The clinical importance of Mycobacterium abscessus subsp. abscessus (M. abscessus) lung disease has been increasing, but few studies have assessed the clinical characteristics associated with the treatment outcome. We retrospectively analyzed 75 consecutive patients with M. abscessus lung disease diagnosed at a tertiary hospital from January 2004 to April 2018. Among 52 patients with sufficient clinical data, 19 patients (42.2%) achieved treatment success. Compared with 26 (57.8%) patients in the treatment failure group, body mass index (BMI) (19.8 vs 17.5 kg/m2, P = 0.022), previous nontuberculous mycobacterial (NTM) lung disease (26.3% vs 61.5%, P = 0.034), the presence of cavitary lesions (31.6% vs 69.2%, P = 0.017), and the bronchiectasis score (3.0 vs 5.0, P = 0.003) were significantly different in the treatment success group. Multivariate analysis showed that age (adjusted hazard ratio (aHR), 0.94; 95% confidence interval (CI), 0.90 to 0.99; P = 0.010), the presence of cavitary lesions (aHR, 0.34; 95% CI, 0.12 to 0.94; P = 0.039), and previous NTM lung disease (aHR, 0.28; 95% CI, 0.09 to 0.86; P = 0.026) were negatively associated with treatment success. This is the first study to show that previous NTM lung disease might be a clinically important factor related to unfavorable treatment outcomes in M. abscessus lung disease patients. To increase our understanding the characteristics of M. abscessus lung disease, this factor should be independently analyzed in future research.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Prevots DR, Marras TK (2015) Epidemiology of human pulmonary infection with nontuberculous mycobacteria: a review. Clin Chest Med 36:13–34. https://doi.org/10.1016/j.ccm.2014.10.002
Koh WJ, Chang B, Jeong BH, Jeon K, Kim SY, Lee NY, Kwon OJ (2013) Increasing recovery of nontuberculous mycobacteria from respiratory specimens over a 10-year period in a tertiary referral hospital in South Korea. Tuberc Respir Dis (Seoul) 75:199–204. https://doi.org/10.4046/trd.2013.75.5.199
Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, Holland SM, Horsburgh R, Huitt G, Iademarco MF, Iseman M, Olivier K, Ruoss S, von Reyn CF, Wallace RJ Jr, Winthrop K, ATS Mycobacterial Diseases Subcommittee, American Thoracic Society, Infectious Disease Society of America (2007) An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 175:367–416. https://doi.org/10.1164/rccm.200604-571ST
Morimoto K, Hasegawa N, Izumi K, Namkoong H, Uchimura K, Yoshiyama T, Hoshino Y, Kurashima A, Sokunaga J, Shibuya S, Shimojima M, Ato M, Mitarai S (2017) A laboratory-based analysis of nontuberculous mycobacterial lung disease in Japan from 2012 to 2013. Ann Am Thorac Soc 14:49–56. https://doi.org/10.1513/AnnalsATS.201607-573OC
Koh WJ, Jeon K, Lee NY, Kim BJ, Kook YH, Lee SH, Park YK, Kim CK, Shin SJ, Huitt GA, Daley CL, Kwon OJ (2011) Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus. Am J Respir Crit Care Med 183:405–410. https://doi.org/10.1164/rccm.201003-0395OC
Bastian S, Veziris N, Roux AL, Brossier F, Gaillard JL, Jarlier V, Cambau E (2011) Assessment of clarithromycin susceptibility in strains belonging to the Mycobacterium abscessus group by erm(41) and rrl sequencing. Antimicrob Agents Chemother 55:775–781. https://doi.org/10.1128/AAC.00861-10
Yoshida S, Tsuyuguchi K, Suzuki K, Tomita M, Okada M, Hayashi S, Iwamoto T, Saito H (2013) Further isolation of Mycobacterium abscessus subsp. abscessus and subsp. bolletii in different regions of Japan and susceptibility of these isolates to antimicrobial agents. Int J Antimicrob Agents 42:226–231. https://doi.org/10.1016/j.ijantimicag.2013.04.029
Brown-Elliott BA, Vasireddy S, Vasireddy R, Iakhiaeva E, Howard ST, Nash K, Parodi N, Strong A, Gee M, Smith T, Wallace RJ Jr (2015) Utility of sequencing the erm (41) gene in isolates of Mycobacterium abscessus subsp. abscessus with low and intermediate clarithromycin MICs. J Clin Microbiol 53:1211–1215. https://doi.org/10.1128/JCM.02950-14
