Clinical significance of the differentiation between Mycobacterium avium and Mycobacterium intracellulare in M avium complex lung disease

Won Jung Koh, Byeong Ho Jeong, Kyeongman Jeon, Nam Yong Lee, Kyung Soo Lee, Sook Young Woo, Sung Jae Shin, O. Jung Kwon

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Abstract

Background: Mycobacterium avium and Mycobacterium intracellulare are grouped together as the M avium complex;however, little is known about the clinical impact of this species differentiation. This study compared the clinical features and prognoses of patients with M avium and M intracellulare lung disease. Methods: From 2000 to 2009, 590 patients were given a new diagnosis of M avium complex lung disease; 323 (55%) had M avium lung disease, and 267 (45%) had M intracellulare lung disease. Results: Compared with the patients with M avium lung disease, the patients with M intracellulare lung disease were more likely to have the following characteristics: older age (64 vs 59 years, P =.002), a lower BMI (19.5 kg/m2 vs 20.6 kg/m 2, P<.001), respiratory symptoms such as cough (84% vs 74%, P =.005), a history of previous treatment for TB (51% vs 31%, P<.001), the fibrocavitary form of the disease (26% vs 13%, P<.001), smear-positive sputum (56% vs 38%, P<.001), antibiotic therapy during the 24 months of follow-up (58% vs 42%, P<.001), and an unfavorable microbiologic response after combination antibiotic treatment (56% vs 74%, P =.001). Conclusions: Patients with M intracellulare lung disease exhibited a more severe presentation and had a worse prognosis than patients with M avium lung disease in terms of disease progression and treatment response. Therefore, species differentiation between M avium and M intracellulare may have prognostic and therapeutic implications.

Original languageEnglish
Pages (from-to)1482-1488
Number of pages7
JournalChest
Volume142
Issue number6
DOIs
Publication statusPublished - 2012 Dec

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All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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