Lung Microbiome in Patients with Pulmonary Mycobacterial Diseases

C. Nishio1, K. Oh1, H. Konishi1, H. Tomioka2;

Author address: 

1general internal medicine, Kobe City Medical Center West Hospital, Kobe, Japan, 2respiratory medicine, Kobe City Medical Center West Hospital, Kobe, Japan.

Abstract: 

Backgrounds
Incidence of pulmonary nontuberculous mycobacterial (NTM) disease is increasing globally. The NTM incidence rate in Japan is estimated to be 14.7 cases per 100,000 person-years, which may be the highest among worldwide. Lung microbiome may play a role in the pathophysiological processes associated with mycobacterial disease. Few reports have studied the difference in lung microbiota between patients with NTM disease and tuberculosis (TB).
Objectives
Our aims were to determine the prevalence of mycobacterial disease in our hospital, and to compare lung microbiome composition between patients with NTM and those with TB.
Setting
A 358-bed community teaching hospital in Japan.
Methods
We retrospectively reviewed NTM and TB cases, who were newly diagnosed between January 2007 and August 2017 at our institution. Bacteriological and fungal culture was evaluated on the bronchial lavage fluid used to diagnose mycobacterial disease.
Results
311 pulmonary NTM patients and 258 TB were diagnosed on the basis of the American Thoracic Society criteria during the study period. NTM cases included 174 M. avium, 101 M. intracellulare, 16 M. kansasii, 10 M. fortuitum, 8 M. abscessus, 5 M. chelonae, 4 M. gordonae, 1 M. terrae, and 1 unidentifiable mycobacterium. Of those, 74 NTM cases and 29 TB were diagnosed by bronchial lavage. NTM group included 31males and 43 females with a median age of 69. TB group patients were 14 males and 15 females with a median age of 56. Mycobacterium avium complex was the most frequently isolated microorganism (66 patients, 89.1%) in NTM group. Other mycobacterial species included M. kansasii (5 patients), M. terrae (1), M. fortuitum (1), and unidentifiable mycobacterium (1). Pseudomonas aeruginosa was isolated in 6.7% (5 patients) in
NTM group and 3.4% (1 patient) in TB group. Staphylococcus aureus, Hemophilus influenzae and enteric bacteria were seen in 7.4%, 4.1%, and 5.4% in NTM group, and 0%, 3.4%, and 3.4% in TB group. Aspergillus spp. was isolated in 2.7% in NTM group, and none in TB group. No significant difference in Bacterial and fungal isolation was identified between two groups.
Limitation
Rather small number at single center. We used ordinary cultivation methods, which rarely reveals anaerobes.
Conclusion
A small number of bacteria and fungus were isolated at diagnosis of mycobacterial disease. There were no significant difference in isolated organisms between NTM and TB group. Molecular methods may better evaluate the microbiome and clinical impact on two diseases.

2018

abstract No: 

A2590 / 802

Full conference title: 

The American Thoracic Society Conference 2018
    • ATS 2018