Effect of nontuberculous mycobacteria on lung function in patients with cystic fibrosis

[ November 18, 2014 ]

There has been much debate about whether to treat airway colonization with nontuberculous mycobacteria (NTM) in patients with cystic fibrosis (CF). The rationale for therapy is based upon an association between NTM colonization and severity of CF. However, while patients with CF are at an increased risk of colonization with NTM, it is unknown if NTM contributes to decreasing lung function. This study retrospectively evaluated whether NTM colonization in adult patients with CF is associated with impairment of lung function. In addition, the effect of cystic fibrosis related diabetes (CFRD), and gastro-esophageal reflux disease (GERD) on NTM colonization was evaluated. Data from adult CF patients enrolled in the Gunnar Esiason Adult Cystic Fibrosis Lung Program at Columbia UniversityMedical Center in the year 2013 were analyzed. Medical records were reviewed to determine body mass index (BMI), lung function, sputum culture, and presence of CFRD and GERD. Lung function parameters included the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and forced expiratory flow from 25-75% of the vital capacity (FEF25-75). To account for differences in age, gender and body size, data were analyzed as percent of predicted. If a patient tested positive for NTM in any culture they were placed in the positive-NTM group (n=23), while all others were placed in the negative-NTM group (n=95). Gender was similar in the positive and negative NTM groups (13F/10M vs 40F/55M, respectively; p=NS). Mean values for age, body size, lung function, and the prevalence of CFRD and GERD in the positive NTM group were not found as significantly different from the negative NTM group (see Table 1; p=NS for all comparisons). Thus, in this study cohort NTM colonization was not associated with increased severity of disease as assessed by lung function. These data have implications on the decision to treat NTM colonization in adult CF patients.

By Jennifer Berger

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