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Chest Infections |

Clinical Significance of Isolations of Nontuberculous Mycobacteria From Respiratory Specimens in Hematopoietic Stem Cell Transplantation Recipients

Kihoon Park*, MD; Ji Young Kang, MD; Hea Yeon Lee, MD; Chin Kook Rhee, MD; Jick Hwan Ha, MD; Seok Chan Kim, PhD; Sook Young Lee, PhD; Young Kyoon Kim, PhD; Dong-Gun Lee, PhD
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College of Medicine, Catholic University of Korea, Seoul, Korea, Seoul, Republic of Korea


Chest. 2012;142(4_MeetingAbstracts):207A. doi:10.1378/chest.1390833
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Abstract

SESSION TYPE: Respiratory Infections Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: the clinical importance of the NTM isolations is not clear, especially after hematopoetic stem cell transplantation (HSCT). We aimed to investigate the characteristics of NTM isolations and risk factors of NTM pulmonary disease in SCT recipients.

METHODS: Medical records of adult patients who underwent HSCT at Catholic HSCT center from Jan 2004 to Mar 2012, were retrospectively reviewed. Of them, we evaluated the clinical features, radiologic findings and outcome in the patient with NTM isolation from respiratory specimens.

RESULTS: Twenty four patients were enrolled. Their mean age was 40 year- old (19-58) and the number of male were 17(70.8%). Among the underlying hematologic diseases, acute myeloid leukemia and acute lymphoid leukemia are the two most common entity (n=10 and n=6, respectively). Twenty three patients performed allo SCT and the types of it are as follows; 8 sibling, 2 family, 12 unrelated, and 1 not available. The source of stem cells are bone marrow (n=14) and peripheral blood (n=10). The most common NTM species are M. avium (n=7) and M.intracelluare (n=6). M. abscessus (n=5) and M. fortuitum (n=3),are followed. The duration of NTM isolation from HSCT is 1055 day and three cases were detected before transplantation. Mostly, changes in radiologic features were concurrently found and nodules (n= 7), cavitation (n=6), bronchiectasis (n=2), consolidation (n=15). Normal finding was seen in two cases and only nine patients had underlying bronchiectasis. Two of three in all patients had graft-versus-host disease (GVHD) and subsequently took immuosuppresants. Especially, there were ten cases of bronchiolitis obliterans with/without organizing pneumonia and sixteen cases of pulmonary coinfection. The most frequent pathogen is aspergillus species (n=8). Seven of twenty four patients (29%) patients were treated and three patients of them died.

CONCLUSIONS: This study shows that NTM detection from respiratory specimens was commonly encountered with allo BMT and moreover, GVHD history. Microbiologically, M.avium/intracelluare species are isolated frequently and pulmonary coinfection with aspergillus was combined often.

CLINICAL IMPLICATIONS: NTM isolation from respiratory specimens occur commonly with alloBMT, GVHD, and pulmonary aspergillus infection.

DISCLOSURE: The following authors have nothing to disclose: Kihoon Park, Ji Young Kang, Hea yeon Lee, Chin Kook Rhee, Jick Hwan Ha, Seok Chan Kim, Sook Young Lee, Young Kyoon Kim, Dong-Gun Lee

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College of Medicine, Catholic University of Korea, Seoul, Korea, Seoul, Republic of Korea

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