Wang Ping-Huai, Shu Chin-Chung, Sheu Chau-Chyun, Chang Chia-Ling, Hsieh Meng-Heng, Hsu Wu-Huei, Chen Ming-Tsung, Ou Wei-Fan, Wei Yu-Feng, Yang Tsung-Ming, Lan Chou-Chin, Wang Cheng-Yi, Lin Chih-Bin, Lin Ming-Shian, Wang Yao-Tung, Lin Ching-Hsiung, Liu Shih-Feng, Cheng Meng-Hsuan, Chen Yen-Fu, Cheng Wen-Chien, Peng Chung-Kan, Chan Ming-Cheng, Chen Ching-Yi, Jao Lun-Yu, Wang Ya-Hui, Chen Chi-Jui, Chen Shih-Pin, Tsai Yi-Hsuan, Cheng Shih-Lung, Lin Horng-Chyuan, Chien Jung-Yien, Wang Hao-Chien
Division of Thoracic Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Open Forum Infect Dis. 2024 Jul 18;11(8):ofae427. doi: 10.1093/ofid/ofae427. eCollection 2024 Aug.
In bronchiectasis, nontuberculous mycobacteria (NTM) lung disease (NTM-LD) is a well-known coexisting infection. However, microorganism coisolates and clinical NTM-LD predictors are poorly studied.
Patients with bronchiectasis diagnosed by means of computed tomography between January 2017 and June 2020 were screened, using the date of computed tomography as the index date. Those with a major bronchiectasis diagnosis in ≥2 follow-up visits after the index date were enrolled in the study, and NTM-LD occurrence and its association with pneumonia and hospitalization within 1 year were analyzed.
Of the 2717 participants, 79 (2.9%) had NTM-LD diagnosed. The factors associated with NTM-LD included hemoptysis, postinfectious bronchiectasis, a tree-in-bud score ≥2, a modified Reiff score ≥4, and chronic obstructive pulmonary disease (adjusted odds ratios, 1.80, 2.36, 1.78, 2.95, and 0.51, respectively). Compared with patients in the non-NTM group, those with NTM-LD had higher rates of hospitalization (15.9% vs 32.9%; < .001) and pneumonia (9.8% vs 20.3%; = .003). was the most common microorganism in those with NTM-LD and those in the non-NTM group (10.1% vs 7.8%; = .40). However, compared with those in the non-NTM group, and were more prevalent in patients with NTM-LD (0.7% vs 3.8% [ = .03%] and 1.0% vs 3.8% [ = .05], respectively).
Postinfectious bronchiectasis with hemoptysis, higher radiological involvement, and a tree-in-bud pattern were associated with NTM-LD risk. The rate of and coisolation was higher in bronchiectasis populations with NTM-LD.
在支气管扩张症中，非结核分枝杆菌（NTM）肺病（NTM-LD）是一种常见的合并感染。然而，微生物共分离情况以及临床NTM-LD的预测因素研究较少。
筛选2017年1月至2020年6月间通过计算机断层扫描诊断为支气管扩张症的患者，以计算机断层扫描日期作为索引日期。在索引日期后的≥2次随访中被诊断为重度支气管扩张症的患者纳入研究，分析NTM-LD的发生情况及其与1年内肺炎和住院的相关性。
在2717名参与者中，79名（2.9%）被诊断为NTM-LD。与NTM-LD相关的因素包括咯血、感染后支气管扩张症、芽生树评分≥2、改良Reiff评分≥4以及慢性阻塞性肺疾病（调整后的比值比分别为1.80、2.36、1.78、2.95和0.51）。与非NTM组患者相比，NTM-LD患者的住院率（15.9%对32.9%；P<0.001）和肺炎发生率（9.8%对20.3%；P = 0.003）更高。NTM-LD组和非NTM组中最常见的微生物都是肺炎链球菌（10.1%对7.8%；P = 0.40）。然而，与非NTM组相比，NTM-LD患者中金黄色葡萄球菌和铜绿假单胞菌更为常见（分别为0.7%对3.8%[P = 0.03]和1.0%对3.8%[P = 0.05]）。
伴有咯血的感染后支气管扩张症、更高的影像学累及程度和芽生树模式与NTM-LD风险相关。NTM-LD的支气管扩张症人群中金黄色葡萄球菌和铜绿假单胞菌的共分离率更高。
