Risk factors for Nontuberculous Mycobacteria Infections in Solid Organ Transplant recipients: a multinational case-control study

Resource type
Journal Article
Title
Risk factors for Nontuberculous Mycobacteria Infections in Solid Organ Transplant recipients: a multinational case-control study
Abstract
Risk factors for nontuberculous mycobacteria (NTM) infections after solid organ transplant (SOT) are not well characterized. Here we aimed to describe these factors.Retrospective, multinational, 1:2 matched case-control study that included SOT recipients ≥12 years old diagnosed with NTM infection from January 1, 2008, to December 31, 2018. Controls were matched on transplanted organ, NTM treatment center, and post-transplant survival greater than or equal to the time to NTM diagnosis. Logistic regression on matched pairs was used to assess associations between risk factors and NTM infections.Analyses included 85 cases and 169 controls; (59% male, 88% white, median age at time of SOT of 54 years (IQR 40-62)). NTM infection occurred in kidney (42%), lung (35%), heart and liver (11% each), and pancreas transplant recipients (1%). Time from transplant to infection was 21.6 months (IQR 5.3-55.2). Most underlying comorbidities were evenly distributed between groups; however, cases were older at the time of NTM diagnosis, more frequently on systemic corticosteroids and had a lower lymphocyte count (all P < 0.05). In the multivariable model, older age at transplant (adjusted odds ratio [aOR] 1.04; 95 confidence interval [CI] 1.01-1.07), hospital admission within 90 days (aOR, 3.14; [1.41-6.98]), receipt of antifungals (aOR, 5.35; [1.7-16.91]), and lymphocyte-specific antibodies (aOR, 7.73, [1.07-56.14]), were associated with NTM infection.Risk of NTM infection in SOT recipients was associated with older age at SOT, prior hospital admission, receipt of antifungals or lymphocyte-specific antibodies. NTM infection should be considered in SOT patients with these risk factors.
Publication
Clinical Infectious Diseases
Date
2022-07-26
Pages
ciac608
Journal Abbr
Clinical Infectious Diseases
Accessed
8/6/22, 9:42 AM
ISSN
1058-4838
Short Title
Risk factors for Nontuberculous Mycobacteria Infections in Solid Organ Transplant recipients
Library Catalog
Silverchair
Citation
Mejia-Chew, C., Carver, P. L., Rutjanawech, S., Camargo, L. F. A., Fernandes, R., Belga, S., Daniels, S. A., Mueller, N. J., Burkhard, S., Theodoropoulos, N. M., Postma, D. F., van Duijn, P. J., Fariñas, M. C., González-Rico, C., Hand, J., Lowe, A., Bodro, M., Vanino, E., Cruz, A. F., … on behalf of the EMOTE study group. (2022). Risk factors for Nontuberculous Mycobacteria Infections in Solid Organ Transplant recipients: a multinational case-control study. Clinical Infectious Diseases, ciac608. https://doi.org/10.1093/cid/ciac608
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