Pulmonary Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinksy St, Petach Tikva, 4941492, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
Respir Res. 2024 Jul 15;25(1):278. doi: 10.1186/s12931-024-02904-0.
The global mortality and morbidity rates of bronchiectasis patients due to nontuberculous mycobacteria (NTM) pulmonary infection are on a concerning upward trend. The aims of this study to identify the phenotype of NTM-positive individuals with bronchiectasis.
A retrospective single-center observational study was conducted in adult patients with bronchiectasis who underwent bronchoscopy in 2007-2020. Clinical, laboratory, pulmonary function, and radiological data were compared between patients with a positive or negative NTM culture.
Compared to the NTM-negative group (n=677), the NTM-positive group (n=94) was characterized (P ≤0.05 for all) by older age, greater proportion of females, and higher rates of gastroesophageal reflux disease and muco-active medication use; lower body mass index, serum albumin level, and lymphocyte and eosinophil counts; lower values of forced expiratory volume in one second, forced vital capacity, and their ratio, and lower diffusing lung capacity for carbon monoxide; higher rates of bronchiectasis in both lungs and upper lobes and higher number of involved lobes; and more exacerbations in the year prior bronchoscopy. On multivariate analysis, older age (OR 1.05, 95% CI 1.02-1.07, P=0.001), lower body mass index (OR 1.16, 95% CI 1.16-1.07, P <0.001), and increased number of involved lobes (OR 1.26, 95% CI 1.01-1.44, P=0.04) were associated with NTM infection.
Patients with bronchiectasis and NTM pulmonary infection are more likely to be older and female with more severe clinical, laboratory, pulmonary function, and radiological parameters than those without NTM infection. This phenotype can be used for screening patients with suspected NTM disease.
非结核分枝杆菌（NTM）肺部感染导致的支气管扩张症患者的全球死亡率和发病率呈上升趋势。本研究旨在确定 NTM 阳性支气管扩张症患者的表型。
这是一项 2007 年至 2020 年期间在接受支气管镜检查的成年支气管扩张症患者中进行的回顾性单中心观察性研究。比较了 NTM 培养阳性和阴性患者的临床、实验室、肺功能和影像学数据。
与 NTM 阴性组（n=677）相比，NTM 阳性组（n=94）的特征为（所有 P≤0.05）年龄较大、女性比例较高、胃食管反流病和黏液活性药物使用率较高；体重指数、血清白蛋白水平、淋巴细胞和嗜酸性粒细胞计数较低；一秒用力呼气量、用力肺活量及其比值以及一氧化碳弥散量较低；双肺和上叶支气管扩张症发生率较高、受累肺叶数较多；支气管镜检查前一年的加重次数较多。多变量分析显示，年龄较大（OR 1.05，95%CI 1.02-1.07，P=0.001）、体重指数较低（OR 1.16，95%CI 1.16-1.07，P<0.001）和受累肺叶数增加（OR 1.26，95%CI 1.01-1.44，P=0.04）与 NTM 感染相关。
与无 NTM 感染的患者相比，支气管扩张症合并 NTM 肺部感染的患者年龄较大、女性较多，临床、实验室、肺功能和影像学参数更严重。这种表型可用于筛查疑似 NTM 疾病的患者。
