scholarly journals Levels of Antibody against Glycopeptidolipid Core as a Marker for Monitoring Treatment Response in Mycobacterium avium Complex Pulmonary Disease: a Prospective Cohort Study

2016 ◽  
Vol 55 (3) ◽  
pp. 884-892 ◽  
Author(s):  
Seigo Kitada ◽  
Ryoji Maekura ◽  
Kenji Yoshimura ◽  
Keisuke Miki ◽  
Mari Miki ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Mycobacterium Avium ◽  
Serum Levels ◽  
Chemotherapy Response ◽  
Content Type ◽  
Therapeutic Outcomes ◽  
Significant Difference ◽  
Antibody Levels ◽  
Culture Conversion ◽  
Percent Decrease

ABSTRACT The diagnosis of Mycobacterium avium complex pulmonary disease (MAC-PD) is sometimes complicated and time-consuming. A serodiagnostic kit that measures the serum levels of IgA antibodies against the glycopeptidolipid (GPL) core is commercially available and has good diagnostic accuracy for MAC-PD. However, the significance of measurement of GPL core IgA antibody levels in monitoring for chemotherapy response in patients with MAC-PD was not well investigated. Thirty-four treatment naive MAC-PD patients who were started on multidrug chemotherapy were enrolled. Their antibody levels were prospectively measured at regular intervals. The relationships between their antibody levels and the therapeutic outcomes were examined. The patients were classified into three groups (conversion, recurrence, and nonconversion) based on the bacteriological outcomes after chemotherapy. There were no significant differences in the antibody levels before treatment between the culture conversion ( n = 19), recurrence ( n = 7), and nonconversion ( n = 8) groups ( P = 0.9881). The levels decreased significantly after the chemotherapy ( P < 0.0001). Recurrence and/or worsening of chest radiography findings were observed in cases whose antibody levels subsequently increased after cessation of the chemotherapy. No significant difference in the percent decrease in antibody levels by the chemotherapy was observed between the culture conversion and recurrence groups ( P = 0.9338). The initial antibody levels are not a predictor of therapeutic outcomes, and also the percent decrease in antibody levels is not a sufficient indicator of the cessation of chemotherapy. However, serial measurements of antibody levels may allow objective monitoring of disease activity in individual MAC-PD patients.

scholarly journals Intermittent Treatment with Azithromycin and Ethambutol for Noncavitary Mycobacterium avium Complex Pulmonary Disease

2019 ◽  
Vol 64 (1) ◽  
Author(s):  
Seong Mi Moon ◽  
In Young Yoo ◽  
Hee Jae Huh ◽  
Nam Yong Lee ◽  
Byung Woo Jhun
Keyword(s):  
Pulmonary Disease ◽  
Mycobacterium Avium ◽  
Odds Ratio ◽  
Mycobacterium Avium Complex ◽  
Adjusted Odds Ratio ◽  
Sputum Smear ◽  
Intermittent Treatment ◽  
Content Type ◽  
Sputum Culture Conversion ◽  
Culture Conversion

ABSTRACT We evaluated the efficacy of intermittent azithromycin and ethambutol therapy for noncavitary Mycobacterium avium complex pulmonary disease (MAC-PD). Twenty-nine (76%) of 38 patients achieved sputum culture conversion after 12 months of treatment, and sputum smear positivity was an independent factor for failure to achieve culture conversion (adjusted odds ratio, 26.7; 95% confidence interval, 2.1 to 339.9; P = 0.011). Intermittent azithromycin and ethambutol may be an optional treatment regimen for noncavitary MAC-PD.

Difference in drug susceptibility distribution and clinical characteristics between Mycobacterium avium and Mycobacterium intracellulare lung diseases in Shanghai, China

2021 ◽  
Vol 70 (5) ◽  
Author(s):  
Weiping Wang ◽  
Jinghui Yang ◽  
Xiaocui Wu ◽  
Baoshan Wan ◽  
Hongxiu Wang ◽  
...  
Keyword(s):  
Mycobacterium Avium ◽  
Antimicrobial Susceptibility ◽  
Type Species ◽  
Clinical Characteristics ◽  
Radiographic Findings ◽  
Content Type ◽  
Mycobacterium Intracellulare ◽  
Link Type ◽  
Broth Microdilution Method ◽  
Significant Difference

