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Incidence,characteristics, and treatment outcomes of mycobacterial diseases in transplant recipients
Authors:Jung‐Wan Yoo  Kyung‐Wook Jo  Sung‐Han Kim  Sang‐Oh Lee  Jae Joong Kim  Su‐Kil Park  Je‐Hwan Lee  Duck Jong Han  Shin Hwang  SeungGyu Lee  Tae Sun Shim
Institution:1. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;2. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;3. Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;4. Department of Nephrology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;5. Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;6. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Abstract:The incidence, clinical characteristics, and treatment outcomes of tuberculosis (TB) and nontuberculous mycobacterial (NTM) disease developed after transplantation (TPL) in transplant recipients were investigated retrospectively. Between 1996 and 2013, 7342 solid‐organ transplantation and 1266 hematopoietic stem cell transplantation were performed at a tertiary referral center in South Korea. Among them, TB and NTM disease developed in 130 and 22 patients, respectively. The overall incidence of TB was 257.4 cases/100 000 patient‐years (95% confidence interval CI], 215.1–305.7) and that of NTM disease was 42.7 cases/100 000 patient‐years (95% CI, 26.8–64.7). The median interval from organ TPL to the development of mycobacterial disease was 8.5 months (95% CI, 6.3–11.4) in recipients with TB patients and 24.2 months (95% CI, 13.5–55.7) in those with NTM, respectively. Among NTM patients, Mycobacterium avium–intracellulare complex was the most common causative organism, and nodular bronchiectatic type (77.8%) was the most frequent radiologic feature. Favorable treatment outcome was achieved in 83.7% (95% CI, 76.4–89.1) and 68.8% (95% CI, 44.4–85.8) of TB and NTM patients, respectively (P = 0.166). In conclusion, the overall incidence of TB was higher than that of NTM disease in transplant recipients and treatment outcomes were favorable in both drug‐susceptible TB and NTM patients.
Keywords:incidence  nontuberculous mycobacteria  transplantation  treatment outcomes  tuberculosis
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