Abstract
Introduction
The prevalence of nontuberculous mycobacteria (NTM) infections is increasing worldwide.
Although NTM can affect extrapulmonary organs, studies on the clinical characteristics
of extrapulmonary NTM are rare.
Methods
We retrospectively analyzed patients who were newly diagnosed with NTM infections
at Hiroshima University Hospital between 2001 and 2021 to investigate species distribution,
infected sites, and risk factors of extrapulmonary NTM compared to pulmonary NTM.
Results
Of the 261 NTM infections, 9.6% and 90.4% had extrapulmonary and pulmonary NTM, respectively.
The mean ages of patients with extrapulmonary and pulmonary NTM were 53.4 and 69.3
years, 64.0% and 42.8% were male, 36.0% and 9.3% received corticosteroids, 20.0% and
0% had acquired immune deficiency syndrome (AIDS), and 56.0% and 16.1% had any immunosuppressive
conditions, respectively. Younger age, corticosteroid use, and AIDS were associated
with extrapulmonary NTM. In pulmonary NTM, Mycobacterium avium complex (MAC) accounted for 86.4% of NTM species, followed by M. abscessus complex (4.2%), whereas in extrapulmonary NTM, M. abscessus complex, MAC, M. chelonae, and M. fortuitum accounted for 36.0%, 28.0%, 12.0%, and 8.0%, respectively. Compared to pulmonary
NTM, extrapulmonary NTM were significantly more likely to be rapid-growing mycobacteria
(RGM) (56.0% vs. 5.5%). The most common sites of infection were the skin and soft
tissues (44.0%), followed by the blood (20.0%), tenosynovium, and lymph nodes (12.0%).
Conclusion
Younger age and immunosuppressive conditions are associated with extrapulmonary NTM,
with a higher prevalence of RGM in extrapulmonary NTM than in pulmonary NTM. These
results provide a better understanding of extrapulmonary NTM.
Keywords
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Article info
Publication history
Published online: May 22, 2023
Accepted:
May 11,
2023
Received in revised form:
March 23,
2023
Received:
September 30,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
