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Int. J. Mol. Sci. 2016, 17(11), 1913; doi:10.3390/ijms17111913

Characterizing Non-Tuberculous Mycobacteria Infection in Bronchiectasis

1
Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy
2
Department of Internal Medicine, Division of Infectious Diseases, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900 Monza, Italy
3
Department of Pathophysiology and Transplantation, University of Milan, Cardio-Thoracic Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
4
Villa Marelli Institute, Niguarda Ca’ Granda Hospital, 20122 Milan, Italy
5
Scottish Centre for Respiratory Research, University of Dundee, Dundee DD1 9SY, UK
6
Host Defence Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK Imperial College London, London SW3 6NP, UK
*
Author to whom correspondence should be addressed.
Academic Editor: William Chi-shing Cho
Received: 16 September 2016 / Revised: 3 November 2016 / Accepted: 7 November 2016 / Published: 16 November 2016
(This article belongs to the Special Issue Lung Diseases: Chronic Respiratory Infections)
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Abstract

Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease. This was a prospective, observational study enrolling 261 adult bronchiectasis patients during the stable state at the San Gerardo Hospital, Monza, Italy, from 2012 to 2015. Three groups were identified: pNTM disease; chronic P. aeruginosa infection; chronic infection due to bacteria other than P. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronic P. aeruginosa infection, patients with pNTM were more likely to have cylindrical bronchiectasis and a “tree-in-bud” pattern, a history of weight loss, a lower disease severity and a lower number of pulmonary exacerbations. Among pNTM patients who started treatment, 68% showed a radiological improvement, and 37% achieved culture conversion without recurrence, while 21% showed NTM isolation recurrence. NTM isolation seems to be a frequent event in bronchiectasis patients, and few parameters might help to suspect NTM infection. Treatment indications and monitoring still remain an important area for future research. View Full-Text
Keywords: non-cystic fibrosis bronchiectasis; non-tuberculous mycobacteria; pulmonary infection non-cystic fibrosis bronchiectasis; non-tuberculous mycobacteria; pulmonary infection
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MDPI and ACS Style

Faverio, P.; Stainer, A.; Bonaiti, G.; Zucchetti, S.C.; Simonetta, E.; Lapadula, G.; Marruchella, A.; Gori, A.; Blasi, F.; Codecasa, L.; Pesci, A.; Chalmers, J.D.; Loebinger, M.R.; Aliberti, S. Characterizing Non-Tuberculous Mycobacteria Infection in Bronchiectasis. Int. J. Mol. Sci. 2016, 17, 1913.

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