Nontuberculous mycobacterial pulmonary disease diagnosed by two methods: a prospective cohort study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-05-24

AUTHORS

Hyung-Jun Kim, Jong Hyuk Lee, Soon Ho Yoon, Sung A. Kim, Myoung Sil Kim, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sung Koo Han, Jae-Joon Yim

ABSTRACT

BackgroundMicrobiological criteria for diagnosing nontuberculous mycobacterial pulmonary disease (NTM-PD) include positive culture results from at least two separately expectorated sputum specimens or one bronchial washing or lavage. However, the clinical similarities and differences between patients diagnosed by these two methods remain unclear. We compared clinical features and prognoses of patients with NTM-PD diagnosed from both specimen types.MethodsWe analysed data from patients who participated in the Seoul National University Hospital NTM-PD cohort (ClinicalTrials.gov identifier: NCT01616745). Baseline demographics, symptoms, radiographic findings, disease progression, and treatment responses were summarized and compared between patients diagnosed from sputum specimens and patients diagnosed from bronchoscopic specimens.ResultsThree hundred forty-seven patients were included in the analyses. Of these, 279 (80.4%) were diagnosed from two separately expectorated sputum specimens, and 68 (19.6%) were diagnosed from bronchoscopic specimens. Patients diagnosed from sputum specimens had more frequent and severe cough, sputum, postnasal drip, and high St. George’s Respiratory Questionnaire scores. However, the extent and severity of the radiographic lesions, disease progression, and treatment responses were similar for both groups. Further analysis based on the following three groups (sputum culture positive, sputum culture negative/bronchoscopy, and scanty sputum/bronchoscopy groups) suggested that the scanty sputum/bronchoscopy group appeared to have the worst prognosis in terms of both time to progression and time to culture conversion.ConclusionsAlthough some symptoms and quality of life were worse in patients with NTM-PD diagnosed from sputum specimens, their prognoses were similar to those of patients diagnosed by bronchoscopic specimen. We recommend bronchoscopic sampling for patients in whom NTM-PD is suspected clinically or radiographically, especially those who have no or scanty sputum. More... »

PAGES

468

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12879-019-4078-0

DOI

http://dx.doi.org/10.1186/s12879-019-4078-0

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https://app.dimensions.ai/details/publication/pub.1115626960

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31126235


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