Outcomes of Mycobacterium avium complex lung disease based on clinical phenotype

Won Jung Koh; Seong Mi Moon; Su Young Kim; Min Ah Woo; Seonwoo Kim; Byung Woo Jhun; Hye Yun Park; Kyeongman Jeon; Hee Jae Huh; Chang Seok Ki; Nam Yong Lee; Myung Jin Chung; Kyung Soo Lee; Sung Jae Shin; Charles L. Daley; Hojoong Kim; O. Jung Kwon

doi:10.1183/13993003.02503-2016

Outcomes of Mycobacterium avium complex lung disease based on clinical phenotype

Won Jung Koh, Seong Mi Moon, Su Young Kim, Min Ah Woo, Seonwoo Kim, Byung Woo Jhun, Hye Yun Park, Kyeongman Jeon, Hee Jae Huh, Chang Seok Ki, Nam Yong Lee, Myung Jin Chung, Kyung Soo Lee, Sung Jae Shin, Charles L. Daley, Hojoong Kim, O. Jung Kwon

Department of Microbiology

Research output: Contribution to journal › Article › peer-review

134 Citations (Scopus)

Abstract

The effect of the clinical phenotype of Mycobacterium avium complex (MAC) lung disease on treatment outcome and redevelopment of nontuberculous mycobacterial (NTM) lung disease after treatment completion has not been studied systematically. We evaluated 481 treatment-naïve patients with MAC lung disease who underwent antibiotic treatment for ≥ 12 months between January 2002 and December 2013. Out of 481 patients, 278 (58%) had noncavitary nodular bronchiectatic (NB) disease, 80 (17%) had cavitary NB disease and 123 (25%) had fibrocavitary disease. Favourable outcome was higher in patients with noncavitary disease (88%) than in patients with cavitary disease (76% for fibrocavitary and 78% for cavitary NB disease; p<0.05). Cavitary disease was independently associated with unfavourable outcomes (p<0.05). Out of 402 patients with favourable outcomes, 118 (29%) experienced redevelopment of NTM lung disease, with the same MAC species recurring in 65 (55%) patients. The NB form was an independent risk factor for redevelopment of NTM lung disease (p<0.05). In patients with recurrent MAC lung disease due to the same species, bacterial genotyping revealed that 74% of cases were attributable to reinfection and 26% to relapse. Treatment outcomes and redevelopment of NTM lung disease after treatment completion differed by clinical phenotype of MAC lung disease.

Original language	English
Article number	1602503
Journal	European Respiratory Journal
Volume	50
Issue number	3
DOIs	https://doi.org/10.1183/13993003.02503-2016
Publication status	Published - 2017 Sept 1

Bibliographical note

Funding Information:
Support statement: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and future Planning (NRF-2015R1A2A1A01003959) and by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI15C2778). The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript. Funding information for this article has been deposited with the Crossref Funder Registry.

Publisher Copyright:
Copyright © ERS 2017

All Science Journal Classification (ASJC) codes

Pulmonary and Respiratory Medicine

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10.1183/13993003.02503-2016

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Koh, W. J., Moon, S. M., Kim, S. Y., Woo, M. A., Kim, S., Jhun, B. W., Park, H. Y., Jeon, K., Huh, H. J., Ki, C. S., Lee, N. Y., Chung, M. J., Lee, K. S., Shin, S. J., Daley, C. L., Kim, H., & Kwon, O. J. (2017). Outcomes of Mycobacterium avium complex lung disease based on clinical phenotype. European Respiratory Journal, 50(3), Article 1602503. https://doi.org/10.1183/13993003.02503-2016

