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Risk factors for nontuberculous mycobacterial pulmonary disease (NTM-PD) in Croatia

Glodić, Goran; Samaržija, Miroslav; Sabol, Ivan; Bulat Kardum, Ljiljana; Carević Vladić, Vesna; Džubur, Feđ; Jakopović, Marko; Kuhtić, Ivana; Marušić, Ante; Mihelčić, Dina; Popović Grle, Sanja; Strelec, Dražen; Šklebar, Tomislav; Šola, Ana Marija; Žmak, Ljiljana; van Ingen, Jakko; Janković Makek, Mateja (2021) Risk factors for nontuberculous mycobacterial pulmonary disease (NTM-PD) in Croatia. Wiener klinische Wochenschrift . ISSN 0043-5325

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Abstract

Background The incidence, geographical distribution and clinical relevance of different nontuberculous mycobacteria (NTM) in Croatia are well described. There are few data on the risk factors for developing NTM pulmonary disease (NTM-PD) in this setting. Methods We conducted a retrospective cohort study on all Croatian residents with NTM isolated from respiratory samples in the period from 2006 to 2015 with follow-up to 2018. The American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines were used to establish NTM-PD diagnosis. Clinical, radiological and treatment data were collected from hospital records. Results Risk analysis calculations were made on the 439 isolation episodes that were classified as definitive NTM-PD (n= 137) or no disease (n= 302). Female gender, presence of bronchiectasis, low BMI and longterm systemic corticosteroid treatment were indepen-dent risk factors associated with NTM-PD. Hemoptysis and malaise were presenting symptoms independently associated with NTM-PD. Chronic obstructive pulmonary disease (COPD) and low/moderate dose inhaled corticosteroid (ICS) treatment were not associated with NTM-PD. High dose ICS treatment was a significant risk factor for developing NTM-PD (aOR = 4.73, CI 1.69-13.23 p= 0.003). Conclusion The NTM-PD patients in Croatia are similar to those in other published cohorts in terms of their characteristics and risk factors. The significant dose-dependent association between ICS use and NTM-PD adds to the body of evidence suggesting that high dose ICS use is associated with NTM-PD.

Item Type: Article
Uncontrolled Keywords: Nontuberculous mycobacteria; Inhaled corticosteroids (ICS); Risk factors; Patient characteristics
Subjects: BIOMEDICINE AND HEALTHCARE > Clinical Medical Sciences
BIOMEDICINE AND HEALTHCARE > Public Health and Health Care > Epidemiology
Divisions: Division of Molecular Medicine
Depositing User: Ivan Sabol
Date Deposited: 08 Sep 2021 09:12
Last Modified: 08 Sep 2021 09:12
URI: http://fulir.irb.hr/id/eprint/6543
DOI: 10.1007/s00508-021-01923-x

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