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Published ahead of print on November 14, 2002, doi:10.1164/rccm.200207-678OC

Am. J. Respir. Crit. Care Med., Volume 167, Number 6, March 2003, 828-834

A more recent version of this article appeared on March 15, 2003
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Submitted on July 9, 2002
Accepted on November 4, 2002

Nontuberculous Mycobacteria: I. Multicenter prevalence study in cystic fibrosis

Kenneth N Olivier1*, David J Weber2, Richard J Wallace, Jr.3, Ali R Faiz4, Ji-Hyun Lee4, Yansheng Zhang3, Barbara A Brown-Elliot3, Allison Handler5, Rebecca W Wilson3, Michael S Schechter6, Lloyd J Edwards4, Subha Chakraborti4, and Michael R Knowles5

1 Pulmonary/Critical Medicine Flight, Wilford Hall USAF Medical Center, Lackland AFB, TX, USA; Cystic Fibrosis/Pulmonary Research and Treatment Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Verne S. Caviness General Clinical Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 2 Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Verne S. Caviness General Clinical Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 3 Department of Microbiology, University of Texas Health Center at Tyler, Tyler, TX, USA, 4 Department of Biostatistics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 5 Cystic Fibrosis/Pulmonary Research and Treatment Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 6 Division of Allergy/Immunology and Respiratory Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA

* To whom correspondence should be addressed. E-mail: kenneth.olivier{at}lackland.af.mil.

Nontuberculous mycobacteria (NTM) are potential respiratory pathogens in cystic fibrosis (CF). The overall and species-specific prevalence, risk factors for acquisition, and clinical characteristics of NTM in CF have not been defined. We conducted a period, cross-sectional study of the prevalence of NTM and associated clinical features of prospectively enrolled patients at 21 U.S. centers. Almost 10% of CF patients >10 years in the U.S. were included (N=986). The overall prevalence of NTM was 13.0% (range by center, 6.7-23.5%). Mycobacterium avium complex (72.1%) and M. abscessus (16.4%) were the most common species. When compared to CF patients without NTM, culture-positive subjects were older (3.9 years), had a higher FEV1 (5.8%), higher frequency of Staphylococcus aureus (11.6%), and lower frequency of Pseudomonas aeruginosa (10.4%). Molecular typing of M. avium complex and M. abscessus isolates revealed that almost all patients within each center had unique strains. In summary, NTM are common in CF patients, but neither person-to-person nor nosocomial acquisition explained the high prevalence. Older age was the most significant predictor for NTM. The clinical significance of NTM in CF is incompletely defined, but patients with these organisms should be monitored with repeat cultures.
Key words: Cystic Fibrosis, Nontuberculous Mycobacteria, Mycobacterium Infections,; Mycobacterium avium-intracellulare, Mycobacterium abscessus




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