Introduction. Mycobacterium avium complex (MAC) has been reported as the most common aetiology of lung disease involving nontuberculous mycobacteria. Hypothesis. Antimicrobial susceptibility and clinical characteristics may differ between Mycobacterium avium and Mycobacterium intracellulare . Aim. We aimed to evaluate the differences in antimicrobial susceptibility profiles between two major MAC species ( Mycobacterium avium and Mycobacterium intracellulare ) from patients with pulmonary infections and to provide epidemiologic data with minimum inhibitory concentration (MIC) distributions. Methodology. Between January 2019 and May 2020, 45 M. avium and 242 M . intracellulare isolates were obtained from Shanghai Pulmonary Hospital. The demographic and clinical characteristics of patients were obtained from their medical records. The MICs of 13 antimicrobials were determined for the MAC isolates using commercial Sensititre SLOWMYCO MIC plates and the broth microdilution method, as recommended by the Clinical and Laboratory Standards Institute (CLSI; Standards M24-A2). MIC50 and MIC90 values were derived from the MIC distributions. Results. M. intracellulare had higher resistance rates than M. avium for most tested antimicrobials except clarithromycin, ethambutol, and ciprofloxacin. Clarithromycin was the most effective antimicrobial against both the M. avium (88.89 %) and M. intracellulare (91.32 %) isolates, with no significant difference between the species (P=0.601). The MIC90 of clarithromycin was higher for M. avium (32 µg ml−1) than M. intracellulare (8 µg ml−1). The MIC50 of rifabutin was more than four times higher for M. intracellulare (1 µg ml−1) than M. avium (≤0.25 µg ml−1). The percentages of patients aged >60 years and patients with sputum, cough, and cavitary lesions were significantly higher than among patients with M. intracellulare infection than M. avium infections. Conclusions. The pulmonary disease caused by distinct MAC species had different antimicrobial susceptibility, symptoms, and radiographic findings.

scholarly journals Treatment Outcomes of Mycobacterium Avium Complex Pulmonary Disease According to Disease Severity

2021 ◽  
Author(s):  
Bo-Guen Kim ◽  
Byung Woo Jhun ◽  
Hojoong Kim ◽  
O Jung Kwon
Keyword(s):  
Pulmonary Disease ◽  
Disease Severity ◽  
Mycobacterium Avium ◽  
Treatment Strategies ◽  
Term Treatment ◽  
Intermittent Therapy ◽  
Mild Disease ◽  
Conversion Rates ◽  
Long Term Treatment ◽  
Culture Conversion

Abstract Mycobacterium avium complex pulmonary disease (MAC-PD) requires long-term treatment. We analyzed the outcomes of 992 MAC-PD patients according to disease severity and compared the outcomes of intermittent and daily therapy for mild disease. Patients were divided into groups according to severity using the body mass index, age, cavity, erythrocyte sedimentation rate, and sex (BACES) system, and culture conversion rates were evaluated. We also evaluated the effects of intermittent treatment on the culture conversion rates in mild disease group. Using the BACES, 992 patients were divided into mild (n=331), moderate (n=503), and severe (n=158) disease groups, and culture conversion at the end of treatment was achieved in 85% (282/331), 80% (403/503), and 61% (97/158), respectively. Differences in culture conversion among the severity groups were significant (p<0.001). In patients with mild disease, culture conversion rates were similar between intermittent (84%, 166/198) and daily (87%, 116/133) treatment (p=0.396), and intermittent antibiotic therapy did not negatively impact culture conversion (adjusted hazard ratio 1.08; confidence interval 0.83–1.15; p=0.552). MAC-PD patients with mild disease had higher culture conversion rates. Daily and intermittent therapy yielded similar culture conversion rates for mild disease. Treatment strategies with lower pill burden may be applicable in mild MAC-PD.

Comparison of the Spectrum of Radiologic and Clinical Manifestations of Pulmonary Disease Caused by Mycobacterium avium Complex and Mycobacterium xenopi

2014 ◽  
Vol 65 (3) ◽  
pp. 207-213 ◽  
Author(s):  
Maria C. Carrillo ◽  
Demetris Patsios ◽  
Ute Wagnetz ◽  
Frances Jamieson ◽  
Theodore K. Marras
Keyword(s):  
Computed Tomography ◽  
Lung Disease ◽  
Pulmonary Disease ◽  
Clinical Data ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Clinical Manifestations ◽  
Ground Glass ◽  
Mycobacterium Xenopi ◽  
Significant Difference

