학술논문
Management of patients with pulmonary mycobacteriosis in France: a multicenter retrospective cohort study
Document Type
Original Paper
Author
Bemer, Pascale; Peuchant, Olivia; Guet-Revillet, Hélène; Bador, Julien; Balavoine, Charlotte; Basille, Damien; Beltramo, Guillaume; Blanc, François-Xavier; Blanchard, Elodie; Boulanger, Sarah; Bourgoin, Anne; Boutoille, David; Cambau, Emmanuelle; Canis, Frédérique; Caparros, Didier; Carricajo, Anne; Carrière, Christian; Couetdic, Gérard; Couturaud, Francis; Dalphin, Jean-Charles; Degot, Tristan; Desquiens, Marion; Devouassoux, Gilles; Duez, Jean-Marie; Dumitrescu, Oana; Dupuy-Grasset, Magali; Gaudart, Alice; Georges, Marjolaine; Godet, Cendrine; Godreuil, Sylvain; Guillouzouic, Aurélie; Hamdad-Daoudi, Farida; Héry-Arnaud, Geneviève; Koebel, Christelle; Lagrange, Aurore; Lanotte, Philippe; Marchand-Adam, Sylvain; Mougari, Faïza; Murris, Marlène; Patry, Isabelle; Pérouse de Montclos, Michèle; Raskine, Laurent; Risso, Karine; Segonds, Christine; Sicard, Dominique; Terru, Dominique; Vachée, Anne; Vergnon, Jean-Michel; Martin, Christian; Schramm, Frédéric; Andrejak, Claire
Source
BMC Pulmonary Medicine. 21(1)
Subject
Language
English
ISSN
1471-2466
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.