Haworth CS, Banks J, Capstick T, Fisher AJ, Gorsuch T, Laurenson IF, Leitch A, Loebinger MR, Milburn HJ, Nightingale M, Ormerod P, Shingadia D, Smith D, Whitehead N, Wilson R, Floto RA (2017) British Thoracic Society guidelines for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD). Thorax 72:ii1–ii64. https://doi.org/10.1136/thoraxjnl-2017-210927
Pasipanodya JG, Ogbonna D, Ferro BE, Magombedze G, Srivastava S, Deshpande D, Gumbo T (2017) Systematic review and meta-analyses of the effect of chemotherapy on pulmonary Mycobacterium abscessus outcomes and disease recurrence. Antimicrob Agents Chemother 61:e01206–e01217. https://doi.org/10.1128/AAC.01206-17
Kwak N, Dalcolmo MP, Daley CL, Eather G, Gayoso R, Hasegawa N, Jhun BW, Koh WJ, Namkoong H, Park J, Thomson R, van Ingen J, Zweijpfenning SMH, Yim JJ (2019) Mycobacterium abscessus pulmonary disease: individual patient data meta-analysis. Eur Respir J 54:1801991. https://doi.org/10.1183/13993003.01991-2018
Koh WJ, Jeong BH, Kim SY, Jeon K, Park KU, Jhun BW, Lee H, Park HY, Kim DH, Huh HJ, Ki CS, Lee NY, Kim HK, Choi YS, Kim J, Lee SH, Kim CK, Shin SJ, Daley CL, Kim H, Kwon OJ (2016) Mycobacterial characteristics and treatment outcomes in Mycobacterium abscessus lung disease. Clin Infect Dis 64:309–316. https://doi.org/10.1093/cid/ciw724
Koh WJ, Moon SM, Kim SY, Woo MA, Kim S, Jhun BW, Park HY, Jeon K, Huh HJ, Ki CS, Lee NY, Chung MJ, Lee KS, Shin SJ, Daley CL, Kim H, Kwon OJ (2017) Outcomes of Mycobacterium avium complex lung disease based on clinical phenotype. Eur Respir J 50:1602503. https://doi.org/10.1183/13993003.02503-2016
Xu HB, Jiang RH, Li L (2014) Treatment outcomes for Mycobacterium avium complex: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis 33:347–358. https://doi.org/10.1007/s10096-013-1962-1
Pasipanodya JG, Ogbonna D, Deshpande D, Srivastava S, Gumbo T (2017) Meta-analyses and the evidence base for microbial outcomes in the treatment of pulmonary Mycobacterium avium–intracellulare complex disease. J Antimicrob Chemother 72:i3–i19. https://doi.org/10.1093/jac/dkx311
Guo Q, Chu H, Ye M, Zhang Z, Li B, Yang S, Ma W, Yu F (2018) The clarithromycin susceptibility genotype affects the treatment outcome of patients with Mycobacterium abscessus lung disease. Antimicrob Agents Chemother 62:e02360–e02317. https://doi.org/10.1128/AAC.02360-17
Park J, Cho J, Lee CH, Han SK, Yim JJ (2016) Progression and treatment outcomes of lung disease caused by Mycobacterium abscessus and Mycobacterium massiliense. Clin Infect Dis 64:301–308. https://doi.org/10.1093/cid/ciw723
Tung YJ, Bittaye SO, Tsai JR, Lin CY, Huang CH, Chen TC, Lin WR, Chang K, Lai CC, Lu PL, Chen YH (2015) Risk factors for microbiologic failure among Taiwanese adults with Mycobacterium abscessus complex pulmonary disease. J Microbiol Immunol Infect 48:437–445. https://doi.org/10.1016/j.jmii.2014.08.005
Kobashi Y, Matsushima T, Oka M (2007) A double-blind randomized study of aminoglycoside infusion with combined therapy for pulmonary Mycobacterium avium complex disease. Respir Med 101:130–138. https://doi.org/10.1016/j.rmed.2006.04.002
Morimoto K, Nakagawa T, Asami T, Morino E, Fujiwara H, Hase I, Tsujimoto Y, Izumi K, Hayashi Y, Matsuda S, Murase Y, Yano R, Takasaki J, Betsuyaku T, Aono A, Goto H, Nishimura T, Sasaki Y, Hoshino Y, Kurashima A, Ato M, Ogawa K, Hasegawa N, Mitarai S (2018) Clinico-microbiological analysis of 121 patients with pulmonary Mycobacterium abscessus complex disease in Japan–an NTM-JRC study with RIT. Respir Med 145:14–20. https://doi.org/10.1016/j.rmed.2018.10.012
Morimoto K, Namkoong H, Hasegawa N, Nakagawa T, Morino E, Shiraishi Y, Ogawa K, Izumi K, Takasaki J, Yoshiyama T, Hoshino Y, Matsuda S, Hayashi Y, Sasaki Y, Ishii M, Kurashima A, Nishimura T, Betsuyaku T, Goto H, Nontuberculous Mycobacteriosis Japan Research Consortium (2016) Macrolide-resistant Mycobacterium avium complex lung disease: analysis of 102 consecutive cases. Ann Am Thorac Soc 13:1904–1911. https://doi.org/10.1513/AnnalsATS.201604-246OC
Kurashima A, Morimoto K, Horibe M, Hoshino Y, Shiraishi Y, Kudoh S (2013) A method for visual scoring of pulmonary mycobacterium avium complex disease:“Nice scoring system”. J Mycobac Dis 3:127. https://doi.org/10.4172/2161-1068.1000127
