Clinical and epidemiological characteristics of M. kansasii pulmonary infections from Rio de Janeiro, Brazil, between 2006 and 2016

• Published in: Jornal brasileiro de pneumologia Vol. 46; no. 6; p. e20190345
• Main Authors: Goldenberg, Telma, Gayoso, Regina, Mogami, Roberto, Lourenço, Maria Cristina, Ramos, Jesus Paes, Carvalho, Luciana Distasio de, Dalcolmo, Margareth Pretti, Mello, Fernanda Carvalho de Queiroz
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil 2020
• Subjects: Antitubercular Agents - therapeutic use; Brazil - epidemiology; Drug Resistance, Microbial; Ethambutol - therapeutic use; Female; Humans; Isoniazid - therapeutic use; Lung - diagnostic imaging; Lung Diseases - drug therapy; Lung Diseases - microbiology; Male; Middle Aged; Mycobacterium Infections, Nontuberculous - diagnosis; Mycobacterium Infections, Nontuberculous - drug therapy; Mycobacterium Infections, Nontuberculous - epidemiology; Mycobacterium kansasii - isolation & purification; Rifampin - therapeutic use; Tomography, X-Ray Computed; Treatment Outcome; Brazil
• ISSN: 1806-3756; 1806-3756
• DOI: 10.36416/1806-3756/e20190345

Objective To evaluate clinical, tomographic, and microbiological characteristics of pulmonary disease caused by M. kansasii (MKPD) in patients treated at an outpatient unit from 2006-2016. Methods We studied thirty eight patients, and analyzed socio-demographic, clinical-radiological, laboratory, and therapeutic characteristics. Results The mean age was 64 years (SD = 10.6; IIQ = 57-72; median = 65.0), and 22 (57.9%) male patients. Pulmonary comorbidity was present in 89.5% of the patients. The most frequent comorbidity was bronchiectasis (78.9%). Previous treatment for pulmonary tuberculosis (PTB) was found in 65.9%. The most used therapeutic regimen was rifampicin, isoniazid and ethambutol (44.7%). Chest tomography (CT) showed bronchiectasis (94.1%), architectural distortion (76.5%), septum thickening (67.6%), and cavities (64.7%). Disease was bilateral in 85.2%. We observed 10.7% resistance to rifampicin, 67.9% resistance to ethambutol, and sensitivity to clarithromycin. Conclusion In patients with structural lung disease, it is important to search for NTM, the main differential diagnosis with PTB. Chest CT showed different patterns that overlapped with structural disease caused by PTB or other lung diseases. We observed resistance to ethambutol, a drug component of the recommended regimen.