학술논문
Management of patients with pulmonary mycobacteriosis in France: a multicenter retrospective cohort study
Document Type
article
Author
Pascale Bemer; Olivia Peuchant; Hélène Guet-Revillet; Julien Bador; Charlotte Balavoine; Damien Basille; Guillaume Beltramo; François-Xavier Blanc; Elodie Blanchard; Sarah Boulanger; Anne Bourgoin; David Boutoille; Emmanuelle Cambau; Frédérique Canis; Didier Caparros; Anne Carricajo; Christian Carrière; Gérard Couetdic; Francis Couturaud; Jean-Charles Dalphin; Tristan Degot; Marion Desquiens; Gilles Devouassoux; Jean-Marie Duez; Oana Dumitrescu; Magali Dupuy-Grasset; Alice Gaudart; Marjolaine Georges; Cendrine Godet; Sylvain Godreuil; Aurélie Guillouzouic; Farida Hamdad-Daoudi; Geneviève Héry-Arnaud; Christelle Koebel; Aurore Lagrange; Philippe Lanotte; Sylvain Marchand-Adam; Faïza Mougari; Marlène Murris; Isabelle Patry; Michèle Pérouse de Montclos; Laurent Raskine; Karine Risso; Christine Segonds; Dominique Sicard; Dominique Terru; Anne Vachée; Jean-Michel Vergnon; Christian Martin; Frédéric Schramm; Claire Andrejak
Source
BMC Pulmonary Medicine, Vol 21, Iss 1, Pp 1-9 (2021)
Subject
Language
English
ISSN
1471-2466
Abstract
Abstract Background Recent studies report very low adherence of practitioners to ATS/IDSA recommendations for the treatment of nontuberculous mycobacteria pulmonary disease (NTM-PD), as well as a great variability of practices. Type of management could impact prognosis. Methods To evaluate management and prognosis of patients with NTM-PD cases with respect to ATS recommendations, we conducted a multicenter retrospective cohort study (18 sentinel sites distributed throughout France), over a period of six years. We collected clinical, radiological, microbiological characteristics, management and outcome of the patients (especially death or not). Results 477 patients with NTM-PD were included. Respiratory comorbidities were found in 68% of cases, tuberculosis sequelae in 31.4% of patients, and immunosuppression in 16.8% of cases. The three most common NTM species were Mycobacterium avium complex (60%), M. xenopi (20%) and M. kansasii (5.7%). Smear-positive was found in one third of NTM-PD. Nodulobronchiectatic forms were observed in 54.3% of cases, and cavitary forms in 19.1% of patients. Sixty-three percent of patients were treated, 72.4% of patients with smear-positive samples, and 57.5% of patients with smear-negative samples. Treatment was in adequacy with ATS guidelines in 73.5%. The 2-year mortality was 14.4%. In the Cox regression, treatment (HR = 0.51), age (HR = 1.02), and M. abscessus (3.19) appeared as the 3 significant independent prognostic factors. Conclusion These findings highlight the adequacy between French practices and the ATS/IDSA guidelines. Treatment was associated with a better survival.