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Chest Infections |

Mycobacterium abscessus Pulmonary Disease: Important Pathogen as Microbial Substitution During the Treatment of Non-abscessus Mycobacterial Disease FREE TO VIEW

Yoshiya Tsunoda*, MD; Yuki Sumazaki, MD; Akimasa Sekine, MD; Toru Tanaka, MD; Hiroyuki Takoi, MD; Yohei Yatagai, MD; Shin-Yuan Lin, MD; Kenji Hayashihara, PhD; Takefumi Saito, PhD; Shimao Fukai, PhD
Author and Funding Information

National Organization Ibarakihigashi National Hospital, Tokai Village, Japan


Chest. 2012;142(4_MeetingAbstracts):143A. doi:10.1378/chest.1386140
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Abstract

SESSION TYPE: TB and NTM

PRESENTED ON: Sunday, October 21, 2012 at 01:15 PM - 02:45 PM

PURPOSE: To elucidate the characteristics of the patients with M. abscessus pulmonary disease(MAPD).

METHODS: From 2001 through 2010, all patients, whose sputum or bronchoscopic lavage culture yielded M. absessus , were included.

RESULTS: Among 11 patients included (male/female: 4/7), four male patients had smoking histories. Ten patients met the diagnostic criteria of nontuberculous-mycobacterial infection from ATS/IDSA. All eleven patients presented with bronchiectasis on CT scan before the detection of M. abscessus, and most of patients had the pattern of nodular-bronchiectasis on chest CT. As for therapy, five patients received drug-therapy. Three of them were treated with multiple-drug therapy including CAM, EB, and RFP, and the remaining two patients with low-dose macrolide therapy. However, M. abscessus was detected continuously in all patients, and the deterioration of chest CT findings was shown in the four patients. Among the remaining six patients untreated with drugs, sputum culture yielded M. abscessus with deterioration of radiograph in four patients. Six patients (54.5%) developed MAPD during the therapy for non-abscessus NTM disease. Five of them were treated as MAC pulmonary disease and one as M. kansasii disease. Although non-abscessus mycobacterium became negative at the time of the detection of M. abscessus, radiographic deterioration was observed in four of six patients.

CONCLUSIONS: Our results indicated that MAPD was refractory regardless of the treatment with drugs, and MAPD developed during the treatment for non-abscessus mycobacterium which was mainly MAC in most of patients. MAPD might develop as microbial substitution.

CLINICAL IMPLICATIONS: This phenomenen should be considered to be an important issue during the treatment for non-abscessus mycobacterial disease which require long-term medication.

DISCLOSURE: The following authors have nothing to disclose: Yoshiya Tsunoda, Yuki Sumazaki, Akimasa Sekine, Toru Tanaka, Hiroyuki Takoi, Yohei Yatagai, Shin-Yuan Lin, Kenji Hayashihara, Takefumi Saito, Shimao Fukai

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National Organization Ibarakihigashi National Hospital, Tokai Village, Japan

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