Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Division of Infectious Diseases, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
J Microbiol Immunol Infect. 2022 Feb;55(1):123-129. doi: 10.1016/j.jmii.2020.08.021. Epub 2020 Oct 7.
Nontuberculous mycobacteria (NTM) infection is an important issue after lung transplantation. However, a large-scale epidemiological study on this issue in Korea is lacking. We aimed to evaluate the epidemiology of NTM infection after lung transplant surgery in Korea.
Between October 2012 and December 2018, we retrospectively evaluated lung transplant recipients in a referral hospital in South Korea. A total of 215 recipients were enrolled. The median age at transplantation was 56 years (range, 17-75), and 62% were men. Bronchoscopy was performed according to the surveillance protocol and clinical indications. A diagnosis of NTM infection was defined as a positive NTM culture from a bronchial washing, bronchoalveolar lavage sample, or two separate sputum samples. We determined NTM pulmonary disease (NTM-PD) according to the American Thoracic Society/Infectious Disease Society of America 2007 guidelines. The Kaplan-Meier method and log-rank test were used for conditional survival analysis in patients with follow-up of ≥12 months.
Fourteen patients (6.5%) were diagnosed with NTM infection at a median of 11.8 months (range, 0.3-51.4) after transplantation. Nine patients (4.2%) were diagnosed with NTM-PD, and the incidence rate was 1980/100,000 person-years. Mycobacterium abscessus was the most common species causing NTM-PD (66%), followed by M. avium complex (33%). The presence of NTM infection did not influence all-cause mortality among those who underwent follow-up for ≥12 months (N = 133, log-rank P = 0.816).
The incidence of NTM-PD was considerably high among lung-transplant recipients. M. abscessus was the most common causative species of NTM-PD after lung transplantation.
非结核分枝杆菌（NTM）感染是肺移植后的一个重要问题。然而，韩国缺乏对此问题的大规模流行病学研究。我们旨在评估韩国肺移植术后 NTM 感染的流行病学情况。
2012 年 10 月至 2018 年 12 月，我们回顾性评估了韩国一家转诊医院的肺移植受者。共纳入 215 名受者。移植时的中位年龄为 56 岁（范围，17-75 岁），62%为男性。根据监测方案和临床指征进行支气管镜检查。从支气管冲洗、支气管肺泡灌洗液或两份单独的痰样本中培养出 NTM 即可诊断为 NTM 感染。根据美国胸科学会/传染病学会 2007 年指南，我们确定了 NTM 肺部疾病（NTM-PD）。对于随访时间≥12 个月的患者，使用 Kaplan-Meier 方法和对数秩检验进行条件生存分析。
14 名患者（6.5%）在移植后中位数为 11.8 个月（范围，0.3-51.4）时被诊断为 NTM 感染。9 名患者（4.2%）被诊断为 NTM-PD，发病率为 1980/100,000 人年。引起 NTM-PD 最常见的物种是 M. abscessus（66%），其次是 M. avium complex（33%）。在随访时间≥12 个月的患者中，NTM 感染的存在并不影响全因死亡率（N=133，对数秩 P=0.816）。
肺移植受者中 NTM-PD 的发生率相当高。M. abscessus 是肺移植后 NTM-PD 最常见的致病物种。
