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Stroffolini G, Gaviraghi A, Penna D, Piccioni P, Venuti F, Botto C, Trezzi M, Betti M, Sestini S, Erba PA, Lupia T, Di Perri G, Aliberti S, Calcagno A. 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with non-tuberculous mycobacterial infections. J Infect 2023; 87:462-464. [PMID: 36935023 DOI: 10.1016/j.jinf.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/11/2023] [Indexed: 03/19/2023]
Affiliation(s)
- Giacomo Stroffolini
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, c/o Amedeo di Savoia Hospital, ASL Città di Torino, Turin, Italy; Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37204 Verona, Italy.
| | - Alberto Gaviraghi
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, c/o Amedeo di Savoia Hospital, ASL Città di Torino, Turin, Italy
| | | | - Pavilio Piccioni
- Unit of Pneumology, 'Amedeo di Savoia' Hospital, ASL 'Città di Torino', Torino, Italy
| | - Francesco Venuti
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, c/o Amedeo di Savoia Hospital, ASL Città di Torino, Turin, Italy
| | - Carlotta Botto
- Unit of Pneumology, 'Amedeo di Savoia' Hospital, ASL 'Città di Torino', Torino, Italy
| | - Michele Trezzi
- UOC Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Margherita Betti
- UOC Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Stelvio Sestini
- UOC Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Paola Anna Erba
- UOC Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Tommaso Lupia
- Infectious Diseases Unit, Cardinal Massaia Hospital, 14100 Asti, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, c/o Amedeo di Savoia Hospital, ASL Città di Torino, Turin, Italy
| | - Stefano Aliberti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy; IRCCS Humanitas Research Hospital, Respiratory Unit, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, c/o Amedeo di Savoia Hospital, ASL Città di Torino, Turin, Italy
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Wagner D, van Ingen J, van der Laan R, Obradovic M. Non-tuberculous mycobacterial lung disease in patients with bronchiectasis: perceived risk, severity and guideline adherence in a European physician survey. BMJ Open Respir Res 2021; 7:7/1/e000498. [PMID: 32332023 PMCID: PMC7204844 DOI: 10.1136/bmjresp-2019-000498] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 02/25/2020] [Accepted: 04/03/2020] [Indexed: 01/29/2023] Open
Abstract
Background Patients with bronchiectasis are at increased risk of developing non-tuberculous mycobacteria lung disease (NTM-LD), and published guidelines recommend regular testing for NTM infection in this patient population. Objective This study aimed to survey physicians managing patients with bronchiectasis to understand the perceived risk of NTM to their patients, perceived disease severity and frequency of testing for NTM. Methods The study comprised an online survey of hospital-based physicians in the UK, Germany, Italy, France and the Netherlands. The target group were hospital-based physicians who had managed at least 10 adult patients with bronchiectasis over the preceding 12 months. Results In total, 280 physicians completed the survey. Most (87%) thought their patients to be at particular risk of NTM, although it was perceived as a moderate risk versus other respiratory pathogens. Most perceived NTM-LD to impact patient morbidity (84%), and 61% indicated that NTM-LD significantly impacted mortality. 68% of all respondents did not test for NTM prior to initiating macrolide monotherapy, despite guidelines recommending testing. The perceived risk of and screening for NTM varied among countries. Conclusions The study demonstrates that physicians understand the risk of NTM-LD and associated morbidity in patients with bronchiectasis; however, a minority do not perceive that NTM-LD significantly affects mortality. Greater awareness of the need to test for NTM infection before initiating macrolide monotherapy for bronchiectasis is essential due to potential emergence of drug-resistant NTM.
