Abstract
Introduction: NTM infection is a potential complication of established bronchiectasis but the incidence and associated risk factors are unknown.
Methods: The EMBARC registry is a prospective observational study of patients with CT confirmed bronchiectasis from 30 countries. Patients without active NTM infection, having negative AFB cultures at baseline and no clinical diagnosis of NTM disease were followed-up for up to 4 years. Risk factors for NTM diagnosis during follow-up based on ATS/IDSA criteria were analysed by logistic regression.
Results: 4085 patients did not have NTM infection at baseline and only 1905 of these patients had at least 1 AFB culture performed during follow-up. Median age was 68 years, 58.5% female. 87 patients (4.6%) developed active NTM during follow-up (58, M. avium complex, 19 M. abscessus complex, M. fortuitum 5, M. simiae 2, M. kansasii 2, M. malmoense 1) . In logistic regression, older age OR 1.04 95% CI 1.02-1.07,p=0.002, female sex OR 1.87 95% CI 1.07-3.29,p=0.03, current treatment with inhaled corticosteroids OR 2.00 95% CI 1.22-3.30,p=0.006, low BMI OR 0.93 95% CI 0.89-0.98,p=0.003 and a history of allergic bronchopulmonary aspergillosis OR 3.06 95% CI 1.01-9.24,p=0.04. Severity of disease, either defined using radiological severity or multidimensional scoring systems, did not predict NTM infection.
Conclusion: Classical risk factors for NTM disease including female sex, low BMI and older age are confirmed in bronchiectasis. The strong association with ABPA suggests these patients should be screened for NTM. The association with ICS treatment requires further study.
Support: IMI/EFPIA (iABC, grant 115721).
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2937.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019