Table 1.
Patient demographics, clinical characteristics, and outcomes of NTM infection.
| Case number | ||||||
|---|---|---|---|---|---|---|
| Variables | 1 | 2 | 3 | 4 | 5 | 6 |
| Age (years), sex | 78, F | 53, M | 81, M | 70, F | 28, M | 72, M |
| Comorbidities | HTN | CKD, recent Rhizopus PNA | HTN, recent Pseudomonas and MSSA PNA | HTN | Recent typhlitis with hemicolectomy | Rheumatoid arthritis, DM2, HTN |
| Leukemia diagnosis | B-ALL | AML | AML | MDS | AML | MDS |
| Mo. from leukemia diagnosis* | 11.4 | 18.6 | 1.3 | 28.5 | 16 | 26 |
| Leukemia status | Relapsed | CR† | PR | Persistent | Relapsed | Persistent |
| Active chemo* | Yes | No | Yes | Yes | Yes | Yes |
| Stem cell transplant | No | Yes | No | No | Yes x2 | No |
| Mo. from SCT* | N/A | 11.9 | N/A | N/A | 11.0, 3.5 | N/A |
| NTM species isolated | M. canariasense | M. fortuitum | M. abscessus | M. intracellulare | M. abscessus | M. abscessus |
| Culture site | Blood | BAL | BAL + Blood | BAL + Blood | SSTI+Blood | SSTI |
| Days for culture positivity | 3.8 | 17 | 9 | 23 | 3.7 | 16 |
| Disseminated | Yes | No | Yes | Yes | Yes | Yes |
| Reason for AFB culture | Neutropenic fever | Hypoxia requiring intubation; pulmonary infiltrates | Pulmonary infiltrates; cough | Neutropenic fever; pulmonary infiltrates | Neutropenic fever | Fever + skin/soft tissue lesions |
| Antibiotic prophylaxis | Cefpodoxime | Azithromycin | Augmentin | Levofloxacin | Levofloxacin | Levofloxacin |
| NTM sensitivities | S = CFX, IMI, MOX, CLA, AMI, TOB, DOX, TIG, TMP/SMX, LIN I = CIP R = None |
N.D. | S = AMI, CLO, TIG I = IMI, CFX R = CLA |
S = CLA, AMI I = None R = LIN, MOX, CLO |
S = AMI I = CFX, IMI R = CIP, MOX, CLA, TOB, DOX, TMP/SMX, LIN |
N.D. |
| NTM treatment | AZI + IMI + LIN | N/A (dx after death) | AMI + CLO + TIG + IMI-CIL | N/A (dx after death) | AMI + AZI + TIG + IMI-CIL | AZI + IMI-CIL + LIN |
| Additional notes | N/A | Concurrent coronavirus, influenza A H3, RSV | N/A | Concurrent EBV viremia | Concurrent E. faecalis, S. epidermidis, S. salivarius bacteremia, and C. glabrata fungemia | N/A |
| Outcome at 30 days | Cleared NTM blood Cx | Death 17 days after positive culture | Cleared NTM blood Cx, improvement in CT infiltrates | Death 16 days after positive culture | Cleared NTM blood Cx, death from fungemia | Improvement in skin and soft tissue lesions |
*At time of positive mycobacterial culture. †With negative MRD. AFB, acid fast bacilli; AML, acute myeloid leukemia; BAL, bronchoalveolar lavage; B-ALL, B-cell acute lymphoblastic leukemia; HTN, hypertension; CKD, chronic kidney disease; CR, complete remission; DM2, type II diabetes mellitus; MDS, myelodysplastic syndrome; MSSA, methicillin sensitive Staphylococcus aureus; NTM, nontuberculous mycobacteria; PNA, pneumonia; PR, partial response; SSTI, skin and soft tissue infection. Antibiotics: AMI, amikacin; AZI, azithromycin; CFX, Cefoxitin; CIL, cilastatin; CIP, ciprofloxacin; CLA, clarithromycin; CLO, clofazimine; DOX, doxycycline; IMI, imipenem; LIN, linezolid; MOX, moxifloxacin; TIG, tigecycline; TMP/SMX, trimethoprim/sulfamethoxazole; TOB, tobramycin.