Chest
Original Research: Chest InfectionsMicrobiological and Clinical Outcomes of Treating Non-Mycobacterium Avium Complex Nontuberculous Mycobacterial Pulmonary Disease: A Systematic Review and Meta-Analysis
Section snippets
Study Search
We searched studies published in English, French, German, Italian, or Spanish through September 30, 2016 (see e-Appendix 1 for details). Initially, all NTM species were included in our search criteria; our final selection, however, included only articles concerning individual non-MAC species for which a microbiological treatment outcome was reported.
Assessment of Study Quality
The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.14 Risk of bias
Results
Figure 1 presents a flow diagram of the literature search results: In the selection process, 352 abstracts were identified, 87 of which were read in full text (Fig 1). Finally, 24 studies published in peer-reviewed journals could be included in the review.17, 18, 19, 20, 21, 22, 23, 24, 25, 37, 38, 39, 40, 41 Two BTS studies on MX25 and M malmoense33 provide additional information on cases reported in an earlier (2001) BTS study.36 To avoid double counting, the 2001 publication was not included.
Discussion
Unlike pulmonary TB, the treatment decision for NTM-PD is highly complex and depends on (in addition to the presumed clinical benefits to the individual patients) the identity of the respective NTM pathogen and the respective radiographic findings. Cavitary disease deserves particular attention here; it is clearly a more deadly threat than nodular/bronchiectatic forms of NTM disease. Cavitary disease is frequent not only in cases of M xenopi, M malmoense, and M kansasii21 but has been also been
Acknowledgments
Author contributions: R. D. guarantees the integrity of the work, contributed to study selection and review, conducted the statistical analysis, and wrote the manuscript. F. R., E. R., L. W., and J. S. reviewed and amended the manuscript and approved the final decision for submission. A. N. contributed to study selection and review and approved the final decision for submission.
Financial/nonfinancial disclosures: The authors have reported to CHEST the following: R. D. has received fees for
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FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.