Background
Methods
Study setting and study subjects
Data collection
Statistical analysis
Results
Specimen source and NTM species distribution
Specimen source | Sub-total N (%) | Total N (%) |
---|---|---|
Pulmonary | ||
Sputum | 1519 (75) | 1777 (87.7%) |
Broncho alveolar lavage | 195 (9.6) | |
Lung biopsy | 39 (1.9) | |
ETT aspirate | 12 (0.6) | |
Pleural fluid | 12 (0.6) | |
Extra-pulmonary | ||
Skin/soft tissue | 96 (4.7) | 249 (12.3%) |
Blood/sterile sites | 138 (6.8) | |
Lymph node | 15 (0.74) |
Organism | No. of counts (%) |
---|---|
M. abscessus-chelonae group
| 1010 (49.9) |
M. fortuitum group
| 345 (17.0) |
M. avium complex
| 313 (15.4) |
M. kansasii
| 233 (11.5) |
M. haemophilum
| 41 (2.0) |
M. scrofulaceum
| 22 (1.1) |
M. mucogenicum
| 16 (0.8) |
M. lentiflavum
| 14 (0.7) |
M. triplex
| 10 (0.5) |
M. interjectum
| 7 (0.3) |
M. simiae
| 7 (0.3) |
M. marinum
| 5 (0.2) |
M. terrae complex
| 5 (0.2) |
M. szulgai
| 4 (0.2) |
M. genavense
| 2 (0.1) |
M. neoaurum
| 2 (0.1) |
M. celatum
| 1 (0.05) |
NTM diseases
Species | Pulmonary N = 352 (%) | Skin/soft tissue N = 50 (%) | Blood/ other sterile sites N = 49 (%) | Lymph node N = 9 (%) | Total N = 460 (%) |
---|---|---|---|---|---|
M. chelonae -M. abscessus group | 197 (56) | 25 (50) | 16 (32.7) | 6(66.7) | 244 (53) |
M. avium complex (MAC) | 99 (28.1) | 4 (8) | 14 (28.6) | 1 (11.1) | 118 (25.7) |
M. fortuitum species group | 91 (25.9) | 7 (14) | 15 (30.6) | 0 | 113 (24.6) |
M. kansasii | 71 (20.2) | 1 (2.0) | 1 (11.1) | 73 (15.9) | |
M. scrofulaceum | 8 (2.3) | 8 (1.7) | |||
M. mucogenicum | 6 (1.7) | 2 (4.1) | 8 (1.7) | ||
M. lentiflavum | 3 (0.9) | 3 (0.7) | |||
M. szulgai | 2 (0.6) | 2 (0.4) | |||
M. interjectum | 1 (0.3) | 1(0.2) | |||
M. simiae | 1 (0.3) | 1(2.0) | 2 (0.4) | ||
M. triplex | 1 (0.3) | 1(0.2) | |||
M. genavense | 1 (11.1) | 1(0.2) | |||
M. haemophilum | 10 (20) | 2 (4.1) | 12 (2.6) | ||
M. marinum | 3 (6.0) | 3 (0.6) | |||
M. neoaurum | 2 (4.1) | 2 (0.4) | |||
M. terrae complex | 1 (2.0) | 1(0.2) |
Characteristics | No. of subjects (%) |
---|---|
Male, No. (%) | 182 (51.7) |
Median Age (IQR) (years) | 67 (58–74) |
Median BMI (IQR) | 18.8 (16.2–21.5) |
Ethnic groups | |
Chinese | 306 (86.9) |
Malay | 19 (5.4) |
Indian | 11 (3.1) |
Others | 16 (4.5) |
Coexisting illness | |
Transplant | 7 (2.0) |
HIV | 13 (3.7) |
Ischemia heart disease | 42 (11.9) |
Congestive heart failure | 7 (2.0) |
Malignant diseases | 96 (27.3) |
Renal disease | 11 (3.1) |
Liver disease | 9 (2.6) |
Diabetes mellitus | 43 (12.2) |
Cardiovascular disease | 42 (11.9) |
COPD | 46 (13.1) |
Bronchiectasis | 128 (36.4) |
