Clinical characteristics and an evaluation of predictors for a favourable outcome of Mycobacterium abscessus otomastoiditis: a systematic review and meta-analysis of individual participant data

Autor: Jordi Manders, Theresa Leow, Koen van Aerde, Myrthe Hol, Dirk Kunst, Sjoert Pegge, Thijs Jansen, Jakko van Ingen, Stijn Bekkers
Rok vydání: 2021
Předmět:
Non–tuberculous mycobacteria
Microbiology (medical)
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]
Mycobacterium Infections
Nontuberculous
Infectious and parasitic diseases
RC109-216
Microbial Sensitivity Tests
Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12]
Anti-Bacterial Agents/pharmacology
Non-tuberculous mycobacteria
Humans
Child
Otitis media
Otomastoiditis
Mycobacterium Infections
Mycobacterium abscessus
General Medicine
Macrolides/pharmacology
OTITIS-MEDIA
Anti-Bacterial Agents
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10]
Infectious Diseases
lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]
MASTOIDITIS
Macrolides
Nontuberculous/drug therapy
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Zdroj: International Journal of Infectious Diseases, 116, pp. 397-402
International Journal of Infectious Diseases, Vol 116, Iss, Pp 397-402 (2022)
International Journal of Infectious Diseases, 116, 397-402
ISSN: 1878-3511
1201-9712
Popis: Background: Otomastoiditis caused by Mycobacterium abscessus is rare, but its incidence has increased over the past decades and its optimal treatment remains unknown. This study aims to summarise the clinical and therapeutic features and find characteristics of patients with M. abscessus otomastoiditis associated with favourable treatment outcomes. Methods: We searched MEDLINE, Embase and Web of Science to identify studies including patients with M. abscessus otomastoiditis. A 1-stage individual patient data (IPD) meta-analysis was conducted. A 2-level mixed-effects linear regression model was provided for antimycobacterial treatment duration. Results: Twenty-three studies reported a total of 85 patients. Children possess a unique clinical profile including a history of ear infections, tympanostomy tube placement and antibiotic treatment. Antimycobacterial treatment was administered for 26 (interquartile range [IQR]: 15-35) weeks. Macrolides were prescribed in 98.8% of the cases. Surgery was performed in 80.5% of the cases, of which, 47.1% required revision surgery. Otalgia was a significant predictor (beta= 9.3; P =.049) of antimycobacterial treatment duration. Conclusions: Mastoid surgery (regularly requiring revision) and a multidrug regimen for a minimum of 6 months, including a minimum of 3 active agents, are most often needed to attain cure. The presence of otalgia significantly extends the treatment duration of M. abscessus otomastoiditis. (C) 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
Databáze: OpenAIRE
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