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Frajman A, Izhakian S, Mekiten O, Hadar O, Lichtenstadt A, Hajaj C, Shchori S, Heching M, Rosengarten D, Kramer MR. Phenotypical characteristics of nontuberculous mycobacterial infection in patients with bronchiectasis. Respir Res 2024; 25:278. [PMID: 39010067 PMCID: PMC11251292 DOI: 10.1186/s12931-024-02904-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 07/03/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND The global mortality and morbidity rates of bronchiectasis patients due to nontuberculous mycobacteria (NTM) pulmonary infection are on a concerning upward trend. The aims of this study to identify the phenotype of NTM-positive individuals with bronchiectasis. METHODS A retrospective single-center observational study was conducted in adult patients with bronchiectasis who underwent bronchoscopy in 2007-2020. Clinical, laboratory, pulmonary function, and radiological data were compared between patients with a positive or negative NTM culture. RESULTS Compared to the NTM-negative group (n=677), the NTM-positive group (n=94) was characterized (P ≤0.05 for all) by older age, greater proportion of females, and higher rates of gastroesophageal reflux disease and muco-active medication use; lower body mass index, serum albumin level, and lymphocyte and eosinophil counts; lower values of forced expiratory volume in one second, forced vital capacity, and their ratio, and lower diffusing lung capacity for carbon monoxide; higher rates of bronchiectasis in both lungs and upper lobes and higher number of involved lobes; and more exacerbations in the year prior bronchoscopy. On multivariate analysis, older age (OR 1.05, 95% CI 1.02-1.07, P=0.001), lower body mass index (OR 1.16, 95% CI 1.16-1.07, P <0.001), and increased number of involved lobes (OR 1.26, 95% CI 1.01-1.44, P=0.04) were associated with NTM infection. CONCLUSIONS Patients with bronchiectasis and NTM pulmonary infection are more likely to be older and female with more severe clinical, laboratory, pulmonary function, and radiological parameters than those without NTM infection. This phenotype can be used for screening patients with suspected NTM disease.
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Affiliation(s)
- Assaf Frajman
- Pulmonary Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinksy St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Shimon Izhakian
- Pulmonary Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinksy St, Petach Tikva, 4941492, Israel.
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
| | - Ori Mekiten
- Pulmonary Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinksy St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Ori Hadar
- Pulmonary Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinksy St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Ariel Lichtenstadt
- The Adelson School of Medicine, Ariel University, Ariel, 4076414, Israel
| | - Chen Hajaj
- Industrial Engineering and Management, Ariel University, Ariel, 40700, Israel
| | - Shon Shchori
- Industrial Engineering and Management, Ariel University, Ariel, 40700, Israel
| | - Moshe Heching
- Pulmonary Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinksy St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Dror Rosengarten
- Pulmonary Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinksy St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Mordechai R Kramer
- Pulmonary Institute, Rabin Medical Center - Beilinson Hospital, 39 Jabotinksy St, Petach Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
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Gao W, Wang T, Dai G, Hu W, Tang X, Chen S, Zeng Y, Yin C. Organizing pneumonia due to pulmonary non-tuberculosis mycobacteria: a case description and literature analysis. Quant Imaging Med Surg 2024; 14:4263-4268. [PMID: 38846291 PMCID: PMC11151243 DOI: 10.21037/qims-24-193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/09/2024] [Indexed: 06/09/2024]
Affiliation(s)
- Weiwei Gao
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tianzhen Wang
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Guangchuan Dai
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Weiyi Hu
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiaoli Tang
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Shanshan Chen
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yi Zeng
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chunyang Yin
- Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
