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Prevalence and risk factors of non-tuberculous mycobacterial pulmonary isolates and infection in interstitial lung disease associated with systemic autoimmune disease
C.-C. Shu1, P.-S. Chen2, Z.-H. Lin3, C.-T. Hsiao4, C.-C. Kuo5, H.-Y. Chiang6, P.-C. Wu7
- College of Medicine, National Taiwan University, Taipei, and Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Big Data Center, China Medical University Hospital, Taichung, Taiwan.
- Big Data Center, China Medical University Hospital, Taichung, Taiwan.
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan.
- Big Data Center, China Medical University Hospital, Taichung; Kidney Institute, China Medical University Hospital, Taichung; and Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
- Big Data Center, China Medical University Hospital, Taichung, Taiwan. t32031@mail.cmuh.org.tw
- PhD Programme in Translational Medicine, National Chung Hsing University, Taichung; School of Medicine, College of Medicine, China Medical University, Taichung; Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung; Rheumatology and Immunology Center; and Medical University Hospital, Taichung, Taiwan. d10752@mail.cmuh.org.tw
CER16987
2024 Vol.42, N°5
PI 1006, PF 1014
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PMID: 38179726 [PubMed]
Received: 10/07/2023
Accepted : 02/11/2023
In Press: 03/01/2024
Published: 14/05/2024
Abstract
OBJECTIVES:
Non-tuberculous mycobacterial (NTM) lung disease (NTM-LD) prevalence is increasing worldwide. In this study, we aimed to evaluate the clinical significance of NTM pulmonary isolates (NTM-PI) and NTM-LD in patients with systemic autoimmune disease (SAD) who had a concurrent interstitial lung disease (ILD) diagnosis.
METHODS:
We retrospectively identified patients with SAD who had a concurrent ILD diagnosis (SAD-ILD) and from whom clinically indicated sputum specimens were collected for NTM culture between 2003 and 2018 at a tertiary referral hospital. We analysed the prevalence and risk factors of NTM pulmonary isolates (NTM-PI; ≥1 positive culture) and NTM-LD (≥2 positive cultures).
RESULTS:
This study included 258 patients. Rheumatoid arthritis and Sjögren’s syndrome were the most common SADs (32.2% and 26.7%, respectively). The NTM-negative subgroup had 204 patients (79.1%) and the NTM-PI subgroup had 54 patients (20.9%). In the NTM-PI subgroup, 33 patients had one NTM positive set of specimens (NTM 1+, 12.8% of the entire sample) and 21 had NTM-LD (8.1% of the entire sample). In a multivariable analysis, chronic kidney disease (CKD; adjusted odds ratio [aOR]: 3.10 [1.53, 6.29]) and chronic obstructive pulmonary disease (COPD; aOR: 2.59 [1.16, 5.78]) were significantly associated with NTM-PI. For NTM-LD, CKD (aOR: 2.79 [1.00, 7.76]) and COPD (aOR: 3.70 [1.23, 10.72]) remained significant risk factors.
CONCLUSIONS:
In patients with SAD-ILD, the NTM-PI and NTM-LD prevalence rates were 20.9% and 8.1%, respectively. COPD and CKD were independent risk factors of both NTM-PI and NTM-LD. Previous use of biological agents was associated with NTM-PI.
