engleski

Mycobacterium xenopi pulmonary disease in Croatia

Background: clinical relevance of M. xenopi in Croatia seems to differ to other countries. Aims and objectives: to assess clinical relevance of M. xenopi, and differences between patients colonized with M. xenopi and those with M. xenopi pulmonary disease (PD) and identify factors that may favor the disease. Methods: Retrospective analysis of all Croatian residents with pulmonary M. xenopi isolated in the period from 2006 to 2016. American Thoracic Society guidelines were used to establish the definition of M. xenopi PD or colonization. Results: medical records were available for 188/326 (57.7%) patients with M. xenopi isolate. Of those 188, 48 had certain PD, and 117 had no disease. Out of 117 classified as no disease, 20 cases of active tuberculosis (TB) co-infection were excluded from further risk analysis. Overall median follow up was 47 month. Patients with low body mass index (BMI), bronchiectasies, or inhalation corticosteroid (ICS) therapy had 6 (p<0.001), 3 (p=0.013), and 2 (p=0.024) times higher likelihood of having M. xenopi PD, compared to colonization, respectively. 5-year survival amounted to 60% in both PD and colonization group. 10-years survival was lower in the colonization group (24% vs 54%) There were no significant differences in all-cause mortality and M. xenopi caused mortality with regard to different therapies administered (adequate therapy ; short duration adequate therapy ; inadequate/no therapy ; TB therapy). Conclusion: low BMI, ICS therapy, and bronchiectasies were associated with M. xenopi PD in comparison to colonization. Percentage of isolates meeting the PD criteria and overal survival of patients with PD, indicate that the pathogenicity of M. xenopy in Croatia is lower copmared to other countries.

mycobacterium, Croatia

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