Chest
Original ResearchChest InfectionsClinical Significance of the Differentiation Between Mycobacterium avium and Mycobacterium intracellulare in M avium Complex Lung Disease
Section snippets
Study Population
Consecutive patients with MAC lung disease who were given the diagnosis between January 2000 and December 2009 were identified using the database of the NTM Registry of Samsung Medical Center (a 1,950-bed referral hospital in Seoul, South Korea).12, 15 The data from January 2008 to December 2009 are being used in an ongoing prospective observational cohort study to investigate NTM lung disease.16 This study protocol was approved by the institutional review board of the Samsung Medical Center
Clinical Features of MAC Lung Disease
During the 10-year period, 590 patients with MAC lung disease were identified. The etiologic organisms included M avium in 323 patients (55%) and M intracellulare in 267 (45%). Other MAC member species, such as Mycobacterium colombiense, were not found during the study period. All patients were HIV negative.
As shown in Table 1, patients with M intracellulare lung disease typically were older than patients with M avium lung disease (64 years vs 59 years, P = .002) and more likely to have a
Discussion
This study examined > 500 patients with MAC lung disease and focused primarily on the clinical relevance of species differentiation between M avium and M intracellulare. In the present cohort of patients with MAC without HIV infection, M avium and M intracellulare differed in the clinical features, disease progression, and treatment response to antibiotic therapy. Patients with M intracellulare lung disease exhibited a more severe and advanced clinical presentation at the time of diagnosis,
Acknowledgments
Author contributions: Drs Koh and Jeong had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Koh: contributed to the study design, data acquisition and interpretation, study supervision, and writing of the manuscript.
Dr Jeong: contributed to the study design, data acquisition and interpretation, and writing of the manuscript.
Dr Jeon: contributed to the data acquisition and interpretation and critical
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2022, One HealthCitation Excerpt :M. avium and M. intracellulare cannot be differentiated through conventional microbiological tests and their clinical features are often considered indistinguishable [1]. However, a study in Korea found that patients with M. intracellulare lung disease exhibited a more severe illnesses and worse prognosis than patients with M. avium lung disease [30]. A previous study using an animal model also suggested that M. intracellulare was the more virulent species [31].
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.
Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or in the preparation of the manuscript.
Drs Koh and Jeong contributed equally to this work.
Funding/Support: This work was supported by the Mid-Career Researcher Program through a National Research Foundation grant funded by the Ministry of Education, Science and Technology [grants 2011-0015546] in South Korea.