Positive respiratory samples with mycobacteria non tuberculous and aspergillus fumigatus: Retrospective and multicenter study

Introduction: Co-infections with non-tuberculous mycobacteria (NTM) and Aspergillus fumigatus (AF) have rarely been described. The main objective was to describe the management of these co-infections. Secondary objectives were to study the affected population and overall survival. Materials and: Methods: It was a retrospective, multicenter study in three french university hospitals. Patients with NTM and AF positive respiratory samples between 2009 and 2013 were included. Results: 29 men and 19 women were included with a mean age 57,5 ± 20,7 years. 95,8% of patients had a history of respiratory chronic disease and 45.8% an immunosuppression. Smoking was a risk factor for NMT infection and chronic pulmonary aspergillosis. Patients received mostly first an antifungal and in second line,in case of failure, a treatment against NTM. AF was considered as responsible for most cases of respiratory symptoms. 14.6% of patients had a change of treatment (change in dosage or molecules) due to excessive drug interactions. Survival was 81.2%, whether 9 patients died during the study. The cause of death was rarely infection of NMT or AF. Conclusion: In practice, the first treatment started by clinicians was antifungal therapy and in case of failure, antibiotics active against NTM came in second time . It should be closely monitored with therapeutic blood levels evaluation because there is a high risk of drug interactions.