Abstract：
BACKGROUND: The prevalence of nontuberculous mycobacteria (NTM) infections is rising in people with cystic fibrosis (pwCF). NTM infection, especially infection with Mycobacterium abscessus complex (MABC), is commonly associated with severe lung deterioration. The current treatment modalities, including multiple intravenous antibiotics, frequently fail to achieve airway eradication. Although treatment with elexacaftor/tezacaftor/ivacaftor (ETI) has been shown to modulate the lung microbiome, data regarding its role in eradicating NTM in pwCF is lacking. Our aim was to evaluate the impact of ETI on the rate of NTM eradication in pwCF.
METHODS: This retrospective multicenter cohort study included pwCF from five CF centers in Israel. PwCF aged older than 6 who had at least one positive NTM airway culture in the past two years and were treated with ETI for at least one year were included. The annual NTM and bacterial isolations, pulmonary function tests, and body mass index were analyzed before and after ETI treatment.
RESULTS: Fifteen pwCF were included (median age 20.9 years, 73.3% females, 80% pancreatic insufficient). In nine patients (66%) NTM isolations were eradicated following treatment with ETI. Seven of them had MABC. The median time between the first NTM isolation and treatment with ETI was 2.71 years (0.27-10.35 years). Eradication of NTM was associated with improved pulmonary function tests (p<0.05).
CONCLUSIONS: For the first time, we report successful eradication of NTM, including MABC, following treatment with ETI in pwCF. Additional studies are needed to assess whether treatment with ETI can result in the long-term eradication of NTM.
METHODS: This retrospective multicenter cohort study included pwCF from five CF centers in Israel. PwCF aged older than 6 who had at least one positive NTM airway culture in the past two years and were treated with ETI for at least one year were included. The annual NTM and bacterial isolations, pulmonary function tests, and body mass index were analyzed before and after ETI treatment.
RESULTS: Fifteen pwCF were included (median age 20.9 years, 73.3% females, 80% pancreatic insufficient). In nine patients (66%) NTM isolations were eradicated following treatment with ETI. Seven of them had MABC. The median time between the first NTM isolation and treatment with ETI was 2.71 years (0.27-10.35 years). Eradication of NTM was associated with improved pulmonary function tests (p<0.05).
CONCLUSIONS: For the first time, we report successful eradication of NTM, including MABC, following treatment with ETI in pwCF. Additional studies are needed to assess whether treatment with ETI can result in the long-term eradication of NTM.
摘要：
背景：囊性纤维化（pwCF）患者非结核分枝杆菌（NTM）感染的患病率正在上升。NTM感染,特别是感染分枝杆菌脓肿复合体（MABC），通常与严重的肺部恶化有关。目前的治疗方式，包括多种静脉注射抗生素,经常无法实现气道根除。尽管用elexacaftor/tezacaftor/ivacaftor（ETI）治疗已被证明可以调节肺部微生物组，缺乏有关其在pwCF中根除NTM的作用的数据。我们的目的是评估ETI对pwCF中NTM根除率的影响。
方法：这项回顾性多中心队列研究包括来自以色列五个CF中心的pwCF。包括年龄大于6岁的PwCF,其在过去两年中具有至少一个阳性NTM气道培养物并且用ETI治疗至少一年。每年的NTM和细菌分离，肺功能检查,分析ETI治疗前后的体重指数。
结果：纳入了15个pwCF（中位年龄20.9岁，73.3%女性，80%胰腺不足)。在9例患者（66％）中，ETI治疗后根除了NTM隔离。其中七个有MABC。首次NTM分离与ETI治疗之间的中位时间为2.71年（0.27-10.35年）。NTM的根除与改善的肺功能测试相关(p<0.05)。
结论：第一次，我们报告成功根除了NTM，包括MABC,在pwCF中使用ETI治疗后。需要进一步的研究来评估用ETI治疗是否可以导致NTM的长期根除。
方法：这项回顾性多中心队列研究包括来自以色列五个CF中心的pwCF。包括年龄大于6岁的PwCF,其在过去两年中具有至少一个阳性NTM气道培养物并且用ETI治疗至少一年。每年的NTM和细菌分离，肺功能检查,分析ETI治疗前后的体重指数。
结果：纳入了15个pwCF（中位年龄20.9岁，73.3%女性，80%胰腺不足)。在9例患者（66％）中，ETI治疗后根除了NTM隔离。其中七个有MABC。首次NTM分离与ETI治疗之间的中位时间为2.71年（0.27-10.35年）。NTM的根除与改善的肺功能测试相关(p<0.05)。
结论：第一次，我们报告成功根除了NTM，包括MABC,在pwCF中使用ETI治疗后。需要进一步的研究来评估用ETI治疗是否可以导致NTM的长期根除。
