https://scholars.lib.ntu.edu.tw/handle/123456789/637170
標題: | Treatment outcomes and relapse in patients with Mycobacterium avium-intracellulare complex pulmonary disease | 作者: | CHIA-LING CHANG CHONG-JEN YU PO-REN HSUEH JUNG-YIEN CHIEN |
關鍵字: | Mycobacterium avium-intracellulare complex pulmonary disease; microbiological cure; relapse; sputum smear conversion; treatment | 公開日期: | 27-九月-2023 | 卷: | 11 | 期: | 5 | 來源出版物: | Microbiology spectrum | 摘要: | The treatment responses and outcomes in patients with Mycobacterium avium-intracellulare complex pulmonary disease (MAC-PD) remain uncertain. This retrospective study was conducted in Taiwan between 2011 and 2020. A microbiological cure was defined as the requirement for a minimum of three consecutive negative cultures following culture conversion that continued until the completion of anti-MAC treatment. A total of 97 patients with MAC-PD were enrolled in this study. The sputum smear-negative conversion rate was 40% (19/47). Thirty (31%) patients achieved sputum culture-negative conversion rates within 3 years after treatment initiation. All patients with negative sputum culture conversion rates achieved microbiological cure. Patients treated with a macrolide + rifamycin + ethambutol (M + R + EMB)-based regimen had a higher microbiological cure rate than the other patients (39% vs 17%, P = 0.023). Patients with persistently positive sputum smears after 6 months of treatment had a lower microbiological cure rate than those with negative sputum smears (6% vs 44%, P < 0.001). Among 30 patients with microbiological cure, the median time from sputum culture conversion to treatment completion was 221.5 (0-483) days, and the 1-year relapse rate was 17%. Treatment with the M + R + EMB-based regimen was associated with a higher microbiological cure rate, and patients with persistently positive sputum smears after 6 months of treatment had a lower microbiological cure rate. IMPORTANCE The treatment responses and outcomes in patients with Mycobacterium avium-intracellulare complex pulmonary disease (MAC-PD) remain uncertain. In this study, patients with MAC-PD treated with a macrolide + rifamycin + ethambutol (M + R + EMB)-based regimen had a higher microbiological cure rate than those treated with other regimens. After 6 months of treatment, patients with persistently positive sputum smears had a lower microbiological cure rate than those with negative sputum smears. Among patients with microbiological cure, the median time from sputum culture conversion to treatment completion was 221.5 days (range, 0-483), and the 1-year relapse rate was 17%. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/637170 | ISSN: | 2165-0497 | DOI: | 10.1128/spectrum.01640-23 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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