Clinical Management and Outcomes of Nontuberculous Mycobacterial Infections in Solid Organ Transplant Recipients: A Multinational Case-control Study Article

Full Text via DOI: 10.1097/TP.0000000000005156 Web of Science: 001405541500033

Cited authors

  • López-Medrano F, Carver PL, Rutjanawech S, Aranha-Camargo LF, Fernandes R, Belga S, Daniels SA, Mueller NJ, Burkhard S, Theodoropoulos NM, Postma DF, van Duijn PJ, de las Revillas FA, del Molino-Bernal CP, Hand J, Lowe A, Bodro M, Vanino E, Fernández-Cruz A, Ramos-Martínez A, Makek MJ, Mjahed RB, Manuel O, Kamar N, Calvo-Cano A, Rueda-Carrasco L, Muñoz P, Alvarez-Uría A, Pérez-Recio S, Sabé N, Rodríguez-Alvarez R, Silva JT, Mularoni A, Vidal E, Alonso-Titos J, del Rosal T, Classen AY, Goss CW, Agarwal M, Mejia-Chew C

Abstract

  • Background. The management and outcomes of nontuberculous mycobacterial (NTM) infections in solid organ transplant (SOT) recipients are poorly characterized. We aimed to describe the management and 1-y mortality of these patients. Methods. Retrospective, multinational, 1:2 matched case-control study included SOT recipients aged 12 y old or older diagnosed with NTM infection between January 1, 2008, and December 31, 2018. Controls were matched on transplanted organs, NTM treatment center, and posttransplant survival at least equal to the time to NTM diagnosis. The primary aim was 1-y mortality after NTM diagnosis. Differences between cases and controls were compared using the log-rank test, and Cox regression models were used to identify factors associated with mortality at 12 mo among cases. Results. In 85 patients and 169 controls, the median age at the time of SOT was 54 y (interquartile range, 40-62 y), 59% were men, and the lungs were the most common site of infection after SOT (57.6%). One-year mortality was significantly higher in cases than in controls (20% versus 3%; P < 0.001), and higher mortality was associated with lung transplantation (hazard ratio 3.27; 95% confidence interval [1.1-9.77]; P = 0.034). Median time (interquartile range) from diagnosis to treatment initiation (20 [4-42] versus 11 [3-21] d) or the reduction of net immunosuppression (36% versus 45%, hazard ratio 1.35 [95% CI, 0.41-4.43], P = 0.618) did not differ between survivors and those who died. Conclusions. NTM disease in SOT recipients is associated with a higher mortality risk, especially among lung transplant recipients. Time to NTM treatment and reduction in net immunosuppression were not associated with mortality.

Authors

Publication date

  • 2025

Published in

International Standard Serial Number (ISSN)

  • 0041-1337

Number of pages

  • 8

Start page

  • e134

End page

  • e141

Volume

  • 109

Issue

  • 2