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

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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.

References

  1. 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

    Article  PubMed  Google Scholar 

  2. 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

    Article  Google Scholar 

  3. 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

    Article  CAS  PubMed  Google Scholar 

  4. 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

    Article  PubMed  Google Scholar 

  5. 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

    Article  PubMed  Google Scholar 

  6. 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

    Article  CAS  PubMed  Google Scholar 

  7. 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

    Article  CAS  PubMed  Google Scholar 

  8. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

  10. 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

    Article  PubMed  PubMed Central  Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. 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

    Article  CAS  PubMed  Google Scholar 

  13. 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

    Article  CAS  PubMed  Google Scholar 

  14. 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

    Article  CAS  PubMed  Google Scholar 

  15. 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

    Article  CAS  PubMed  Google Scholar 

  16. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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

    Article  CAS  PubMed  Google Scholar 

  18. 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

    Article  PubMed  Google Scholar 

  19. 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

    Article  PubMed  Google Scholar 

  20. 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

    Article  PubMed  Google Scholar 

  21. 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

    Article  PubMed  Google Scholar 

  22. 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

    Article  Google Scholar 

  23. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. 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

    Article  CAS  PubMed  Google Scholar 

  27. 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

    Article  PubMed  Google Scholar 

  28. 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

    Article  PubMed  Google Scholar 

  29. 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

    Article  CAS  PubMed Central  Google Scholar 

  30. 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

    Article  PubMed  Google Scholar 

  31. 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

    Article  PubMed  Google Scholar 

  32. 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

    Article  PubMed  Google Scholar 

  33. 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

    Article  CAS  PubMed  Google Scholar 

  34. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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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 and Affiliations

  1. Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan

    Keiji Fujiwara, Koji Furuuchi, Fumiko Uesugi, Tatsuya Shirai, Keitaro Nakamoto, Yoshiaki Tanaka, Takashi Yoshiyama, Yuji Shiraishi, Atsuyuki Kurashima, Ken Ohta & Kozo Morimoto

  2. Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan

    Akio Aono & Satoshi Mitarai

  3. Department of Respiratory Medicine, Kyorin University School of Medicine, Mitaka, Japan

    Tatsuya Shirai & Keitaro Nakamoto

  4. Department of Respiratory Medicine, Tsukuba Medical Center, Tsukuba, Japan

    Takafumi Shimada, Fumi Mochizuki & Hiroaki Iijima

  5. Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan

    Kozo Morimoto

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  1. Keiji Fujiwara
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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 authors declare that they have no conflict of interest.

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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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