Aim Mycobacterium xenopi is described with upper lobe cavitation (“fibrocavitary” pattern), whereas the Mycobacterium avium complex (MAC) is described with bronchiectasis and centrilobular nodules (“nodular bronchiectasis”). We retrospectively described and compared computed tomography (CT) chest manifestations of disease caused by MAC and M xenopi. Materials and Methods We reviewed patients who had either MAC or M xenopi lung disease and who had CTs between January 2002 and December 2003. Clinical data were recorded, and the patterns on chest CTs were categorized as “fibrocavitary,” “nodular bronchiectatic,” and “unclassified.” Results There were 74 patients; 50 with MAC and 24 with M xenopi. The patients with MAC were older (mean 69 vs 58 years; P = .007). Patients with M xenopi more often had emphysema (50% vs 20%; P = .02), cavities (46% vs 16%; P = .01), and nodules ≤5 mm (88% vs 58%; P = .02). M xenopi cases more commonly had a fibrocavitary radiologic pattern (33% vs 18%), with no statistically significant difference ( P = .24). MA C was more often associated with a nodular bronchiectatic pattern (68% MAC vs 4% M xenopi; P < .0001). Sixty-three percent of patients with M xenopi had a pattern that was predominantly randomly distributed nodules (11/15 [73%]) or consolidation and/or ground-glass opacities (4/15 [27%]). Conclusion Compared with MAC, patients with M xenopi infection develop more cavities and more nodules, and they less often have a predominant nodular bronchiectatic pattern. Although a predominantly cavitary pattern appears to be more common with M xenopi, the majority of patients with M xenopi had CT patterns of random nodules or consolidation and/or ground-glass opacities rather than classically described findings.

scholarly journals Role of ethambutol and rifampicin in the treatment of Mycobacterium avium complex pulmonary disease

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hyung-Jun Kim ◽  
Jong Sik Lee ◽  
Nakwon Kwak ◽  
Jaeyoung Cho ◽  
Chang-Hoon Lee ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Pulmonary Disease ◽  
Mycobacterium Avium ◽  
Immune Deficiency Syndrome ◽  
Drug Regimen ◽  
Deficiency Syndrome ◽  
Proven Efficacy ◽  
Microbiological Cure ◽  
Culture Conversion

Abstract Background A three-drug regimen (macrolide, ethambutol, and rifampicin) is recommended for the treatment of Mycobacterium avium complex pulmonary disease (MAC-PD). Although macrolide has proven efficacy, the role of ethambutol and rifampicin in patients without acquired immune deficiency syndrome is not proven with clinical studies. We aimed to clarify the roles of ethambutol and rifampicin in the treatment of MAC-PD. Methods Patients treated for MAC-PD between March 1st, 2009 and October 31st, 2018 were reviewed retrospectively. Rates of culture conversion, microbiological cure, treatment failure, and recurrence were compared according to the maintenance (≥6 months) of ethambutol or rifampicin with macrolide. Results Among the 237 patients, 122 (51.5%) maintained ethambutol and rifampicin with macrolide, 58 (24.5%) maintained ethambutol and macrolide, 32 (13.5%) maintained rifampicin and macrolide, and 25 (10.6%) maintained macrolide only. Culture conversion was reached for 190/237 (80.2%) patients and microbiological cure was achieved for 129/177 (72.9%) who completed the treatment. Treatment failure despite ≥12 months of treatment was observed in 66/204 (32.4%), and recurrence was identified in 16/129 (12.4%) who achieved microbiological cure. Compared with maintenance of macrolide only, maintenance of ethambutol, rifampicin or both with macrolide were associated with higher odds of culture conversion [odds ratio (OR), 95% confidence interval (CI): 18.06, 3.67–88.92; 15.82, 2.38–105.33; and 17.12, 3.93–74.60, respectively]. Higher odds of microbiological cure were associated with maintenance of both ethambutol and rifampicin with macrolide (OR, 95% CI: 5.74, 1.54–21.42) and macrolide and ethambutol (OR, 95% CI: 5.12, 1.72–15.24) but not macrolide and rifampicin. Maintenance of both ethambutol and rifampicin with macrolide was associated with lower odds of treatment failure (OR, 95% CI: 0.09, 0.01–0.53) compared with macrolide only, while maintenance of one of these with macrolide was not. Maintenance of both ethambutol and rifampicin or one of these with macrolide did not decrease the probability of recurrence when compared with macrolide only. Conclusions Maintenance (≥6 months) of ethambutol and rifampicin with macrolide was associated with the most favorable treatment outcomes among patients with MAC-PD. Given the association between ongoing ethambutol use and microbiological cure, clinicians should maintain ethambutol unless definite adverse events develop.

