Clinical risk factors related to treatment failure in Mycobacterium abscessus lung disease

Abstract

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.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgments

The authors are grateful to all the hospital staff who supported this research.

Funding

This study was supported by the Japan Agency for Medical Research and Development (19fk0108043, JP20fk0108129).

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Authors

Contributions

K.F. was responsible for data collection, statistical analysis, data analysis, and writing the manuscript. K.M. designed and conducted the study and assisted S.M. with writing the manuscript. K.F. contributed to the statistical analysis. A.A., F.U., T.S., K.N., and Y.T. contributed to data collection. T.S., F.M., H.I., T.Y., Y.S., A.K., and K.O. contributed to the interpretation of the results. All other authors critically read and commented on the manuscript.

Corresponding author

Correspondence to Kozo Morimoto.

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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.

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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

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Keywords

  • Mycobacterium abscessus
  • Treatment outcomes
  • Lung disease
  • Cavity