Risk factors for nontuberculous mycobacterial infections in solid organ transplant recipients: a case-control study.
BACKGROUND
The epidemiology of nontuberculous mycobacteria (NTM) disease in solid organ transplant recipients is poorly defined.


METHODS
We identified all solid organ transplant recipients with NTM disease at a single center over a 7.5-year period, and collected data on patient demographics, co-morbidities, immunosuppressive medications, and rejection. We conducted a case-control study to identify risk factors for disease, matching 3 control patients to each case patient by date of transplantation.


RESULTS
A total of 34 cases of NTM disease occurred during the study period, involving 6 single lung, 13 bilateral lung, 8 heart, 4 liver, 2 kidney, and 1 pancreas-kidney recipients. Cases were predominantly male (24/34), with a median age of 55 years (interquartile range [IQR]: 46-61 years), and developed after a median of 8 months post transplantation (IQR: 2-87 months). Mycobacterium abscessus and Mycobacterium avium complex were the most common pathogens, and the lung (including pleura) was the most common site of disease. In the adjusted case-control analysis, lung transplant recipients had the highest risk of NTM disease.


CONCLUSIONS
Additional studies are needed to evaluate the role of targeted surveillance measures for NTM disease in high-risk patients, particularly lung transplant recipients, and to characterize the mechanisms of disease acquisition.
['Longworth|S A|SA|', 'Vinnard|C|C|', 'Lee|I|I|', 'Sims|K D|KD|', 'Barton|T D|TD|', 'Blumberg|E A|EA|']
D000367:Age Factors D016022:Case-Control Studies D015331:Cohort Studies D005260:Female D016027:Heart Transplantation D006801:Humans D007166:Immunosuppressive Agents D016030:Kidney Transplantation D016031:Liver Transplantation D016015:Logistic Models D016040:Lung Transplantation D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D009165:Mycobacterium Infections, Nontuberculous D015269:Mycobacterium avium Complex D015270:Mycobacterium avium-intracellulare Infection D019909:Mycobacterium kansasii D019910:Mycobacterium marinum D016377:Organ Transplantation D016035:Pancreas Transplantation D012307:Risk Factors D012737:Sex Factors D013997:Time Factors D014397:Tuberculosis, Pulmonary
risk factors nontuberculous solid organ transplant epidemiology mycobacteria NTM