sábado, 24 de agosto de 2013

Epidemiology of Nontuberculous Myc... [Am J Respir Crit Care Med. 2013] - PubMed - NCBI

Epidemiology of Nontuberculous Myc... [Am J Respir Crit Care Med. 2013] - PubMed - NCBI

Am J Respir Crit Care Med. 2013 Aug 8. [Epub ahead of print]

Epidemiology of Nontuberculous Mycobacterial Infections and Associated Chronic Macrolide Use among Persons with Cystic Fibrosis.


NIAID, LCID, Bethesda, Maryland, United States.


Rationale: Persons with cystic fibrosis (CF) are at high risk of nontuberculous mycobacterial (NTM) infection, with treatment requiring prolonged multi-drug regimens that include macrolides. While macrolides, specifically azithromycin, are used in the management of CF patients with chronic Pseudomonas, macrolide-resistant NTM infections are of growing concern. We sought to evaluate the relationship between macrolide use and NTM infections among CF patients. Objective: To evaluate the relationship between chronic macrolide use and NTM infection among CF patients included in the 2011 CF Patient Registry (CFPR). Main Results: The 2011 CFPR included 27,112 patients; 5,403 (20%) were cultured for mycobacteria in 2010-2011 and met all inclusion criteria. Of these, 191 (4%) were NTM-positive in 2011 only (incident cases), while 5,212 (96%) were NTM-negative in both 2010 and 2011 (controls). Among the cases, 122 (64%) were culture-positive for Mycobacterium avium complex (MAC) and 69 (36%) for M. abscessus. Azithromycin use in 2010 was less frequently reported among MAC cases (57%; OR=0.7, p< 0.05) and M. abscessus cases (51%; OR=0.5, p< 0.01) than in controls (66%). Among adolescents and adults, patients with the greatest number of years on chronic macrolides were the least likely to develop incident NTM in 2011 (p<0 .01="" abscessus="" azithromycin="" be="" because="" cf.="" chronic="" conclusions:="" considered="" either="" for="" from="" had="" have="" however="" in="" incident="" infections="" lead="" less="" likely="" m.="" mac="" macrolide="" may="" monotherapy="" ntm="" or="" p="" past="" patients="" persons="" resistance="" routine="" screening="" should="" the="" to="" treatment="" were="" with="" year.="">
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