Risk factors for Nontuberculous Mycobacteria Infections in Solid Organ Transplant recipients: a multinational case-control study

Carlos Mejia-Chew*, Peggy L Carver, Sasinuch Rutjanawech, Luis F Aranha Camargo, Ruan Fernandes, Sara Belga, Shay Anne Daniels, Nicolas J Mueller, Sara Burkhard, Nicole M Theodoropoulos, Douwe F Postma, Pleun J van Duijn, Maria Carmen Fariñas, Claudia González-Rico, Jonathan Hand, Adam Lowe, Marta Bodro, Elisa Vanino, Ana Fernández Cruz, Antonio RamosMateja Jankovic Makek, Ribal Bou Mjahed, Oriol Manuel, Nassim Kamar, Antonia Calvo-Cano, Laura Rueda Carrasco, Patricia Muñoz, Sara Rodriguez, Sandra Pérez-Recio, Núria Sabé, Regino Rodríguez Álvarez, José Tiago Silva, Alessandra Mularoni, Elisa Vidal, Juana Alonso-Titos, Teresa Del Rosal, Annika Y Classen, Charles W Goss, Mansi Agarwal, Francisco López-Medrano

*Bijbehorende auteur voor dit werk

    OnderzoeksoutputAcademicpeer review


    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 January 1, 2008, to December 31, 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 (IQR 40-62)). NTM infection occurred in kidney (42%), lung (35%), heart and liver (11% each), and pancreas transplant recipients (1%). 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 < 0.05). 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; [1.41-6.98]), receipt of antifungals (aOR, 5.35; [1.7-16.91]), and lymphocyte-specific antibodies (aOR, 7.73, [1.07-56.14]), were associated with NTM infection.

    CONCLUSION: 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.

    Originele taal-2English
    Aantal pagina's27
    TijdschriftClinical infectious diseases : an official publication of the Infectious Diseases Society of America
    StatusE-pub ahead of print - 26-jul-2022

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