Chronic Mycobacterium abscessus infection and lung function decline in cystic fibrosis

Esther, Charles R.; Esserman, Denise A.; Gilligan, Peter; Kerr, Alan; Noone, Peadar G.

doi:10.1016/j.jcf.2009.12.001

« Previous Next »Journal of Cystic Fibrosis
Volume 9, Issue 2 , Pages 117-123, March 2010

Chronic Mycobacterium abscessus infection and lung function decline in cystic fibrosis

Statistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA

Clinical Microbiology–Immunology Laboratories, University of North Carolina Hospitals, Chapel Hill, NC 27599, USA

Pulmonology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA

Received 12 October 2009; received in revised form 4 December 2009; accepted 7 December 2009.

Abstract

Background

Although nontuberculous mycobacteria (NTM) are recognized pathogens in cystic fibrosis (CF), associations with clinical outcomes remain unclear.

Methods

Microbiological data was obtained from 1216 CF patients over 8years (481±55patients/year). Relationships to clinical outcomes were examined in the subset (n=271, 203±23 patients/year) with longitudinal data.

Results

Five hundred thirty-six of 4862 (11%) acid-fast bacilli (AFB) cultures grew NTM, with Mycobacterium abscessus (n=298, 55.6%) and Mycobacterium avium complex (n=190, 35.4%) most common. Associated bacterial cultures grew Stenotrophomonas or Aspergillus species more often when NTM were isolated (18.2% vs. 8.4% and 13.9% vs. 7.2%, respectively, p<0.01). After controlling for confounders, patients with chronic M. abscessus infection had greater rates of lung function decline than those with no NTM infection (−2.52 vs. −1.64% predicted FEV₁/year, p<0.05).

Conclusions

NTM infection is common in CF and associated with particular pathogens. Chronic M. abscessus infection is associated with increased lung function decline.

Keywords: Nontuberculous mycobacteria