scholarly journals Clinical characteristics and treatment outcomes of patients with macrolide-resistant Mycobacterium avium complex pulmonary disease: a systematic review and meta-analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Youngmok Park ◽  
Eun Hye Lee ◽  
Inkyung Jung ◽  
Goeun Park ◽  
Young Ae Kang
Keyword(s):  
Systematic Review ◽  
Treatment Outcomes ◽  
Pulmonary Disease ◽  
Surgical Resection ◽  
Mycobacterium Avium ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Treatment Modalities ◽  
Significant Difference ◽  
Newcastle Ottawa Scale

Abstract Background Macrolide is a key drug in the treatment of Mycobacterium avium complex pulmonary disease (MAC-PD). Macrolide-resistant MAC is gaining importance, but there are little data in clinical characteristics and treatment outcomes of macrolide-resistant MAC-PD (MR-MAC-PD). Methods We performed a systematic review and meta-analysis of published studies reporting clinical characteristics and treatment outcomes of patients with MR-MAC-PD. Risk of bias was assessed using the modified Newcastle-Ottawa Scale. Results Nine studies (seven retrospective and two prospective) comprising 319 patients were identified through a database search. Around 73% were women, and 52% had the fibrocavitary form. Pooled sputum culture conversion rate after combined multiple antibiotics or surgical resection was 21% (95% confidence interval [CI], 14–30%), and the one-year all-cause mortality was 10% (95% CI, 5–20%). There was no significant difference in treatment outcomes between nodular bronchiectatic and fibrocavitary types. Conclusions Even combination therapy with fluoroquinolone, aminoglycoside, and surgical resection, the treatment outcomes of MR-MAC-PD were poor. The investigation of new treatment modalities is urgent.

scholarly journals Levels of Thyroid Peroxidase Antibodies is Higher in Threatened Abortion

2016 ◽  
pp. 134-138
Author(s):  
I Nyoman A. Sanjaya ◽  
Syarif T Hidayat
Keyword(s):  
Serum Levels ◽  
Normal Pregnancy ◽  
Cross Sectional Study ◽  
Thyroid Peroxidase ◽  
Cross Sectional ◽  
Thyroid Peroxidase Antibody ◽  
Significant Difference ◽  
Threatened Abortion ◽  
The Mean ◽  
Antibody Levels

Objective: To assess the relationship between the incidence of threatened abortion with serum levels of TPO antibodies. Methods: This was cross-sectional study involving subjects 40 cases and 40 controls. The study was conducted September 2012 to November 2012. The difference in the levels of thyroid peroxidase antibody was tested by Mann-Whitney test. Result: In this study, hypothyroidism was found only in the abortion group, as many as 6 subjects (15%) and subclinical hypothyroidism was more prevalent in threatened abortion group, found in 2 people (5%), compared to normal pregnant group, found in only 1 person (2.5%). This study revealed a significant difference in the mean levels of TPO antibodies in the threatened abortion and normal pregnancy group. The mean levels of TPO antibodies in threatened abortion group was 91.76 ± 133.18 IU/ml with the lowest level of 14.41 IU/ml and the highest levels of 534.47 IU/ml while in the normal pregnancy group found an average 12.97 ± 3.91 IU/ml with the lowest value 2.02 IU/ml and the highest value of 20.78 IU/ml. In this study, subjects with TPO antibody levels ≥ 125 IU/ml, all of them experienced threatened abortion (n = 7) and found the risk of miscarriage by 2.212-fold compared with subjects with TPO levels < 125 IU/ml. Conclusion: There are differences in the levels of TPO antibodies in patients with threatened abortion and in normal pregnancies, with average levels of TPO antibodies in imminent abortion group is higher than normal pregnancy group. There is a relationship between TPO antibody levels ≥ 125 IU/ml with the incidence of threatened abortion, with the risk of threatened abortion increasing 2.212 times. [Indones J Obstet Gynecol 2013; 1-3: 134-8] Keywords: threatened abortion, thyroid peroxidase antibody (TPO)

scholarly journals Autoimmune thyroiditis CRP association

2018 ◽  
Vol 6 (10) ◽  
pp. 3270
Author(s):  
Melih Pamukcu ◽  
Atilla Badem ◽  
Omer Parlak
Keyword(s):  
Sedimentation Rate ◽  
Subclinical Hypothyroidism ◽  
Roc Analysis ◽  
Serum Levels ◽  
Acute Phase Reactant ◽  
Overt Hypothyroidism ◽  
Reactive Protein ◽  
Significant Difference ◽  
Antibody Levels ◽  
Serum Crp