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Affiliation(s)
- Dirk Wagner
- Division of Infectious Diseases, Department of Internal Medicine II, Medical Center - University of Freiburg, University of Freiburg, Freiburg im Breisgau, Germany
| | - Jakko van Ingen
- Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
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Polastri M, Comellini V. Physiotherapy for patients with non-tuberculous mycobacterial disease. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Massimiliano Polastri
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, St Orsola University Hospital, Bologna, Italy
| | - Vittoria Comellini
- Respiratory and Critical Unit, St Orsola University Hospital, Bologna, Italy
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Martinez-García MA, Villa C, Dobarganes Y, Girón R, Maíz L, García-Clemente M, Sibila O, Golpe R, Rodríguez J, Barreiro E, Rodriguez JL, Menéndez R, Prados C, de la Rosa D, Olveira YC. RIBRON: The Spanish online bronchiectasis registry. Characterization of the first 1912 patients. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.arbr.2020.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Chalmers JD, Balavoine C, Castellotti PF, Hügel C, Payet A, Wat D, Rohde G. European Respiratory Society International Congress, Madrid, 2019: nontuberculous mycobacterial pulmonary disease highlights. ERJ Open Res 2020; 6:00317-2020. [PMID: 33123559 PMCID: PMC7569164 DOI: 10.1183/23120541.00317-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/03/2020] [Indexed: 11/05/2022] Open
Abstract
Once overlooked, awareness of nontuberculous mycobacterial pulmonary disease (NTM-PD) is rapidly rising, in line with increasing prevalence worldwide. The European Respiratory Society (ERS) International Congress 2019, held in Madrid, Spain, provided a platform for invigorating discussions and exciting new research in the field. This article explores approaches being taken to combat NTM-PD with a focus not only on novel prevalence and risk factor data, but also on emerging antimicrobials and their routes of delivery, and other potential treatment options in early clinical development.
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Affiliation(s)
| | | | | | | | - Annabelle Payet
- Pneumologie, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Réunion
| | - Dennis Wat
- Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Gernot Rohde
- University Hospital Frankfurt, Frankfurt, Germany
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Kwak N, Choi H, Jeon D, Jhun BW, Jo KW, Kang YA, Kwon YS, Lee M, Mok J, Shim TS, Shin HJ, Whang J, Yim JJ. Protocol of a Nationwide Observational Study among Patients with Nontuberculous Mycobacterium Pulmonary Disease in South Korea (NTM-KOREA). Tuberc Respir Dis (Seoul) 2020; 83:141-146. [PMID: 32185919 PMCID: PMC7105436 DOI: 10.4046/trd.2019.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/10/2019] [Accepted: 01/02/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The burden of nontuberculous mycobacterial (NTM) pulmonary disease (PD) is increasing globally. To understand the treatment outcomes and prognosis of NTM-PD, a unified registry is needed. In this project, we aim to construct a multicenter prospective observational cohort with NTM-PD in South Korea (NTM-KOREA). METHODS The primary objective of this study is to analyze treatment outcomes according to the species. In addition, recurrence rate, adverse events, the impact of each drug on treatment outcomes as well as the impact of characteristics of mycobacteriology will be analyzed. The inclusion criteria for the study are as follows: fulfilling the criteria for NTM-PD having one of the following etiologic organisms: Mycobacterium avium complex, M. abscessus subspecies abscessus, M. abscessus subspecies massiliense, or M. kansasii; receiving the first treatment for NTM-PD after enrollment; age >20 years; and consenting to participate in the study. Seven institutions will participate in patient enrollment and about 500 patients are expected to be enrolled. Participants will be recruited from 1 March 2020 until 19 March 2024 and will be observed through 19 March 2029. During the follow-up period, participants' clinical course will be tracked and their clinical data as well as NTM isolates will be collected. CONCLUSION NTM-KOREA will be the first nationwide observational cohort for NTM-PD in South Korea. It will provide the information to optimize treatment modalities and will contribute to deeper understanding of the treatment outcomes and long-term prognosis of patients with NTM-PD in South Korea.
