Bronchoscopic Microsampling for Bacterial Colony Counting in Relevant Lesions in Patients with Pulmonary Mycobacterium avium Complex Infection
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概要
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Objective The incidence of pulmonary Mycobacterium avium complex (MAC) infections with nodular/bronchiectasis lesions is increasing. However, factors determining deterioration are unknown. In the present study, we investigated quantitative MAC cultures obtained through bronchoscopic microsampling (BMS) from patients with pulmonary MAC infection and analyzed the relationship between MAC culture and the short-term natural history. We also assessed chest computed tomography (CT) findings for the deteriorating factors. Design For this prospective study, MAC was collected from peripheral lung lesions by BMS through endobronchial ultrasonography. MAC colonies were counted on Middlebrook 7H11 agar. We compared the number of MAC colonies with laboratory data and chest CT findings. Patients We studied 26 patients with pulmonary MAC infection. Results The patients were divided into 2 groups: 11 patients in the non-deteriorated group and 15 patients in the deteriorated group. The number of MAC colonies was significantly correlated with deterioration of MAC infection (p<0.001). In the non-deteriorated group, chest CT scans showed nodular/bronchiectasis lesions in 8 patients (73%) and consolidated lesions in 3 patients (27%). In the deteriorated group, chest CT scans showed nodular/bronchiectasis lesions in 1 patient (7%), consolidated lesions in 6 patients (40%), and cavitary lesions in 8 patients (53%). Conclusion The number of MAC colonies in relevant lesions investigated by BMS was significantly larger in the deteriorated group than in the non-deteriorated group. Cavitary and consolidated lesions observed from chest CT scans are thought to indicate a high risk of progression of pulmonary MAC infection.
著者
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Hanaoka Masayuki
The First Department of Internal Medicine, Shinshu University School of Medicine
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Koyama Sekiya
Department Of Internal Medicine National Sanatorium Higashimatsumoto Hospital
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Kubo Keishi
The Department Of Neurology Nagano Red Cross Hospital
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Yamamoto H
Department Of Orthopaedic Surgery Nara Medical University
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Kubo Keishi
The First Department Of Internal Medicine Shinshu University
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Ushiki Atsuhito
The First Department of Internal Medicine, Shinshu University School of Medicine
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Tsushima Kenji
The First Department Of Internal Medicine Shinshu University School Of Medicine
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Yamazaki Yoshitaka
Department Of Endoscopy Shinshu University Hospital
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Yamamoto Hiroshi
The First Department Of Internal Medicine Kobe University School Of Medicine
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Tsushima Kenji
The First Department of Internal Medicine, Shinshu University School of Medicine, Japan
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Yamazaki Yoshitaka
Department of Infectious Disease, Suzaka Hospital, Japan
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Koyama Sekiya
Department of Respiratory Medicine, Chushin Matsumoto Hospital, Japan
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Kubo Keishi
The First Department of Internal Medicine, Shinshu University School of Medicine, Japan
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Ushiki Atsuhito
The First Department of Internal Medicine, Shinshu University School of Medicine, Japan
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Hanaoka Masayuki
The First Department of Internal Medicine, Shinshu University School of Medicine, Japan
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