Significance of changes in cavity after treatment in Mycobacterium avium complex pulmonary disease.

Autor: Kim JY; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea., Bae J; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea., Hyung K; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea., Lee I; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea., Park HJ; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea., Kim SY; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea., Lee KE; Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Pulmonology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea., Ahn YH; Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Republic of Korea., Yoon SM; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea., Kwak N; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea., Yim JJ; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. yimjj@snu.ac.kr.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. yimjj@snu.ac.kr.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Sep 10; Vol. 14 (1), pp. 21133. Date of Electronic Publication: 2024 Sep 10.
DOI: 10.1038/s41598-024-71971-6
Abstrakt: Cavities are characteristic radiological features related to increased mycobacterial burden and poor prognosis in Mycobacterium avium complex pulmonary disease (MAC-PD). However, cavity changes following treatment and their clinical implications remain unknown. We aimed to elucidate whether cavity obliteration or reduction in cavity size or wall thickness correlates with microbiological cure. In total, 136 adult patients with cavitary MAC-PD treated for ≥ 6 months between January 1st, 2009, and December 31st, 2021, in a tertiary referral centre in South Korea were enrolled. The cavity with the largest diameter at treatment initiation was tracked for size and thickness changes. Following median treatment of 20.0 months, 74 (54.4%) patients achieved microbiological cure. Cavity obliteration, achieved in 58 (42.6%) patients at treatment completion, was independently associated with microbiological cure. In patients with persistent cavities, size reduction of ≥ 10% was significantly associated with microbiological cure, whereas thickness reduction was not. Five-year mortality rates in patients with cavity obliteration, persistent but reduced cavity, and persistent cavity without shrinkage were 95.6%, 72.1%, and 65.3%, respectively (P < 0.001). In conclusion, cavity obliteration or shrinkage at treatment completion is associated with microbiological cure and reduced mortality in MAC-PD, suggesting that cavity changes could serve as a proxy indicator for treatment response.
(© 2024. The Author(s).)
Databáze: MEDLINE
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