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Xu Q, Mei Z, Zha Q, Chen J, Qin H, Liu B, Jie Z, Wu X. Characterization of bronchoalveolar lavage fluid microbiota in acute exacerbations of bronchiectasis with non-tuberculous mycobacterial detection. Int J Infect Dis 2024; 146:107120. [PMID: 38821186 DOI: 10.1016/j.ijid.2024.107120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/01/2024] [Accepted: 05/26/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVES Non-tuberculous mycobacteria (NTM) frequently colonize the airways of patients with bronchiectasis; however, there has been limited research into airway microbiota composition and predisposing factors for NTM detection during acute bronchiectasis exacerbations. METHODS This study enrolled 34 patients with bronchiectasis experiencing acute exacerbations. Metagenomic next-generation sequencing was used to detect microbiota in bronchoalveolar lavage fluid (BALF), and bioinformatics methods were used for the comparative analysis of meaningful microbiota in the BALF of patients with acute exacerbations of bronchiectasis. A correlation analysis was conducted to identify susceptibility factors for NTM in patients with bronchiectasis. RESULTS Compared with patients with community-acquired pneumonia, patients with bronchiectasis had higher detection rates of NTM (38.2%), Pseudomonas aeruginosa, and Haemophilus influenzae. Patients with NTM-positive bronchiectasis had lower body mass index and lipid profiles than patients who were NTM-negative. Metagenomic next-generation sequencing of BALF revealed patients who were NTM-positive had increased relative abundance of Rothia and other anaerobic genera compared with patients who were NTM-negative. Patients who were NTM-positive also showed higher levels of Streptococcus parasanguinis at the species level. Elevated Rothia mucilaginosa and S. parasanguinis correlated with decreased percentages of clusters of differentiation 3+ T lymphocytes and clusters of differentiation 3+ T-cell subgroups in peripheral blood. CONCLUSIONS NTM colonization increases the risk of acute bronchiectasis exacerbations. Low body mass index, lipid levels, and isolation of R. mucilaginosa and S. parasanguinis in BALF are susceptibility factors for NTM colonization in patients with bronchiectasis.
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Affiliation(s)
- Qiong Xu
- Department of Respiratory and Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhoufang Mei
- Department of Pulmonary and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Qiongfang Zha
- Department of Respiratory and Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiajun Chen
- Department of Respiratory and Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Qin
- Department of Respiratory and Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Liu
- Department of Respiratory and Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhijun Jie
- Department of Pulmonary and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Xueling Wu
- Department of Respiratory and Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Gu SY, Lu HW, Bai JW, Yang JW, Mao B, Yu L, Xu JF. The role of volatile organic compounds for assessing characteristics and severity of non-cystic fibrosis bronchiectasis: an observational study. Front Med (Lausanne) 2024; 11:1345165. [PMID: 38633315 PMCID: PMC11022847 DOI: 10.3389/fmed.2024.1345165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Background Hypoxic conditions and Pseudomonas aeruginosa (P. aeruginosa) infection are significant factors influencing the prognosis and treatment of patients with bronchiectasis. This study aimed to explore the potential for breath analysis to detect hypoxic conditions and P. aeruginosa infection in bronchiectasis patients by analyzing of volatile organic compounds (VOCs) in exhaled breath condensate (EBC). Methods EBC samples were collected from stable bronchiectasis patients and analyzed using solid phase microextraction-gas chromatography-mass spectrometry (SPME-GCMS). The association of VOCs with bronchiectasis patients' phenotypes including hypoxic conditions and P. aeruginosa isolation was analyzed, which may relate to the severity of bronchiectasis disease. Results Levels of 10-heptadecenoic acid, heptadecanoic acid, longifolene, and decanol in the hypoxia group were higher compared to the normoxia group. Additionally, the levels of 13-octadecenoic acid, octadecenoic acid, phenol, pentadecanoic acid, and myristic acid were increased in P. aeruginosa (+) group compared to the P. aeruginosa (-) group. Subgroup analysis based on the bronchiectasis severity index (BSI)reveled that the levels of 10-heptadecenoic acid, heptadecanoic acid, decanol, 13-octadecenoic acid, myristic acid, and pentadecanoic acid were higher in the severe group compared to the moderate group. Multivariate linear regression showed that 10-heptadecenoic acid and age were independent prognostic factors for bronchiectasis patients with hypoxia. Furthermore, octadecenoic acid, phenol and gender were identified as independent prognostic factors for bronchiectasis patients with P. aeruginosa isolation. Conclusion The study provides evidence that specific VOCs in EBC are correlated with the severity of bronchiectasis, and 10-heptadecenoic acid is shown to be a predictive marker for hypoxia condition in bronchiectasis patients.
