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Treating nontuberculous mycobacteria in children with cystic fibrosis: a multicentre retrospective study

Lookup NU author(s): Dr Matthew Thomas, Dr Noreen Zainal Abidin, Dr Malcolm Brodlie

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Abstract

© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. BACKGROUND: Respiratory infection with nontuberculous mycobacteria (NTM) in children with cystic fibrosis (CF) has increased in prevalence. The condition is difficult to diagnose and treatments are complex with limited evidence to guide practice. This study describes the approaches to diagnosis, management and consequences of treatment in a multicentre cohort of children with CF in the UK. METHODS: Retrospective data were collected from 11 CF specialist centres from patients less than 17 years old, treated for NTM infection between 2006 and 2017. Descriptive statistics were used to describe the clinical characteristics of children treated. Treatment regimens, adverse events and success of treatment, with respect to lung function and culture conversion, were evaluated. RESULTS: Data from 70 patients treated for NTM pulmonary disease were collated (60 Mycobacterium abscessus complex (MABSC); 10 M. avium complex (MAC)). Older age and previous diagnosis of allergic bronchopulmonary aspergillosis were all significantly associated with NTM. There was a wide variance in drug choice and side effects were reported with all agents. NTM eradication occurred in 80% of patients with MAC and 48% with MABSC, with variable outcomes on lung function. CONCLUSIONS: Diagnosis and treatment of NTM infection in children with CF is challenging. Treatment success is not guaranteed, particularly for MABSC. Large clinical trials are urgently required to evaluate treatment regimes and their suitability and efficacy in children.


Publication metadata

Author(s): Saint GL, Thomas MF, Zainal Abidin N, Langley RJ, Brodlie M, McNamara P

Publication type: Article

Publication status: Published

Journal: Archives of Disease in Childhood

Year: 2022

Volume: 107

Issue: 5

Pages: 479-485

Print publication date: 01/05/2022

Online publication date: 05/11/2021

Acceptance date: 18/10/2021

ISSN (print): 0003-9888

ISSN (electronic): 1468-2044

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/archdischild-2021-322177

DOI: 10.1136/archdischild-2021-322177

PubMed id: 34740877


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