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Original Research: Chest Infections |

Clinical Significance of the Differentiation Between Mycobacterium avium and Mycobacterium intracellulare in M avium Complex Lung DiseaseMycobacterium Avium vs M Intracellulare Disease

Won-Jung Koh, MD; Byeong-Ho Jeong, MD; Kyeongman Jeon, MD; Nam Yong Lee, MD; Kyung Soo Lee, MD; Sook Young Woo, MS; Sung Jae Shin, PhD; O. Jung Kwon, MD
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine (Drs Koh, Jeong, Jeon, and Kwon), Department of Medicine; Department of Laboratory Medicine (Dr N. Y. Lee); and Department of Radiology (Dr K. S. Lee), Samsung Medical Center, Sungkyunkwan University School of Medicine; Biostatistics Team (Ms Woo), Samsung Biomedical Research Institute, Samsung Medical Center; and Department of Microbiology (Dr Shin), Yonsei University College of Medicine, Seoul, South Korea.

Correspondence to: Won-Jung Koh, MD, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul 135-710, South Korea; e-mail: wjkoh@skku.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or in the preparation of the manuscript.

Drs Koh and Jeong contributed equally to this work.

Funding/Support: This work was supported by the Mid-Career Researcher Program through a National Research Foundation grant funded by the Ministry of Education, Science and Technology [grants 2011-0015546] in South Korea.


Chest. 2012;142(6):1482-1488. doi:10.1378/chest.12-0494
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Background:  Mycobacterium avium and Mycobacterium intracellulare are grouped together as the M avium complex; however, little is known about the clinical impact of this species differentiation. This study compared the clinical features and prognoses of patients with M avium and M intracellulare lung disease.

Methods:  From 2000 to 2009, 590 patients were given a new diagnosis of M avium complex lung disease; 323 (55%) had M avium lung disease, and 267 (45%) had M intracellulare lung disease.

Results:  Compared with the patients with M avium lung disease, the patients with M intracellulare lung disease were more likely to have the following characteristics: older age (64 vs 59 years, P = .002), a lower BMI (19.5 kg/m2 vs 20.6 kg/m2, P < .001), respiratory symptoms such as cough (84% vs 74%, P = .005), a history of previous treatment for TB (51% vs 31%, P < .001), the fibrocavitary form of the disease (26% vs 13%, P < .001), smear-positive sputum (56% vs 38%, P < .001), antibiotic therapy during the 24 months of follow-up (58% vs 42%, P < .001), and an unfavorable microbiologic response after combination antibiotic treatment (56% vs 74%, P = .001).

Conclusions:  Patients with M intracellulare lung disease exhibited a more severe presentation and had a worse prognosis than patients with M avium lung disease in terms of disease progression and treatment response. Therefore, species differentiation between M avium and M intracellulare may have prognostic and therapeutic implications.

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