Valenciennes, Valenciennes, France., Caparros D; Department of Respiratory Diseases, CH Valenciennes, Valenciennes, France., Carricajo A; Department of Bacteriology, CHU Saint Etienne, Saint Etienne, France., Carrière C; Department of Bacteriology, CHU Montpellier, Montpellier, France., Couetdic G; Department of Bacteriology, CHU Besançon, Besançon, France., Couturaud F; Department of Respiratory Diseases, CHU Brest, Brest, France., Dalphin JC; Department of Respiratory Diseases, CHU Besançon, Besançon, France., Degot T; Department of Respiratory Diseases, CHRU Strasbourg, Strasbourg, France., Desquiens M; Department of Respiratory Diseases, Amiens University Hospital, CHU Amiens, 80054, Amiens Cedex 1, France., Devouassoux G; Department of Respiratory Diseases, Hospices Civils Lyon, Lyon, France., Duez JM; Department of Bacteriology, CHU Dijon, Dijon, France., Dumitrescu O; Department of Bacteriology, Hospices Civils Lyon, Lyon, France., Dupuy-Grasset M; Department of Respiratory Diseases, CHU Limoges, Limoges, France., Gaudart A; Department of Bacteriology, CHU Nice, Nice, France., Georges M; Department of Respiratory Diseases, CHU Dijon, Dijon, France., Godet C; Department of Respiratory Diseases, CHU Poitiers, Poitiers, France., Godreuil S; Department of Bacteriology, CHU Montpellier, Montpellier, France., Guillouzouic A; Department of Bacteriology, CHU Nantes, Nantes, France., Hamdad-Daoudi F; Department of Bacteriology, CHU Amiens, Amiens, France., Héry-Arnaud G; Department of Bacteriology, CHU Brest, Brest, France., Koebel C; Department of Bacteriology, CHRU Strasbourg, Strasbourg, France., Lagrange A; Department of Respiratory Diseases, Amiens University Hospital, CHU Amiens, 80054, Amiens Cedex 1, France., Lanotte P; Department of Bacteriology, CHU Tours, Tours, France., Marchand-Adam S; Department of Respiratory Diseases, CHU Tours, Tours, France., Mougari F; Department of Bacteriology, AP-HP, Paris, France.; Laboratoire Associé du Centre National de Référence des Mycobactéries et Résistance des Mycobactéries aux Antibiotiques (CNR-MyRMA), Paris, France., Murris M; Department of Respiratory Diseases, CHU Toulouse, Toulouse, France., Patry I; Department of Bacteriology, CHU Besançon, Besançon, France., Pérouse de Montclos M; Department of Bacteriology, Hospices Civils Lyon, Lyon, France., Raskine L; Department of Bacteriology, AP-HP, Paris, France.; Laboratoire Associé du Centre National de Référence des Mycobactéries et Résistance des Mycobactéries aux Antibiotiques (CNR-MyRMA), Paris, France., Risso K; Department of Respiratory Diseases, CHU Nice, Nice, France., Segonds C; Department of Bacteriology, CHU Toulouse, Toulouse, France., Sicard D; Department of Bacteriology, CHU Nice, Nice, France., Terru D; Department of Bacteriology, CHU Montpellier, Montpellier, France., Vachée A; Department of Bacteriology, CH Roubaix, Roubaix, France., Vergnon JM; Department of Respiratory Diseases, CHU Saint Etienne, Saint Etienne, France., Martin C; Department of Bacteriology, CHU Limoges, Limoges, France., Schramm F; Department of Bacteriology, CHRU Strasbourg, Strasbourg, France., Andrejak C; Department of Respiratory Diseases, Amiens University Hospital, CHU Amiens, 80054, Amiens Cedex 1, France. andrejak.claire@chu-amiens.fr.; EA 4294 AGIR, Picardie Jules Verne University, Amiens, France. andrejak.claire@chu-amiens.fr.
Jazyk: angličtina
Zdroj: BMC pulmonary medicine [BMC Pulm Med] 2021 Oct 26; Vol. 21 (1), pp. 333. Date of Electronic Publication: 2021 Oct 26.
DOI: 10.1186/s12890-021-01701-5
Abstrakt: 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.
(© 2021. The Author(s).)
Databáze: MEDLINE
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