Treating nontuberculous mycobacteria in children with cystic fibrosis: a multicentre retrospective study.

Saint, Gemma L., Thomas, Matthew F., Abidin, Noreen Zainal, Langley, Ross John, Brodie, Malcom, McNamara, Paul and Forton, Julian ORCID: https://orcid.org/0000-0002-0580-0432 2022. Treating nontuberculous mycobacteria in children with cystic fibrosis: a multicentre retrospective study. Archives of Disease in Childhood 107 , pp. 479-485. 10.1136/archdischild-2021-322177

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Abstract

<h4>Background</h4>Respiratory infection with nontuberculous mycobacteria (NTM) in children with cystic fibrosis (CF) has increased in prevalence. The condition is difficult to diagnose and treatments are complex with limited evidence to guide practice. This study describes the approaches to diagnosis, management and consequences of treatment in a multicentre cohort of children with CF in the UK.<h4>Methods</h4>Retrospective data were collected from 11 CF specialist centres from patients less than 17 years old, treated for NTM infection between 2006 and 2017. Descriptive statistics were used to describe the clinical characteristics of children treated. Treatment regimens, adverse events and success of treatment, with respect to lung function and culture conversion, were evaluated.<h4>Results</h4>Data from 70 patients treated for NTM pulmonary disease were collated (60 <i>Mycobacterium abscessus</i> complex (MABSC); 10 <i>M</i>. <i>avium</i> complex (MAC)). Older age and previous diagnosis of allergic bronchopulmonary aspergillosis were all significantly associated with NTM. There was a wide variance in drug choice and side effects were reported with all agents. NTM eradication occurred in 80% of patients with MAC and 48% with MABSC, with variable outcomes on lung function.<h4>Conclusions</h4>Diagnosis and treatment of NTM infection in children with CF is challenging. Treatment success is not guaranteed, particularly for MABSC. Large clinical trials are urgently required to evaluate treatment regimes and their suitability and efficacy in children.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Additional Information:	Julian Forton contributed as part of the NTM Collaborators Group
Publisher:	BMJ Publishing Group
ISSN:	0003-9888
Date of Acceptance:	18 October 2021
Last Modified:	13 Dec 2022 12:15
URI:	https://orca.cardiff.ac.uk/id/eprint/154736

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