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Original Research: Chest Infections |

The Significance of Mycobacterium abscessus Subspecies abscessus Isolation During Mycobacterium avium Complex Lung Disease TherapyMycobacterium avium Complex Therapy

David E. Griffith, MD, FCCP; Julie V. Philley, MD; Barbara A. Brown-Elliott, MS; Jeana L. Benwill, MD; Sara Shepherd, MS; Deanna York, RN; Richard J. Wallace, Jr, MD, FCCP
Author and Funding Information

From the Departments of Medicine (Drs Griffith, Philley, Benwill, and Wallace) and Microbiology (Mss Brown-Elliott, Shepherd, and York and Dr Wallace), the University of Texas Health Science Center, Tyler, TX.

CORRESPONDENCE TO: David E. Griffith, MD, FCCP, University of Texas Health Science Center, Tyler, 11937 US Hwy 271, Tyler, TX 75708; e-mail: david.griffith@uthct.edu


Data included in this manuscript were presented in part at the European Respiratory Society Annual Meeting, September 7-11, 2013, Barcelona, Spain.

FUNDING/SUPPORT: This manuscript was supported in part by institutional funds from the University of Texas Health Science Center, Tyler; the Amon G. Carter Foundation (Dr Wallace), Ft. Worth, TX; and the Moncrief Foundation (Dr Griffith), Ft. Worth, TX.

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


Chest. 2015;147(5):1369-1375. doi:10.1378/chest.14-1297
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BACKGROUND:  Isolation of Mycobacterium abscessus subspecies abscessus (MAA) is common during Mycobacterium avium complex (MAC) lung disease therapy, but there is limited information about the clinical significance of the MAA isolates.

METHODS:  We identified 53 of 180 patients (29%) treated for MAC lung disease who had isolation of MAA during MAC lung disease therapy. Patients were divided into those without (group 1) and those with (group 2) MAA lung disease.

RESULTS:  There were no significant demographic differences between patients with and without MAA isolation or between groups 1 and 2. Group 1 and 2 patients had similar total sputum cultures obtained (P = .7; 95% CI, −13.4 to 8.6) and length of follow-up (P = .8; 95% CI, −21.5 to 16.1). Group 2 patients had significantly more total positive cultures for MAA (mean±SD, 15.0 ± 11.1 vs 1.2 ± 0.4; P < .0001; 95% CI, −17.7 to −9.9), were significantly more likely to develop new or enlarging cavitary lesions while on MAC therapy (P > .0001), and were significantly more likely to meet all three American Thoracic Society diagnostic criteria for nontuberculous mycobacterial disease (21 of 21 [100%] vs 0 of 32 [0%]; P < .0001) compared with group 1 patients. Group 1 patients were significantly more likely to have single, positive MAA cultures than group 2 patients (25 of 31 vs 0 of 21; P < .0001).

CONCLUSIONS:  Microbiologic and clinical follow-up after completion of MAC lung disease therapy is required to determine the significance of MAA isolated during MAC lung disease therapy. Single MAA isolates are not likely to be clinically significant.

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