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Prevalence of NTM Pulmonary Infection in the Patients with Bronchiectasis  

Lee, Jung Yeon (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Song, Jae-Woo (Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center)
Hong, Sang-Bum (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Oh, Yeon-Mok (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Lim, Chae-Man (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Lee, Sang Do (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Koh, Younsuck (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Kim, Woo Sung (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Kim, Dong Soon (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Kim, Won Dong (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Shim, Tae Sun (Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Publication Information
Tuberculosis and Respiratory Diseases / v.57, no.4, 2004 , pp. 311-319 More about this Journal
Abstract
Background : It has been well known that bronchiectasis (BE) is a predisposing condition for pulmonary NTM infection, whereas there are some suggestions that BE, especially nodular BE, may be a result of NTM pulmonary infection. This retrospective study was done to investigate the prevalence of NTM pulmonary infection in the patients with BE. Methods : Eight hundred sixty-six patients, who underwent chest CT and sputum AFB examination and had BE detected by chest CT at Asan Medical Center in 2002, were included in this study. They were divided into Group I (bilateral BE, especially in RML, lingular or both lower lobes; 134), Group II (BE accompanied with fibrocavitary lesions commonly found in tuberculosis, usually both upper lobes; 233) and Group III (except Group I, II; 499) according to the radiological findings. Group I was subdivided into Group I+ (62) or Group I- (72) according to the presence or absence of centrilobular nodules, respectively. The sputum AFB examination, clinical and radiological findings were analyzed and compared between groups. Results : The number of patients who had at least one positive NTM culture was significantly higher in Group I+ compared with others (p<0.05); 24.2% in Group I+, 6.9% in Group I-, 9.9% in Group II, 6.0% in Group III and 4.1% in control. The number of patients who had true NTM infection defined by ATS guideline was higher in Group I+ (5, 8.1%) compared with others (p<0.05). In all groups, M. avium-intracellulare comlex was the most common isolates. Conclusion : Even though true NTM pulmonary disease was more prevalent in the patients with nodular BE, especially located in RML, left linguar, or both lower lobes, only a small population of the patients with nodular BE met the ATS diagnostic criteria for NTM pulmonary disease. The other patients in nodular BE group may have subclinical stage of NTM infection or completely different diseases from NTM infection. Long-term clinical studies are needed to clarify this issue.
Keywords
Bronchiectasis; Lung; Nontuberculous mycobacterium;
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