Risk factors for nontuberculous mycobacterial isolation in patients with cystic fibrosis: a meta‐analysis

BACKGROUND To better understand mechanisms of infection with nontuberculous mycobacteria (NTM) in cystic fibrosis (CF) patients, we explore different risk factors associated with NTM positivity in a meta-analysis. METHODS Studies published before 31 July 2019 were selected from MEDLINE. Combined odds ratios (ORs) were calculated by pooling the ORs of each study. The weighted mean difference (WMD) was used for continuous numerical measurements. Summary data were pooled using fixed or random effect models according to the presence of heterogeneity (p 50%). RESULTS 19 studies with a total 23418 patients, of whom 1421 (6%) were diagnosed as NTM positive, were included. Older age was significantly associated with NTM positivity (WMD = 2.12, 95% CI [1.11; 3.13], p < 0.01, fixed effect model). The OR for Staphylococcus aureus colonization was 1.66 (95% CI [1.21; 2.26], p = 0.001) in 11 studies (8091 patients), the OR for Aspergillus fumigatus colonization was 3.59 (95% CI [3.05; 4.23], p <0.001) in 11 studies (20480 patients), and the OR for Stenotrophomonas maltophilia colonization was 3.41 (95% CI [2.66; 4.39], p < 0.01) in 7 studies (14935 patients). Oral corticosteroids were significantly associated with NTM positivity (OR = 1.98, 95% CI [1.24; 3.16], p < 0.01, 6 studies, 1936 patients). No other factor showed a significant association. CONCLUSION Older age, Staphylococcus aureus, Stenotrophomonas maltophilia and Aspergillus fumigatus chronic colonization, and oral corticosteroids were significantly associated with an increased risk of NTM positivity. CF patients with more severe conditions should be closely monitored for NTM. This article is protected by copyright. All rights reserved.