Autor(es): Monteiro, Jos? Tadeu Colares ; Lima, Karla Val?ria Batista ; Barreto, Adriana Rodrigues ; Furlaneto, Ismari Perini ; Gon?alves, Glenda Moraes ; Costa, Ana Roberto Fusco da ; Lopes, Maria Luiza ; Dalcolmo, Margareth Pretti
Data: 2018
Origem: Oasisbr
Assunto(s): Pulm?o / microbiologia; Micobact?rias n?o Tuberculosas / classifica??o; Micobact?rias n?o Tuberculosas / efeitos dos f?rmacos; Mycobacterium abscessus / patogenicidade
Universidade do Estado do Par?. Centro Universit?rio do Estado do Par?. Programa de P?s-Gradua??o em Biologia Parasit?ria na Amaz?nia. Bel?m, PA, Brasil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Biologia Molecular. Ananindeua, PA, Brasil.
Universidade Federal do Par?. Faculdade de Medicina. Bel?m, PA, Brasil.
Universidade do Estado do Par?. Centro Universit?rio do Estado do Par?. Programa de P?s-Gradua??o em Biologia Parasit?ria na Amaz?nia. Bel?m, PA, Brasil / Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Biologia Molecular. Ananindeua, PA, Brasil.
Universidade Federal do Par?. Faculdade de Medicina. Bel?m, PA, Brasil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Biologia Molecular. Ananindeua, PA, Brasil.
Minist?rio da Sa?de. Secretaria de Vigil?ncia em Sa?de. Instituto Evandro Chagas. Laborat?rio de Biologia Molecular. Ananindeua, PA, Brasil.
Pontif?cia Universidade Cat?lica do Rio de Janeiro. Programa de P?s-Gradua??o. Rio de Janeiro, RJ, Brasil / Funda??o Oswaldo Cruz. Escola Nacional de Sa?de P?blica S?rgio Arouca. Centro de Refer?ncia H?lio Fraga. Rio de Janeiro, RJ, Brasil.
Objective: To describe the clinical manifestations of patients with pulmonary infection caused by mycobacteria of the Mycobacterium abscessus complex (MABSC), and to compare these manifestations with those of patients infected with other nontuberculous mycobacteria (NTM). Methods: This was a retrospective cohort study involving 43 patients divided into two groups: the MABSC group, consisting of patients with pulmonary infection caused by MABSC (n = 17); and the NTM group, consisting of patients with pulmonary infection caused by NTM other than MABSC (n = 26). Patients were previously treated with a regimen of rifampin, isoniazid, pyrazinamide, and ethambutol before the diagnosis of NTM was confirmed by two culture-positive sputum samples. The nucleotide sequences of the hsp65, 16S rRNA, and/or rpoB genes were analyzed to identify the mycobacteria. Data were collected on demographic, clinical, and radiological characteristics, as well as on treatment responses and outcomes. Results: Loss of appetite was the only clinical manifestation that was significantly more common in the MABSC group than in the NTM group (p = 0.0306). The chance of having to use a second treatment regimen was almost 12 times higher in the MABSC group than in the NTM group. Treatment success was significantly higher in the NTM group than in the MABSC group (83.2% vs. 17.6%; p < 0.0001). The chance of recurrence was approximately 37 times higher in the MABSC group than in the NTM group. Conclusions: In the study sample, treatment response of pulmonary disease caused by MABSC was less favorable than that of pulmonary disease caused by other NTM.