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Affiliation(s)
- Nakwon Kwak
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hongjo Choi
- Research Center, Korean Institute of Tuberculosis, Cheongju, Korea
| | - Doosoo Jeon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Byung Woo Jhun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Wook Jo
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Ae Kang
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Soo Kwon
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Myungsun Lee
- Clinical Research Section, International Tuberculosis Research Center, Seoul, Korea
| | - Jeongha Mok
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Tae Sun Shim
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong Joon Shin
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Jake Whang
- Research Center, Korean Institute of Tuberculosis, Cheongju, Korea
| | - Jae Joon Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Martinez-García MA, Villa C, Dobarganes Y, Girón R, Maíz L, García-Clemente M, Sibila O, Golpe R, Rodríguez J, Barreiro E, Rodriguez JL, Menéndez R, Prados C, de la Rosa D, Olveira C. RIBRON: The spanish Online Bronchiectasis Registry. Characterization of the First 1912 Patients. Arch Bronconeumol 2020; 57:28-35. [PMID: 32081438 DOI: 10.1016/j.arbres.2019.12.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/15/2019] [Accepted: 12/15/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The SEPAR Spanish Bronchiectasis Registry (RIBRON) began as a platform for the collection of longitudinal data on patients with this disease. The objective of this study is to describe its operation and to analyze the characteristics of bronchiectasis patients according to sex. METHODS A total of 1912 adult patients diagnosed with bronchiectasis in 43 centers were included between February 2015 and 2019. All patients had complete data consisting of at least 79 basic required variables, controlled by an external audit. RESULTS Mean age was 67.6 (15.2) years; 63.9% were women. The most common symptom was productive cough (78.3%) which was mucopurulent-purulent in 45.9% of cases. The most common etiology was post-infectious (40.4%), while 18.5% were idiopathic. Pseudomonas aeruginosa was the most frequently isolated microorganism (40.4%), of which 25.6% were associated with chronic infection. The annual number of mild-to-moderate/severe exacerbations was 1.62 (1.9)/0.59 (1.3). Half of the patients (50%) presented with airflow obstruction (17% severe). The most frequent radiological localization was lower lobes. The average FACED/E-FACED/BSI values were 2.06 (1.7)/2.67 (2.2)/7.8 (4.5), respectively. Overall, 66.7% of patients were taking inhaled corticosteroids, 19.2% macrolides, and 19.5% inhaled antibiotics. Women presented a less severe profile than men in clinical and functional terms, and a similar infectious, radiological and therapeutic profile. CONCLUSIONS RIBRON represents an excellent map of the characteristics of bronchiectasis in our country. Two thirds of patients are women who presented lower disease severity as a specific characteristic.
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Affiliation(s)
| | - Carmen Villa
- Servicio de Neumología, Clínica Fuensanta, Madrid, España
| | | | - Rosa Girón
- Servicio de Neumología, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, España
| | - Luis Maíz
- Servicio de Neumología, Hospital Ramón y Cajal, Madrid, España
| | - Marta García-Clemente
- Servicio de Neumología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | - Oriol Sibila
- Servicio de Neumología, Hospital Clínico, Barcelona, España
| | - Rafael Golpe
- Servicio de Neumología, Hospital Lucus Augusti, Lugo, España
| | - Juan Rodríguez
- Servicio de Neumología, Hospital San Agustín, Avilés, Asturias, España
| | - Esther Barreiro
- Servicio de Neumología, Hospital del Mar-IMIM, UPF, CIBERES, Barcelona, España
| | | | - Rosario Menéndez
- Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | | | - David de la Rosa
- Servicio de Neumología, Hospital Santa Creu i Sant Pau, Barcelona, España
| | - Casilda Olveira
- Servicio de Neumología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA)/Universidad de Málaga, Málaga, España
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Aliberti S, Sotgiu G, Castellotti P, Ferrarese M, Pancini L, Pasat A, Vanoni N, Spotti M, Mazzola E, Gramegna A, Saderi L, Perno CF, van Ingen J, Codecasa LR, Blasi F. Real-life evaluation of clinical outcomes in patients undergoing treatment for non-tuberculous mycobacteria lung disease: A ten-year cohort study. Respir Med 2020; 164:105899. [PMID: 32094101 DOI: 10.1016/j.rmed.2020.105899] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/10/2019] [Accepted: 02/06/2020] [Indexed: 10/25/2022]
