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Long-term relapses after 12-month treatment for Mycobacterium kansasii lung disease

Depts of ¹ Infectious Diseases, ² Respiratory Medicine and ³ Microbiology, Mycobacteriology Section, Bellvitge Institute for Biomedical Research (IDIBELL), Bellvitge University Hospital, University of Barcelona, Barcelona, Spain.

CORRESPONDENCE: M. Santin, Dept of Infectious Diseases, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, University of Barcelona, C/ Feixa Llarga s/n 08907, L’Hospitalet de Llobregat, Barcelona, Spain. Fax: 34 932607637. E-mail: msantin{at}bellvitgehospital.cat

Keywords: Mycobacterium kansasii, relapse, short treatment

Received: February 15, 2008
Accepted September 14, 2008

Long-lasting therapy for Mycobacterium kansasii lung disease with rifampin-containing multidrug regimens is needed to avoid relapses. The aim of the present study is to evaluate a short multidrug treatment regimen for M. kansasii lung disease.

A retrospective observational study of 75 patients with M. kansasii lung disease was conducted in a teaching hospital from January 1990 to December 2005.

In total, 75 (67.6%) out of 111 patients diagnosed with M. kansasii lung disease completed a 12-month multidrug treatment regimen, including rifampin, isoniazid and ethambutol, supplemented with streptomycin during the first 2–3 months. After a 41.5-month median follow-up, five (6.6%) patients relapsed. The relapse rate was 2.19 (95% confidence interval 0.71–5.12) per 100 person·yrs. Treatment compliance was considered to be appropriate in all five patients and no drug resistance developed in any case.

In conclusion, a 12-month fixed-course treatment is effective in most cases of Mycobacterium kansasii lung disease, but may not be long enough for all patients.