Kusunoki S, Ezaki T, Tamesada M, Hatanaka Y, Asano K, Hashimoto Y, Yabuuchi E (1991) Application of colorimetric microdilution plate hybridization for rapid genetic identification of 22 Mycobacterium species. J Clin Microbiol 29:1596–1603. https://doi.org/10.1128/jcm.29.8.1596-1603.1991
Nakanaga K, Sekizuka T, Fukano H, Sakakibara Y, Takeuchi F, Wada S, Ishii N, Makino M, Kuroda M, Hoshino Y (2014) Discrimination of Mycobacterium abscessus subsp. massiliense from Mycobacterium abscessus subsp. abscessus in clinical isolates by multiplex PCR. J Clin Microbiol 52:251–259. https://doi.org/10.1128/JCM.01327-13
Brown-Elliott BA, Woods GL (2019) Antimycobacterial susceptibility testing of nontuberculous mycobacteria. J Clin Microbiol 57:e00834–e00819. https://doi.org/10.1128/JCM.00834-19
Boyle DP, Zembower TR, Reddy S, Qi C (2015) Comparison of clinical features, virulence, and relapse among Mycobacterium avium complex species. Am J Respir Crit Care Med 191:1310–1317. https://doi.org/10.1164/rccm.201501-0067OC
Pan SW, Shu CC, Feng JY, Wang JY, Chan YJ, Yu CJ, Su WJ (2017) Microbiological persistence in patients with Mycobacterium avium complex lung disease: the predictors and the impact on radiographic progression. Clin Infect Dis 65:927–934. https://doi.org/10.1093/cid/cix479
Griffith DE, Philley JV, Brown-Elliott BA, Benwill JL, Shepherd S, York D, Wallace RJ Jr (2015) The significance of Mycobacterium abscessus subspecies abscessus isolation during Mycobacterium avium complex lung disease therapy. Chest 147:1369–1375. https://doi.org/10.1378/chest.14-1297
Faverio P, Stainer A, Bonaiti G, Zucchetti SC, Simonetta E, Lapadula G, Marruchella A, Gori A, Blasi F, Codecasa L, Pesci A, Chalmers JD, Loebinger MR, Aliberti S (2016) Characterizing non-tuberculous mycobacteria infection in bronchiectasis. Int J Mol Sci 17:1913. https://doi.org/10.3390/ijms17111913
Kasperbauer SH, De Groote MA (2015) The treatment of rapidly growing mycobacterial infections. Clin Chest Med 36:67–78. https://doi.org/10.1016/j.ccm.2014.10.004
Jarand J, Levin A, Zhang L, Huitt G, Mitchell JD, Daley CL (2011) Clinical and microbiologic outcomes in patients receiving treatment for Mycobacterium abscessus pulmonary disease. Clin Infect Dis 52:565–571. https://doi.org/10.1093/cid/ciq237
Hwang JA, Kim S, Jo KW, Shim TS (2017) Natural history of Mycobacterium avium complex lung disease in untreated patients with stable course. Eur Respir J 49:1600537. https://doi.org/10.1183/13993003.00537-2016
Hayashi M, Takayanagi N, Kanauchi T, Miyahara Y, Yanagisawa T, Sugita Y (2012) Prognostic factors of 634 HIV-negative patients with Mycobacterium avium complex lung disease. Am J Respir Crit Care Med 185:575–583. https://doi.org/10.1164/rccm.201107-1203OC
Harada T, Akiyama Y, Kurashima A, Nagai H, Tsuyuguchi K, Fujii T, Yano S, Shigeto E, Kuraoka T, Kajiki A, Kobashi Y, Kokubu F, Sato A, Yoshida S, Iwamoto T, Saito H (2012) Clinical and microbiological differences between Mycobacterium abscessus and Mycobacterium massiliense lung diseases. J Clin Microbiol 50:3556–3561. https://doi.org/10.1128/JCM.01175-12
The authors are grateful to all the hospital staff who supported this research.
This study was supported by the Japan Agency for Medical Research and Development (19fk0108043, JP20fk0108129).
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics approval and consent to participate
The study protocol was approved by the Fukujuji Hospital Institutional Review Board (protocol number: 19042), and informed consent was waived because of the retrospective nature of the analysis.
Consent for publication
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
About this article
Cite this article
Fujiwara, K., Furuuchi, K., Aono, A. et al. Clinical risk factors related to treatment failure in Mycobacterium abscessus lung disease. Eur J Clin Microbiol Infect Dis 40, 247–254 (2021). https://doi.org/10.1007/s10096-020-04026-z
- Mycobacterium abscessus
- Treatment outcomes
- Lung disease