Risk Factors for Nontuberculous Mycobacteria Infections in Solid Organ Transplant Recipients: A Multinational Case-Control Study. (26th July 2022)

• Record Type: Journal Article
• Authors: Mejia-Chew, Carlos; Carver, Peggy L; Rutjanawech, Sasinuch; Camargo, Luis F Aranha; Fernandes, Ruan; Belga, Sara; Daniels, Shay-Anne; Müller, Nicolas J; Burkhard, Sara; Theodoropoulos, Nicole M; Postma, Douwe F; van Duijn, Pleun J; Fariñas, María Carmen; González-Rico, Claudia; Hand, Jonathan; Lowe, Adam; Bodro, Marta; Vanino, Elisa; Cruz, Ana Fernández; Ramos, Antonio; Makek, Mateja Jankovic; Mjahed, Ribal Bou; Manuel, Oriol; Kamar, Nassim; Calvo-Cano, Antonia; Carrasco, Laura Rueda; Muñoz, Patricia; Rodríguez, Sara; Pérez-Recio, Sandra; Sabé, Núria; Álvarez, Regino Rodríguez; Silva, José Tiago; Mularoni, Alessandra; Vidal, Elisa; Alonso-Titos, Juana; del Rosal, Teresa; Classen, Annika Y; Goss, Charles W; Agarwal, Mansi; López-Medrano, Francisco;
• Is Part Of: Clinical infectious diseases. Volume 76:Number 3(2023)
• Page Start: e995
• Page End: e1003
• Publication Date: 2022-07-26
• Subjects: nontuberculous mycobacteria -- solid organ transplant -- risk factors -- NTM; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciac608
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Risk factors for nontuberculous mycobacteria (NTM) infections after solid organ transplant (SOT) are not well characterized. Here we aimed to describe these factors. Methods: Retrospective, multinational, 1:2 matched case-control study that included SOT recipients ≥12 years old diagnosed with NTM infection from 1 January 2008 to 31 December 2018. Controls were matched on transplanted organ, NTM treatment center, and post-transplant survival greater than or equal to the time to NTM diagnosis. Logistic regression on matched pairs was used to assess associations between risk factors and NTM infections. Results: Analyses included 85 cases and 169 controls (59% male, 88% White, median age at time of SOT of 54 years [interquartile range {IQR} 40–62]). NTM infection occurred in kidney (42%), lung (35%), heart and liver (11% each), and pancreas transplant recipients (1%). Median time from transplant to infection was 21.6 months (IQR 5.3–55.2). Most underlying comorbidities were evenly distributed between groups; however, cases were older at the time of NTM diagnosis, more frequently on systemic corticosteroids and had a lower lymphocyte count (all P < .05). In the multivariable model, older age at transplant (adjusted odds ratio [aOR] 1.04; 95 confidence interval [CI], 1.01–1.07), hospital admission within 90 days (aOR, 3.14; 95% CI, 1.41–6.98), receipt of antifungals (aOR, 5.35; 95% CI, 1.7–16.91), and lymphocyte-specific antibodies (aOR, 7.73; 95% CI, 1.07–56.14), were associated with NTM infection. Conclusions: Risk of NTM infection in SOT recipients was associated with older age at SOT, prior hospital admission, receipt of antifungals or lymphocyte-specific antibodies. NTM infection should be considered in SOT patients with these risk factors. Abstract : In this multinational, 1:2 matched case-control study of solid organ transplant (SOT) recipients, older age at transplantation; and hospital admission, receipt of antifungals or lymphocyte-specific antibodies within 90 days of nontuberculous mycobacteria (NTM) disease were associated with increased odds of disease in the multivariable model.