Risk factors for recurrence after surgical treatment of nontuberculous mycobacterial lung disease

Katsuo Yamada, Ayuko Yasuda, Yukio Seki, Yasuhiro Fukui, Mitsuaki Yagi, Osamu Tarumi, Yuta Hayashi, Taku Nakagawa, Noritaka Yamada, Kenji Ogawa

研究成果: Article査読

1 被引用数 (Scopus)

抄録

[Purpose] This study analyzed the rate and risk factors of recurrence of nontuberculous mycobacterial lung disease (NTM-LD) in patients treated with adjuvant surgical procedures. [Subjects and Methods] We retrospectively analyzed the medical records of 92 patients treated with adjuvant surgery for NTM-LD at the National Hospital Organization Higashi Nagoya National Hospital and National Hospital Organization Nagoya Medical Center in Japan between August 2004 and June 2015. Recurrence was recorded, and factors associated with recurrence were analyzed. [Results] The mean age of the 92 patients was 53.7 =b12.0 years. The causative organisms were Mycobacterium avium in 59 patients (64.1%), Mycobacterium intracellulare in 23 (25.0%), Mycobacterium abscessus in 7 (7.6%), Mycobac-terium xenopi in 2 (2.2%), and Mycobacterium gordonae in 1(1.1%). Radiographic features included nodular bronchi-ectatic disease in 57 patients (62.0%), fibrocavitary disease in 22 (23.9%), bronchiectatic plus fibrocavitary disease in10 (10.8%), solitary nodular disease in 2 (2.2%), and unclassi-fiable disease in1(1.1%). All patients had been previously treated with a macrolide-containing regimen. During a median follow-up period of 45.0 months after surgery, 21patients (22.8%) experienced recurrence at a median of 29.0 months after surgery. Multivariate analysis showed that age (hazard ratio, 1.06; 95% confidence interval, 1.01 to 1.11) and M. avium (hazard ratio, 0.26 ; 95% confidence interval, 0.07 to 0.88) were independently associated with recurrence after surgery. [Conclusion] Recurrence after adjuvant surgical treatment is not rare in patients with NTM-LD. Age and M. avium were factors influencing postoperative recurrence. The results of this study suggested that it may be necessary to pay more attention to relatively older patients and those with M. avium during follow-up periods after adjuvant surgical treatment for NTM-LD.

本文言語English
ページ(範囲)451-457
ページ数7
ジャーナルKekkaku
92
6
出版ステータスPublished - 06-2017

All Science Journal Classification (ASJC) codes

  • 呼吸器内科
  • 感染症

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