About: A retrospective study of factors associated with treatment decision for nontuberculous mycobacterial lung disease in adults without altered systemic immunity

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About: A retrospective study of factors associated with treatment decision for nontuberculous mycobacterial lung disease in adults without altered systemic immunity Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	A retrospective study of factors associated with treatment decision for nontuberculous mycobacterial lung disease in adults without altered systemic immunity
Creator	Ader, Florence Chidiac, Christian Dumitrescu, Oana Freymond, Nathalie Gamondes, Delphine Kiakouama-Maleka, Lize Lina, Gérard Perrot, Emilie Provoost, Judith Roux, Sandrine Souquet, Pierre-Jean Sénéchal, Agathe Valour, Florent
Source	PMC
abstract	BACKGROUND: Nontuberculous mycobacteria (NTM) lung diseases are increasingly recognized as chronic opportunistic infections, occurring in individuals with a wide variety of underlying conditions. In the absence of systemic immunodeficiency, decision of NTM lung disease treatment must relies on a careful risk/benefit assessment, given the requirement of long-term administration of multidrug therapies supported by limited evidence. The primary objective was to identify the factors associated with anti-NTM treatment initiation. Clinical and radiological outcome upon treatment were studied. METHODS: This retrospective, single center study (2013–2016, 45 months) addressed the criteria supporting treatment decision among adults with NTM lung disease without systemic immunodeficiency at our institution, with the assigned goal to harmonize the practice. All patients matched the current international definitions of NTM lung disease according to the American Thoracic Society criteria. Factors associated with anti-NTM treatment were investigated by conditional logistic regression. Clinical and radiological outcomes of treated and untreated NTM-disease cases were examined. Mortality rate was assessed. An expert radiologist conducted a blinded computed tomography (CT)-scan review of the treated and untreated patients. RESULTS: Among 51 cases of NTM lung diseases, 25 (49%) received anti-NTM treatment. In univariate analysis, a body mass index (BMI) < 18 kg/m(2) (odds ratio (OR), 4.2 [95% confidence interval (CI) 1.2–15.2]; p = 0.042), hemoptysis (OR, 11.8 [95% CI 1.35–12.9]; p = 0.026), excavation(s) (OR, 4.8 [95% CI 1.4–16.4], p = 0.012), prior anti-NTM treatment (OR, 5.65 [95% CI 1.06–29.9]; p = 0.042), Aspergillus spp. co-infection (OR, 6.3 [95% CI 1.8–22.2]; p = 0.004) were associated with treatment initiation. In multivariate analysis, Aspergillus spp. co-infection was the only independent determinant of treatment initiation (OR, 5.3 [95% CI 1.1–25.4]; p = 0.036). Twenty-one (81%) patients received ≥3 anti-NTM drugs. Median treatment duration and follow-up were 36.3 (interquartile range [IQR], 13.1–64.4) weeks and 17.1 (IQR, 8.7–27.1) months, respectively. Regarding radiological outcome, 85 CT-scans were reviewed, showing similar rates of regression or stabilization in treated and untreated patients. Overall mortality rate was not different in treated and untreated patients. CONCLUSION: The most relevant variable associated with anti-NTM treatment initiation was Aspergillus spp. co-infection. Radiological regression or stabilization of pulmonary lesions was not different between the treated and untreated patients.
has issue date	2018-12-14(xsd:dateTime)
bibo:doi	10.1186/s12879-018-3559-x
bibo:pmid	30547753
has license	cc-by
sha1sum (hex)	a5fdb40f1b5bddf4ab24efaddedc40d441e3a130
schema:url	https://doi.org/10.1186/s12879-018-3559-x
resource representing a document's title	A retrospective study of factors associated with treatment decision for nontuberculous mycobacterial lung disease in adults without altered systemic immunity
has PubMed Central identifier	PMC6295085
has PubMed identifier	30547753
schema:publication	BMC Infect Dis
resource representing a document's body	covid:a5fdb40f1b5bddf4ab24efaddedc40d441e3a130#body_text
is schema:about of	named entity 'study' named entity 'immunodeficiency' named entity 'supported' named entity 'lung disease' named entity 'SYSTEMIC' named entity 'IMMUNITY' named entity 'PATIENTS' named entity 'CENTER' named entity 'ACCORDING' named entity 'INVESTIGATED' named entity 'CASES' named entity 'GOAL' named entity 'UNTREATED' named entity 'ADMINISTRATION' named entity 'TREATMENT INITIATION' named entity 'AMERICAN' named entity 'MONTHS' named entity 'NTM' named entity 'SCAN' named entity 'SINGLE' named entity 'EVIDENCE' named entity 'OUTCOME' named entity 'COMPUTED TOMOGRAPHY' named entity 'CONDITIONAL' named entity 'CHRONIC' named entity 'RETROSPECTIVE' named entity 'STUDY' named entity 'ADULTS' named entity 'WIDE' named entity 'RISK' named entity 'ASSIGNED' named entity 'MORTALITY RATE' named entity 'OPPORTUNISTIC INFECTIONS' named entity 'SUPPORTING' named entity 'SOCIETY' named entity 'ASSOCIATED WITH' named entity 'GIVEN' named entity 'TREATMENT' named entity 'THORACIC' named entity 'CLINICAL' named entity 'BLINDED' named entity 'LUNG DISEASES' named entity 'DECISION' named entity 'NONTUBERCULOUS MYCOBACTERIAL LUNG DISEASE' named entity 'RETROSPECTIVE STUDY' named entity 'ASSOCIATED WITH' named entity 'ADULTS' named entity 'ASSESSMENT' named entity 'LIMITED' named entity 'THERAPIES' named entity 'INDIVIDUALS' named entity 'SUPPORTED' named entity 'LONG-TERM' named entity 'NONTUBERCULOUS MYCOBACTERIA' named entity 'METHODS' named entity 'ABSENCE OF' named entity 'INTERNATIONAL' named entity 'LUNG DISEASE' named entity 'VARIETY' named entity 'RADIOLOGIST' named entity 'SYSTEMIC' named entity 'DECISION' named entity 'CURRENT' named entity 'UNDERLYING' named entity 'OUTCOMES' named entity 'CRITERIA' named entity 'LOGISTIC REGRESSION' named entity 'ALTERED' named entity 'TREATED'

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