Epidemiological and clinical features of non tuberculous mycobacteria infection (NTM) in a five-year single centre experience

The incidence and prevalence of NTM disease are increasing globally. NTM disease has been previously reported mainly in immunocompromised patients, but nowadays seems to affect increasingly immunocompetent pts. Aims of this work are: retrospective evaluation of epidemiological, clinical and radiological features of the NTM pulmonary diseases observed at our Clinic from 2010 to 2014. based on this analysis, we designed an algorithm for future management of NTM in our Department - We considered isolates with typing identification and antibiogram and reviewed demographic data, comorbidities, chest CT and treatments. 35 NTM were isolated from 31 pts. Of those, 23 from bronchoalveolar lavage, 12 from other samples (bronchial aspirate, sputum, induced sputum and lung biopsy). 7/31 pts (22,5%) had no apparently known comorbidities/risk factors. The most common lung comorbidities were bronchiectasis (15/31 pts, 25,8%), while extra respiratory comorbidities were type 2 diabetes (7/31 pts, 22,5%) and cancer (6/31 pts, 19,3%). The most frequent chest CT alteration was “tree in bud” (14/31 pts, 40%). Since low uniformity in identification of NTM patients deserving treatment was found, we designed the enclosed algorithm to guide future decisions. We found a high rate of NTM infections in subjects without risk factors. Multidisciplinary discussion is highly recommended.