Non-tuberculous mycobacterial infections after solid organ transplantation: a survival analysis

Clin Microbiol Infect. 2015 Jan;21(1):43-7. doi: 10.1016/j.cmi.2014.07.001. Epub 2014 Oct 29.

Abstract

The relationship of non-tuberculous mycobacterial (NTM) infections and survival among solid organ transplant recipients is unknown. We conducted a retrospective cohort study to measure the impact of NTM infection on survival in this patient population, comparing the effect of Mycobacterium abscessus infection with that of infections due to other pathogenic NTM species. We identified 33 patients with NTM infection post-transplantation, 18 with infection that was diagnosed within the first year. Although drug resistance was common among M. abscessus isolates, patients with M. abscessus infection did not have increased mortality compared with patients with other types of NTM infections (p 0.64). In contrast, we observed a significant association overall between early NTM infection and 3-year mortality post-transplantation (hazard ratio 8.76, 95% CI 2.69-28.57). The mortality burden of NTM infection following transplantation may be due to factors other than the virulence of the organisms. Multicentre studies are needed to identify the optimal approach for diagnosing and treating these uncommon but serious infections.

Keywords: Drug resistance; Mycobacterium abscessus; epidemiology; non-tuberculous mycobacteria; transplantation.

MeSH terms

  • Antitubercular Agents / pharmacology
  • Drug Resistance, Bacterial
  • Humans
  • Mycobacterium Infections, Nontuberculous / complications
  • Mycobacterium Infections, Nontuberculous / mortality*
  • Nontuberculous Mycobacteria / drug effects*
  • Organ Transplantation / adverse effects*
  • Organ Transplantation / mortality*
  • Retrospective Studies
  • Survival Analysis

Substances

  • Antitubercular Agents