Distribution and outcomes of infection of Mycobacterium avium complex species in cystic fibrosis

Michelle Azar; Madsen Zimbric; Kerby Shedden; Lindsay J Caverly

doi:10.1016/j.jcf.2019.07.007

Distribution and outcomes of infection of Mycobacterium avium complex species in cystic fibrosis

J Cyst Fibros. 2020 Mar;19(2):232-235. doi: 10.1016/j.jcf.2019.07.007. Epub 2019 Aug 6.

Authors

Michelle Azar¹, Madsen Zimbric¹, Kerby Shedden², Lindsay J Caverly³

Affiliations

¹ Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.
² Department of Statistics and Biostatistics, University of Michigan, Ann Arbor, MI, USA.
³ Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA. Electronic address: caverlyl@med.umich.edu.

Abstract

Background: The majority of nontuberculous mycobacterial (NTM) pulmonary infections in people with cystic fibrosis (CF) are caused by Mycobacterium avium complex (MAC) species. Data on MAC species distribution and outcomes of infection in CF are lacking.

Methods: This was a single center, retrospective study. MAC isolates had species identification with MLSA of rpoB and the 16S23S ITS region. Clinical data were compared between species.

Results: Twenty-three people with CF and 57 MAC isolates were included. Infection with M. avium was the most common (65.2%). M. intracellulare was associated with higher rates of NTM disease, younger age, and steeper decline in lung function prior to infection.

Conclusions: We observed worse clinical outcomes in people with M. intracellulare infection relative to other MAC species. Further investigation of clinical outcomes of MAC infection among CF patients is warranted to better define the utility of species-level identification of MAC isolates in CF.

Keywords: Mycobacterium avium complex; Mycobacterium intracellulare; Nontuberculous mycobacteria.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anti-Bacterial Agents / therapeutic use*
Cystic Fibrosis* / diagnosis
Cystic Fibrosis* / microbiology
Cystic Fibrosis* / physiopathology
Female
Humans
Male
Mycobacterium Infections, Nontuberculous / classification*
Mycobacterium Infections, Nontuberculous / epidemiology
Mycobacterium Infections, Nontuberculous / therapy
Mycobacterium avium Complex* / classification
Mycobacterium avium Complex* / drug effects
Mycobacterium avium Complex* / genetics
Mycobacterium avium Complex* / pathogenicity
Mycobacterium avium-intracellulare Infection* / epidemiology
Mycobacterium avium-intracellulare Infection* / physiopathology
Mycobacterium avium-intracellulare Infection* / therapy
Outcome Assessment, Health Care / methods
Outcome Assessment, Health Care / statistics & numerical data
Prognosis
Respiratory Function Tests / methods
Retrospective Studies
United States / epidemiology

Substances

Anti-Bacterial Agents

Grants and funding

K23 HL136934/HL/NHLBI NIH HHS/United States