Non-tuberculous mycobacteria in Australians with cystic fibrosis: A national survey

Abstract

Introduction/Aim: We are seeing the rapid emergence of a significant new threat to CF survival; chronic nontuberculous mycobacterial (NTM) infection. This study aims to understand the aetiology and epidemiology of NTM in Australians with CF. Methods: Nationally, nine adult and nine paediatric CF services prospectively collected respiratory samples from people with CF (pwCF) for acid fast bacilli (AFB) culture at regular clinic appointments (Baseline, 6 months, 1 year, then annual to 4 years); associated clinical data, geographic and social data was also collected. Sites commenced recruitment between December 2016 and August 2018. Retrospective clinical and culture data were also collected to offset the shift to a telehealth model of care during the global coronavirus pandemic. Results: 15.1% of 1322 study participants cultured NTM (NTM+) from at least one AFB culture during the study, 5.1% of study participants were M. abscessus (MABS) positive. Adolescents and young adults (11-25 years) had the highest rates of NTM infection (19%, p = 0.0004). MABS was more commonly isolated in participants <25 years (6.7%) compared to participants 25 years and older (2.5%, p < 0.001). Of NTM+ study participants, 49% were incident cases. The species of NTM recovered from participants varied depending on the Australian state of residence, with South Australia, Western Australia and Tasmania having greater diversity of isolated species. Conclusion: In Australia, during this sampling period pwCF <25 years of age were more likely to be infected with MABS than older pwCF. We hypothesize that this may be due to increasing attempts at eradication of Pa in early life and/or increased exposure from environmental sources at a vulnerable age.L6377945962022-04-25 <br />