Abstract
Outcome recognition is a crucial step in the management of non-tuberculous mycobacteria lung disease (NTM-LD). In order to explore NTM-LD outcomes in a real-life setting, an observational, retrospective study enrolling consecutive adults who received treatment for NTM-LD in Milan, Italy, from 2007 to 2017 was conducted. Among 170 patients (68.2% females; median age: 68 years), NTM-LD was mainly due to M. avium complex (MAC) (71.2%), M. kansasii (9.4%) and M. xenopi (7.1%). Along a median follow-up of 31 months, adverse events occurred in 37.6% of the patients. Treatment outcomes of the entire study population included an unsuccessful outcome in 35.3% of the patients, including treatment halted in 13.5%, recurrence in 11.2%, re-infection in 5.3%, treatment failure in 4.1% and relapse in 1.2%. The main reason for treatment halted was drug intolerance. No differences were detected between patients with MAC-LD vs. those with other NTM-LD in terms of unsuccessful outcome in general (35.5% vs. 34.7%). A significantly higher prevalence of patients who underwent treatment halted was found in patients with NTM-LD other than MAC in comparison to patients with MAC-LD (22.4% vs. 9.9%, p = 0.030). One third of adults undergoing treatment for a NTM-LD experiences an unsuccessful outcome with adverse events and treatment discontinuation being major challenges in patients' management.
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Affiliation(s)
- Stefano Aliberti
- University of Milan, Department of Pathophysiology and Transplantation, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit, Cystic Fibrosis Adult Center, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical, Experimental Sciences, University of Sassari, Sassari, Italy
| | - Paola Castellotti
- TB Reference Centre and Lab, Villa Marelli Institute, Niguarda Hospital, Milan, Italy
| | - Maurizio Ferrarese
- TB Reference Centre and Lab, Villa Marelli Institute, Niguarda Hospital, Milan, Italy
| | - Lisa Pancini
- TB Reference Centre and Lab, Villa Marelli Institute, Niguarda Hospital, Milan, Italy
| | - Ana Pasat
- University of Milan, Department of Pathophysiology and Transplantation, Italy
| | - Nicolò Vanoni
- University of Milan, Department of Pathophysiology and Transplantation, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit, Cystic Fibrosis Adult Center, Italy
| | - Maura Spotti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit, Cystic Fibrosis Adult Center, Italy
| | - Ester Mazzola
- Department of Laboratory Medicine, ASST Niguarda Hospital, University of Milan, Milan, Italy
| | - Andrea Gramegna
- University of Milan, Department of Pathophysiology and Transplantation, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit, Cystic Fibrosis Adult Center, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical, Experimental Sciences, University of Sassari, Sassari, Italy
| | - Carlo Federico Perno
- Department of Laboratory Medicine, ASST Niguarda Hospital, University of Milan, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Jakko van Ingen
- Radboud University Medical Center, Department of Medical Microbiology, Nijmegen, the Netherlands
| | - Luigi Ruffo Codecasa
- TB Reference Centre and Lab, Villa Marelli Institute, Niguarda Hospital, Milan, Italy.
| | - Francesco Blasi
- University of Milan, Department of Pathophysiology and Transplantation, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit, Cystic Fibrosis Adult Center, Italy
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Aliberti S, Polverino E, Chalmers JD, Altenburg J, Shteinberg M, Goeminne PC, Welte T, Shoemark A, Almagro M, Blasi F. The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) ERS Clinical Research Collaboration. Eur Respir J 2018; 52:52/5/1802074. [DOI: 10.1183/13993003.02074-2018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 10/31/2018] [Indexed: 11/05/2022]
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Aliberti S, Chalmers JD. Get together to increase awareness in bronchiectasis: a report of the 2 nd World Bronchiectasis Conference. Multidiscip Respir Med 2018; 13:28. [PMID: 30151189 PMCID: PMC6101068 DOI: 10.1186/s40248-018-0138-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Stefano Aliberti
- Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - James D. Chalmers
- Tayside Respiratory Research Group, University of Dundee, Dundee, DD1 9SY UK
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