Epidemiology of nontuberculous mycobacteria among patients with cystic fibrosis in Scandinavia

J Cyst Fibros. 2015 Jan;14(1):46-52. doi: 10.1016/j.jcf.2014.08.002. Epub 2014 Aug 30.

Abstract

Background: Nontuberculous mycobacteria (NTM) are an emerging threat to cystic fibrosis (CF) patients but their epidemiology is not well described.

Methods: In this retrospective observational study we identified all Scandinavian CF patients with a positive NTM culture from airway secretions from 2000 to the end of 2012 and used national CF databases to describe microbiological and clinical characteristics.

Results: During the 13-year period 157 (11%) CF patients were culture positive for NTM at least once. Mycobacterium abscessus complex (MABSC) (45%) and Mycobacterium avium complex (MAC) (32%) were the predominant species with geographical differences in distribution. Younger patients were more prone to MABSC (p<0.01). Despite treatment, less than one-third of MABSC patients with repeated positive cultures cleared their infection and a quarter had a lung transplant or died.

Conclusion: NTM are significant CF pathogens and are becoming more prevalent in Scandinavia. MABSC and MAC appear to target distinct patient groups. Having multiple positive cultures despite treatment conveys a poor outcome.

Keywords: Mycobacterium abscessus; Mycobacterium avium; Prevalence; Susceptibility.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Cohort Studies
  • Comorbidity
  • Cystic Fibrosis / epidemiology*
  • Cystic Fibrosis / microbiology*
  • Female
  • Humans
  • Male
  • Mycobacterium Infections, Nontuberculous / diagnosis
  • Mycobacterium Infections, Nontuberculous / epidemiology*
  • Nontuberculous Mycobacteria / isolation & purification*
  • Prevalence
  • Retrospective Studies
  • Scandinavian and Nordic Countries / epidemiology
  • Severity of Illness Index
  • Sex Distribution
  • Young Adult