Risk Factors and Characteristics of Nontuberculous Mycobacterial Infections

Öz

Aim: Infections caused by nontuberculous Mycobacterium (NTM) are extremely prevalent in nature and challenging to identify and treat. Thus, the purpose of this study was to examine the clinical characteristics and risk factors of NTM. Methods: The present investigation was carried out using 5-year retrospective data in a tertiary university hospital. The study comprised 29 individuals with radiological and clinical signs of NTM infection that were confirmed by microbiological testing. These patients' clinical, laboratory, radiological, and sociodemographic information was documented. Results: The patients' average age was 58.31 ± 14.31 years, and 62.1% of them were men. Cough, weakness, and fever were the most prevalent symptoms, and hypertension and chronic lung disease were the most prevalent comorbidities. M. Kansasii, M. Fortuitum, and M. Abscessus were the most commonly isolated NTM species. HIV, treatment type, and treatment duration were determined to be the most significant factors influencing treatment response (p=0.018, p=0.002, p=0.001, respectively). Two (6.9%) of our patients passed away during the follow-up period, and it was discovered that a high sedimentation rate, a high Charlson comorbidity index score, and a lengthy interval between the onset of symptoms and diagnosis were all linked to death (p=0.010, p=0.002, and p=0.000, respectively). Conclusion: NTM lung disease should be established, contamination should be ruled out, and if the pathogen is found, species-specific and sufficient treatment should be given to patients with NTM risk factors and relevant clinical, radiologic, and laboratory results.

Anahtar Kelimeler

• nontuberculous mycobacterium
• infections
• risk factors
• mortality
• treatment

Nontüberküloz Mikobakteriyel Enfeksiyonların Risk Faktörleri ve Özellikleri

Öz

Giriş ve Amaç: Tüberküloz dışı mikobakterilerin (NTM) neden olduğu enfeksiyonlar doğada oldukça yaygın olup tanımlanması ve tedavisi zordur. Bu çalışmanın amacı NTM'nin klinik özelliklerini ve risk faktörlerini incelemektir. Gereç ve Yöntemler: Bu araştırma, üçüncü basamak bir üniversite hastanesinde 5 yıllık retrospektif veriler kullanılarak gerçekleştirilmiştir. Çalışma, NTM enfeksiyonunun radyolojik ve klinik bulguları olan ve mikrobiyolojik testlerle doğrulanan 29 kişiyi kapsamaktadır. Bu hastaların klinik, laboratuvar, radyolojik ve sosyodemografik bilgileri kayıt altına alınmış ve analizler yapılmıştır. Bulgular: Hastaların yaş ortalaması 58.31 ± 14.31 yıldı ve %62.1'i erkekti. Öksürük, halsizlik ve ateş en sık görülen semptomlar, hipertansiyon ve kronik akciğer hastalığı ise en sık görülen komorbiditelerdi. M. Kansasii, M. Fortuitum ve M. Abscessus en sık izole edilen NTM türleriydi. HIV, tedavi tipi ve tedavi süresi tedavi yanıtını etkileyen en önemli faktörler olarak belirlenmiştir (sırasıyla p=0.018, p=0.002, p=0.001). Hastalarımızın ikisi (%6,9) takip süresi içinde vefat etmiş ve yüksek sedimantasyon hızı, yüksek Charlson komorbidite indeksi skoru ve semptomların başlangıcı ile tanı arasındaki sürenin uzun olmasının ölümle bağlantılı olduğu görülmüştür (sırasıyla p=0,010, p=0,002 ve p=0,000). Tartışma ve Sonuç: NTM risk faktörleri ve ilgili klinik, radyolojik ve laboratuvar sonuçları olan hastalarda NTM akciğer hastalığı tespit edilmeli, kontaminasyon ekarte edilmeli ve patojen bulunursa türe özgü ve yeterli tedavi verilmelidir.

Anahtar Kelimeler

• nontüberküloz mikobakteri
• enfeksiyon
• risk faktörleri
• mortalite
• tedavi

Kaynakça

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