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Seacroft Hospital, York Road, Leeds LS14 6UH, UK
Correspondence to: Dr J K Torrens.
Received 18 April 1997; Returned to authors 4 July 1997; Revised version received 3 December 1997; Accepted for publication 3 December 1997
BACKGROUND
The clinical significance of the
presence of non-tuberculous mycobacteria in the sputum of patients with
cystic fibrosis is unclear. A retrospective case-control study was
performed to assess possible risk factors for non-tuberculous
mycobacteria and its impact on clinical status in patients with cystic fibrosis.
METHODSThe records of all patients attending the
Leeds cystic fibrosis clinics who were positive for non-tuberculous
mycobacteria were examined. Each case was matched with two controls for
sex, age, and respiratory function at the time of the first
non-tuberculous mycobacteria isolate. Details of respiratory function,
nutritional status, antibiotic and corticosteroid therapy,
Shwachman-Kulczycki (S-K) score, Northern chest radiographic score, and
the frequency of isolation of other bacteria and fungi were collected
from two years before to two years after the first non-tuberculous
mycobacteria isolate. The patients' genotype and the presence of
diabetes mellitus were also recorded.
RESULTSNon-tuberculous mycobacteria were isolated
from 14 patients out of a cystic fibrosis population of 372 (prevalence = 3.8%). No significant effect of non-tuberculous mycobacteria was
seen on respiratory function, nutritional status, or S-K score. There was a significant association with the number of intravenous antibiotic courses received before the first isolate with cases receiving, on
average, twice as many courses as controls (cases 6.64, controls 2.86, 95% CI for difference 1.7 to 5.9). No significant difference was seen
between cases and controls for Northern scores, previous steroid
therapy, or the incidence of diabetes mellitus.
CONCLUSIONSNon-tuberculous mycobacteria infection
in patients with cystic fibrosis is uncommon and its clinical impact
appears to be minimal over a two year period. Frequent intravenous
antibiotic usage is a possible risk factor for colonisation with
non-tuberculous mycobacteria.
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