Non-tuberculous mycobacterial bloodstream infections in patients with indwelling vascular catheters - the role of sickle cell anaemia

Infect Dis (Lond). 2017 May;49(5):341-346. doi: 10.1080/23744235.2016.1262058. Epub 2016 Dec 2.

Abstract

Introduction: Few studies have examined risk factors for nontuberculous mycobacteria (NTM) bloodstream infections (BSI) involving indwelling vascular catheters (IDVC). Sickle cell anaemia (HbSS/SC) is known to affect several aspects of the immune system leading to relative immune deficiency. The purpose of this retrospective nested case-control study was to determine if HbSS/SC is a risk factor for NTM BSI among individuals with IDVCs.

Methods: All NTM IDVC infections (cases) at two tertiary hospitals from 2008 to 2014 were reviewed. Cases were matched 2:1 with controls who had IDVC infections due to organisms other than NTM. Matching criteria included age within 10 years and IDVC infection within three months of index case. Logistic regression was used to identify risk factors for IDVC infection due to NTM.

Results: Nineteen NTM BSIs were identified. Three cases were excluded because they did not have IDVCs at the time their BSI was identified. Sixteen cases of NTM IDVC infection were matched to 32 controls with IDVC infections due to other organisms. The mean age of patients with IDVC infections was 48.5 years and 28 (58%) were male. Compared to the control group those with NTM BSI were more likely to have HbSS/SC 38% (6/16) versus 6% (2/32) (p = .006).

Conclusion: IDVCs are a risk factor for NTM BSI. Sickle cell anaemia appears to be a risk factor for IDVC infections due to NTM. This study is limited by the small sample size. A larger study is needed to further investigate the association between HbSS/SC and NTM IDVC infections.

Keywords: Bloodstream infection; nontuberculous mycobacteria; sickle cell anaemia.

MeSH terms

  • Anemia, Sickle Cell / complications*
  • Bacteremia / epidemiology*
  • Case-Control Studies
  • Catheter-Related Infections / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / epidemiology*
  • Nontuberculous Mycobacteria / isolation & purification*
  • Retrospective Studies
  • Risk Assessment
  • Vascular Access Devices / adverse effects*