Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch BioMedical Park Hospital, Zhubei City, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Int J Infect Dis. 2024 Feb;139:118-123. doi: 10.1016/j.ijid.2023.11.018. Epub 2023 Nov 16.
Persistent growth of Mycobacterium abscessus complex (MABC) in the respiratory system is not uncommon and may indicate continuous infection of MABC lung disease (MABC-LD), but its prevalence, risk factors, and clinical impact have not been investigated.
The present study was conducted in two medical centers in northern Taiwan. We enrolled patients with MABC-LD and investigated the prevalence and predictors of persistent culture positivity (MABC-PP). Furthermore, we analyzed the association between MABC-PP and radiographic or clinical progression.
Among 189 patients with MABC-LD, 58 were in the MABC-PP group. Independent predictors for MABC-PP included an increasing radiographic score and highest acid-fast stain (AFS) of strong positivity (3-4+) at initial diagnosis (compared with negative AFS). MABC-PP and highest AFS were independently associated with MABC-LD progression by the multivariable analysis model. The adjusted hazard ratio increased to 3.56 when the two independent factors existed.
MABC-PP accounted for 30.7% and was predicted by initial AFS grade and radiographic score. Patients with MABC-PP, and highest AFS grade might have disease progression.
分枝杆菌脓肿复合体（MABC）在呼吸系统中的持续生长并不少见，可能表明 MABC 肺病（MABC-LD）的持续感染，但尚未研究其流行率、危险因素和临床影响。
本研究在台湾北部的两家医疗中心进行。我们招募了 MABC-LD 患者，并调查了持续培养阳性（MABC-PP）的患病率和预测因素。此外，我们分析了 MABC-PP 与影像学或临床进展之间的关联。
在 189 例 MABC-LD 患者中，有 58 例为 MABC-PP 组。MABC-PP 的独立预测因素包括初始诊断时影像学评分增加和最强抗酸染色（AFS）为强阳性（3-4+）（与 AFS 阴性相比）。多变量分析模型表明，MABC-PP 和最高 AFS 与 MABC-LD 进展独立相关。当两个独立因素存在时，调整后的危险比增加到 3.56。
MABC-PP 占 30.7%，由初始 AFS 分级和影像学评分预测。MABC-PP 患者和最高 AFS 分级可能会出现疾病进展。
