PURPOSE: Immunosuppression and structural lung disease are both risk factors to developing non-tuberculous mycobacterium (NTM) lung infection. Previous studies have reported NTM infection in lung transplant recipients; however, most of these patients had CF lung disease and required treatment for NTM infection. This study seeks to describe the incidence of NTM isolation in non-CF lung transplant recipients performed at a single center.
METHODS: Charts of all 41 patients who underwent lung transplantation for lung disease other than CF from 2004 to 2008 were reviewed retrospectively. Patients with positive respiratory cultures for NTM post-transplant were analyzed.
RESULTS: NTM was isolated in 13 of the 41 patients (33%) via routinely obtained bronchoalveolar lavage (BAL) or transbronchial biopsy (TBBx). 12 NTM cultures were identified as M. avium complex and one culture as M. Xenopi. None of these patients had pre-transplant NTM except one. In all cases, NTM was isolated only on a single sample; subsequent BAL or TBBx failed to isolate NTM. Only one patient presented with clinical and radiographic evidence consistent with NTM disease. No patients were treated for NTM infection. No deaths were attributed to NTM lung disease.
CONCLUSIONS: In this single center experience, respiratory NTM isolation was more common in non-CF lung transplant recipients than previously reported; however, true NTM lung disease was rare. Antibiotic treatment for these patients was deemed unnecessary.
CLINICAL IMPLICATIONS: Although transient respiratory isolation of NTM in non CF lung transplant recipients was quite high, the incidence of NTM lung disease was low, did not require treatment and did not contribute to death.
DISCLOSURE: The following authors have nothing to disclose: Koonj Shah, Sakshi Dua, Maria Padilla
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