Asthma history | 14 (4.0) |
TB history | 97 (27.6) |
Cerebrovascular disease | 14 (4.0) |
Clinical presentations | |
Cough | 261 (74.1) |
Recurrent cough with phlegm production | 160 (45.5) |
Haemoptysis | 114 (32.4) |
Weight loss | 28 (8.0) |
Night sweat | 7 (2.0) |
Laboratory Investigations | 28 (8.0) |
AFB smear (+) | 113 (32.1) |
Blood culture (+) | 3 (0.9) |
Sputum culture (+) | 30 (8.5) |
Radiological findings | |
Chest X-ray (N = 330) | |
Fibrocavitary | 25 (7.6) |
Nodular bronchiectasis | 144 (43.6) |
CT scan (N = 260) | |
Fibrocavitary | 27 (10.4) |
Nodular bronchiectasis | 255 (98.1) |
NTM pulmonary diseases
Demographic information and clinical features
Characteristics | Male (N = 182) | Female (N = 170) | P value |
---|---|---|---|
Median Age (25 th-75th IQR) (years) | 68.5 (61–76) | 66 (56–73) | 0.014* |
Median BMI (25th–75th IQR) | 18.9 (16.2–22.3) | 18.6 (16.1–21.3) | 0.711 |
Coexisting illnesses No. (%) | |||
HIV | 11 (6.0) | 2 (1.2) | 0.021* |
Ischemia heart disease | 34 (18.7) | 8 (4.7) | < 0.001* |
Neoplastic disease | 48 (26.4) | 48 (28.2) | 0.7 |
Diabetes mellitus | 29 (15.9) | 14 (8.2) | 0.028* |
COPD | 43 (23.6) | 3 (1.8) | < 0.001* |
Bronchiectasis | 43 (23.6) | 85 (50.0) | < 0.001* |
TB history | 64 (35.2) | 33 (19.7) | 0.001* |
Clinical symptoms | |||
Cough | 141 (77.5) | 120 (70.6) | 0.14 |
Recurrent cough with phlegm | 94 (51.6) | 66 (38.8) | 0.035* |
Haemoptysis | 50 (27.5) | 64 (37.6) | 0.042* |
Weight loss | 38 (20.9) | 33 (19.4) | 0.73 |
Chest pain | 17 (9.3) | 11(6.5) | 0.33 |
Investigations | |||
Median albumin (25th–75th IQR) | 32 (27–37.2) | 34 (28–40) | 0.076 |
Factors associated with multiple NTM species detection
Characteristics | 1 species (N = 246) | ≥ 2 species (N = 106) | P value | OR (95% CI) |
---|---|---|---|---|
Male (%) | 123 (50) | 59 (55.7) | 0.33 | |
Age ≥ 65 years | 136 (55.3) | 72 (67.9) | 0.027* | 1.7 (1.1–2.8) |
Median BMI (25th–75th IQR) | 19.1 (16.4–21.7) | 18.1 (15.3–21.4) | 0.14 | |
Coexisting illnesses No. (%) | ||||
HIV | 11 (4.5) | 2 (1.9) | 0.36 | |
IHD | 28 (11.4) | 14 (13.2) | 0.63 | |
Neoplastic disease | 73 (29.7) | 23 (21.7) | 0.12 | |
Diabetes mellitus | 28 (11.4) | 15 (14.2) | 0.47 | |
COPD | 25 (10.2) | 21 (19.8) | 0.013* | 2.2 (1.2–4.1) |
Bronchiectasis | 87 (35.4) | 41 (38.7) | 0.55 | |
TB history | 67 (27.2) | 30 (28.3) | 0.84 | |
Clinical symptoms No. (%) | ||||
Cough | 181 (73.6) | 80 (75.5) | 0.71 | |
Phlegm | 110 (44.7) | 51 (48.1) | 0.56 | |
Haemoptysis | 76 (30.9) | 38 (35.8) | 0.36 | |
Weight loss | 50 (20.3) | 21 (19.8) | 0.91 | |
Chest pain | 21 (8.6) | 7 (6.6) | 0.53 |