Background: C-reactive protein (CRP) is an acute phase reactant and its serum levels may be risen during many diseases. Hypothyroidism is a clinical disease state accompanied by mild inflammation that is known to be significantly associated with atherosclerosis. In this study, we aim to determine and compare serum CRP levels in overt and subclinical hypothyroidism subgroups and research their association with autoimmune markers.Methods: Around 79 patients who are diagnosed with overt and subclinical hypothyroidism in our polyclinic were included in this study. Patients’ morning blood samples were collected after 8hours of fast and thyroid functions, CRP, sedimentation rate, anti TG and anti TPO antibody levels were studied. Thyroid ultrasonography was planned for each patient.Results: We found significant differences regarding age, sT3, sT4, TSH, anti-TPO, anti-TG and CRP levels between overt and subclinical groups. There was no significant difference between the groups in thyroxin use, nodularity and sedimentation rate. No significant difference was found between CRP levels and autoimmunity markers anti-TPO and anti-TG among the groups as well. A significant cut-off value was determined for CRP in overt hypothyroidism by using Roc analysis and this value was also considered for being a possible cardiovascular risk marker.Conclusions: In this study, we found out that CRP levels were high in both overt and subclinical subgroups, CRP levels were increased during progression of the disease from subclinical to overt and this increase may be related with higher inflammation and tendency to cardiovascular diseases. 

scholarly journals The Diagnosis of Nontuberculous Mycobacterial Pulmonary Disease by Single Bacterial Isolation Plus Anti-GPL-Core IgA Antibody

2022 ◽  
Author(s):  
Takahiro Kawasaki ◽  
Seigo Kitada ◽  
Kiyoharu Fukushima ◽  
Eri Akiba ◽  
Kako Haduki ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Mycobacterium Avium ◽  
Antibody Test ◽  
Mycobacterium Abscessus ◽  
Bacterial Isolation ◽  
Diagnostic Ability ◽  
Content Type ◽  
Diagnostic Guideline ◽  
Single Positive ◽  
Iga Antibody

To satisfy the microbiologic criteria of the current diagnostic guideline for nontuberculous mycobacterial pulmonary disease (PD), at least two positive sputum cultures of the same species of mycobacteria from sputum are required to avoid the casual isolation of mycobacteria. This study showed that the positivity of a serum anti-glycopeptidolipid (GPL)-core IgA antibody test has an excellent diagnostic ability among patients with radiologically suspected Mycobacterium avium complex (MAC)-PD or Mycobacterium abscessus (MAB)-PD who already had a single positive sputum culture test.

Serum Retinol and β-carotene Levels and Risk Factors for Cardiovascular Disease in Morbid Obesity

2010 ◽  
Vol 80 (3) ◽  
pp. 159-167 ◽  
Author(s):  
Gabriela Villaça Chaves ◽  
Gisele Gonçalves de Souza ◽  
Andréa Cardoso de Matos ◽  
Dra. Wilza Abrantes Peres ◽  
Silvia Elaine Pereira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Morbid Obesity ◽  
Serum Levels ◽  
World Health ◽  
Morbidly Obese ◽  
Serum Retinol ◽  
Significant Difference ◽  
Β Carotene

Objective: To evaluate retinol and β-carotene serum levels and their relationship with risk factors for cardiovascular disease in individuals with morbid obesity, resident in Rio de Janeiro. Methodology: Blood serum concentrations of retinol and β-carotene of 189 morbidly obese individuals were assessed. The metabolic syndrome was identified according to the criteria of the National Cholesterol Education Program (NCEP) and World Health Organization (WHO). Lipid profile, insulin resistance, basal insulin, glycemia, blood pressure, and anthropometry and their correlation with retinol and β-carotene serum levels were evaluated. Results: Metabolic syndrome diagnosis was observed in 49.0% of the sample. Within this percentage the levels of β-carotene were significantly lower when body mass index increased. Serum retinol didn't show this behavior. Serum retinol inadequacy in patients with metabolic syndrome (61.3%), according to WHO criterion, was higher (15.8%) than when the whole sample was considered (12.7%). When metabolic syndrome was diagnosed by NCEP criterion, β-carotene inadequacy was higher (42.8%) when compared to the total sample (37.5%). There was a significant difference between average β-carotene values of patients with and without metabolic syndrome (p=0.048) according to the classification of the NCEP. Lower values were found in patients with metabolic syndrome. Conclusion: Considering the vitamin A contribution in antioxidant protection, especially when risk factors for cardiovascular disease are present, it is suggested that great attention be given to morbidly obese. This could aid in prevention and treatment of cardiovascular disease, which affects a significant part of the population.

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