• J. Infect. Chemother. · Sep 2016

    Comparative Study

    18 Cases of pulmonary Mycobacterium abscessus: Clinical difference depending on the presence or absence of Mycobacterium avium complex.

    • Kenjiro Furuta, Akihiro Ito, Tadashi Ishida, Yuhei Ito, Naoyuki Sone, Takuya Takaiwa, Toshihide Yokoyama, Hiromasa Tachibana, Machiko Arita, and Toru Hashimoto.
    • Department of Respiratory Medicine, Kobe City Hospital Organization Kobe City Medical Center West Hospital, 2-4 Ichibancho, Nagata-ku, Kobe, Hyogo 653-0013, Japan; Department of Respiratory Medicine, Ohara Memorial Kurashiki Healthcare Foundation, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan. Electronic address: k.furuta0113@gmail.com.
    • J. Infect. Chemother. 2016 Sep 1; 22 (9): 622-8.

    Background And ObjectivesIt can be difficult to treat respiratory tract infections caused by Mycobacterium abscessus (M. abscessus) as there is no established treatment strategy. Complications involving other nontuberculous mycobacterial infections such as Mycobacterium avium complex (MAC) are also commonly observed.MethodsWe investigated the clinical background and course of 18 cases of pulmonary M. abscessus infection treated over 8 years at Kurashiki Central Hospital. Radiological evaluation was performed using NICE scoring system, a method of semi-quantitative evaluation of imaging findings of pulmonary MAC infection.ResultsThe mean age of the 18 patients (males, 6; females, 12) was 74.7 years. The median follow-up period was 1316 days (95% confidence interval; 720-1675 days), and 11 patients were concomitantly infected with pulmonary MAC. Among the patients that underwent antibacterial treatment for M. abscessus, there was one MAC-complication case and one non-MAC-complication case. All MAC-complication cases underwent antibacterial treatment including clarithromycin. Chest X-ray NICE scores for all cases were 8.50 ± 5.45 and 10.94 ± 6.03 at baseline and follow-up, respectively (p = 0.0063). For MAC-complication cases, scores were 8.36 ± 4.74 and 12.00 ± 6.02 at baseline and follow-up, respectively (p = 0.00818), and for non-MAC-complication cases, scores were 8.71 ± 6.82 and 9.29 ± 6.13 at baseline and follow-up, respectively (p = 0.356). MAC-complication cases were significantly further exacerbated than non-MAC-complication cases (p = 0.027).ConclusionsSome cases of pulmonary M. abscessus infection progressed well without undergoing antibacterial treatment. In particular, results suggested that the clinical course of MAC-complication and non-MAC-complication cases differs.Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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