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Affiliation(s)
| | | | | | | | | | | | - Jin-Fu Xu
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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Hamed KA, Tillotson G. A narrative review of nontuberculous mycobacterial pulmonary disease: microbiology, epidemiology, diagnosis, and management challenges. Expert Rev Respir Med 2023; 17:973-988. [PMID: 37962332 DOI: 10.1080/17476348.2023.2283135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/09/2023] [Indexed: 11/15/2023]
Abstract
INTRODUCTION Nontuberculous mycobacteria (NTM) are a diverse group of mycobacterial species that are ubiquitous in the environment. They are opportunistic pathogens that can cause a range of diseases, especially in individuals with underlying structural lung disease or compromised immune systems. AREAS COVERED This paper provides an in-depth analysis of NTM infections, including microbiology, environmental sources and transmission pathways, risk factors for disease, epidemiology, clinical manifestations and diagnostic approaches, guideline-based treatment recommendations, drugs under development, and management challenges. EXPERT OPINION Future approaches to the management of NTM pulmonary disease will require therapies that are well tolerated, can be taken for a shorter time period and perhaps less frequently, have few drug-drug interactions, and are active against the various strains of pathogens. As the numbers of infections increase, such therapies will be welcomed by clinicians and patients.
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Zhou Y, Mu W, Zhang J, Wen SW, Pakhale S. Global prevalence of non-tuberculous mycobacteria in adults with non-cystic fibrosis bronchiectasis 2006-2021: a systematic review and meta-analysis. BMJ Open 2022; 12:e055672. [PMID: 35914904 PMCID: PMC9345037 DOI: 10.1136/bmjopen-2021-055672] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To accurately estimate the global prevalence of non-tuberculous mycobacteria (NTM) in adults with non-cystic fibrosis (non-CF) bronchiectasis and to determine the proportion of NTM species and subspecies in clinical patients from 2006 to 2021. DESIGN Systematic review and meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES Medline, Embase, Cochrane Library and Web of Science were searched for articles published between 2006 and 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included all the prospective or retrospective studies without language restrictions and all patients were adults (≥18 years of age) with non-CF bronchiectasis. The studies estimated the effect size of the prevalence of NTM with a sample size ≥40, and patients were registered in and after 2006. DATA EXTRACTION AND SYNTHESIS Two reviewers screened the titles, abstracts and full texts independently. Relevant information was extracted and curated into tables. Risk of bias was evaluated following the Cochrane Collaboration's tool. Meta-analysis was performed with software R Statistics V.3.6.3 using random effect model with 95% CI. I2 index and Q statistics were calculated to assess the heterogeneity, and mixed-effects meta-regression analyses were performed to identify the sources of heterogeneity. The proportions of NTM subspecies were examined using Shapiro-Wilk normality test in R. RESULTS Of all the 2014 studies yielded, 24 met the inclusion criteria. Of these, 14 were identified to be randomised controlled studies and included for an accurate estimation. The global prevalence of NTM in adults with non-CF bronchiectasis from 2006 to 2021 was estimated to be approximately 10%, with great variations primarily due to geographical location. Mycobacterium avium complex was the most common subspecies, followed by Mycobacterium simiae and Mycobacterium gordonae. CONCLUSIONS The prevalence of NTM in adults with non-CF bronchiectasis has been on the rise and the most common subspecies changed greatly in recent years. More cohort studies should be done in many countries and regions for future estimates. PROSPERO REGISTRATION NUMBER CRD42020168473.
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Affiliation(s)
- Yunchun Zhou
- Department of Pulmonary and Critical Care Medicine, People's Hospital of Yuxi City, Yuxi, Yunnan, China
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China
| | - Wei Mu
- Department of Clinical Pharmacology, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jihua Zhang
- Department of Pulmonary and Critical Care Medicine, People's Hospital of Yuxi City, Yuxi, Yunnan, China
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan, China
| | - Shi Wu Wen
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Smita Pakhale
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Respiratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
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