Factors associated with Mycobacterium abscessus group (MABS) infection type in people with cystic fibrosis

Abstract

Objectives: Mycobacterium abscessus group (MABS) lung infection is associated with poorer health outcomes. However, some people with CF are able to clear MABS from the lungs spontaneously. We aimed to investigate factors which may influence whether an infection persists or clears spontaneously. Methods: Clinical and microbiological data were collected and analysed for 72 patients with CF and MABS infection (all cases from 2 CF centres, 2000–2017). The infection types were categorised as follows: “acute”, single or multiple MABS isolates detected ≤12 months; “chronic”, multiple isolates of similar/identical strain or subspecies (subsp.) >12 months; “reinfection”, multiple strains/subsp. detected >12 months; “co-infection”, multiple strains/subsp. detected ≤12 months. Results: 39/72 patients had acute infection, 20 had chronic infection, 5 had re-infections, 2 had co-infections and 6 were not classified (missing data). Clinical factors were similar between patients with acute and chronic infection (Table 1). Furthermore, microbiological factors were similar between acute and chronic infections: smear positivity (p = 0.16), MABS subspecies (p = 0.47), clonal M. a. abscessus infections (p = 0.19), Pseudomonas aeruginosa infection (p = 0.39), Aspergillus infection (p = 0.41) and other nontuberculousmycobacteria infection (p = 0.11). Of the 20 participants with a chronic infection, 14 were treated with antibiotics and 6 (43%) cleared the infection post-treatment. [Table Presented] Conclusions: Acute and chronic infections have similar characteristics. In those with chronic infections, the clearance of MABS is poor despite treatment. Grant Support: Cystic Fibrosis Foundation Therapeutics (USA), The Prince Charles Hospital Foundation, Advance Queensland.L20019766962019-11-07 <br />