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title = "Outcomes of Mycobacterium avium complex lung disease based on clinical phenotype",

abstract = "The effect of the clinical phenotype of Mycobacterium avium complex (MAC) lung disease on treatment outcome and redevelopment of nontuberculous mycobacterial (NTM) lung disease after treatment completion has not been studied systematically. We evaluated 481 treatment-na{\"i}ve patients with MAC lung disease who underwent antibiotic treatment for ≥ 12 months between January 2002 and December 2013. Out of 481 patients, 278 (58%) had noncavitary nodular bronchiectatic (NB) disease, 80 (17%) had cavitary NB disease and 123 (25%) had fibrocavitary disease. Favourable outcome was higher in patients with noncavitary disease (88%) than in patients with cavitary disease (76% for fibrocavitary and 78% for cavitary NB disease; p<0.05). Cavitary disease was independently associated with unfavourable outcomes (p<0.05). Out of 402 patients with favourable outcomes, 118 (29%) experienced redevelopment of NTM lung disease, with the same MAC species recurring in 65 (55%) patients. The NB form was an independent risk factor for redevelopment of NTM lung disease (p<0.05). In patients with recurrent MAC lung disease due to the same species, bacterial genotyping revealed that 74% of cases were attributable to reinfection and 26% to relapse. Treatment outcomes and redevelopment of NTM lung disease after treatment completion differed by clinical phenotype of MAC lung disease.",

author = "Koh, {Won Jung} and Moon, {Seong Mi} and Kim, {Su Young} and Woo, {Min Ah} and Seonwoo Kim and Jhun, {Byung Woo} and Park, {Hye Yun} and Kyeongman Jeon and Huh, {Hee Jae} and Ki, {Chang Seok} and Lee, {Nam Yong} and Chung, {Myung Jin} and Lee, {Kyung Soo} and Shin, {Sung Jae} and Daley, {Charles L.} and Hojoong Kim and Kwon, {O. Jung}",

note = "Funding Information: Support statement: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and future Planning (NRF-2015R1A2A1A01003959) and by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI15C2778). The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript. Funding information for this article has been deposited with the Crossref Funder Registry. Publisher Copyright: Copyright {\textcopyright} ERS 2017",

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AU - Koh, Won Jung

AU - Moon, Seong Mi

AU - Kim, Su Young

AU - Woo, Min Ah

AU - Kim, Seonwoo

AU - Jhun, Byung Woo

AU - Park, Hye Yun

AU - Jeon, Kyeongman

AU - Huh, Hee Jae

AU - Ki, Chang Seok

AU - Lee, Nam Yong

AU - Chung, Myung Jin

AU - Lee, Kyung Soo

AU - Shin, Sung Jae

AU - Daley, Charles L.

AU - Kim, Hojoong

AU - Kwon, O. Jung

N1 - Funding Information: Support statement: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and future Planning (NRF-2015R1A2A1A01003959) and by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI15C2778). The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript. Funding information for this article has been deposited with the Crossref Funder Registry. Publisher Copyright: Copyright © ERS 2017

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Y1 - 2017/9/1

N2 - The effect of the clinical phenotype of Mycobacterium avium complex (MAC) lung disease on treatment outcome and redevelopment of nontuberculous mycobacterial (NTM) lung disease after treatment completion has not been studied systematically. We evaluated 481 treatment-naïve patients with MAC lung disease who underwent antibiotic treatment for ≥ 12 months between January 2002 and December 2013. Out of 481 patients, 278 (58%) had noncavitary nodular bronchiectatic (NB) disease, 80 (17%) had cavitary NB disease and 123 (25%) had fibrocavitary disease. Favourable outcome was higher in patients with noncavitary disease (88%) than in patients with cavitary disease (76% for fibrocavitary and 78% for cavitary NB disease; p<0.05). Cavitary disease was independently associated with unfavourable outcomes (p<0.05). Out of 402 patients with favourable outcomes, 118 (29%) experienced redevelopment of NTM lung disease, with the same MAC species recurring in 65 (55%) patients. The NB form was an independent risk factor for redevelopment of NTM lung disease (p<0.05). In patients with recurrent MAC lung disease due to the same species, bacterial genotyping revealed that 74% of cases were attributable to reinfection and 26% to relapse. Treatment outcomes and redevelopment of NTM lung disease after treatment completion differed by clinical phenotype of MAC lung disease.

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Outcomes of Mycobacterium avium complex lung disease based on clinical phenotype

Abstract

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