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Ministry of Health, Department of Chronic Conditions and Sexually Transmitted Infections (2021) Recommendations for the Diagnosis and Treatment of Diseases Caused by Non-Tuberculous Mycobacteria in Brazil.

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• TITLE: Epidemiology and Clinical Features of Mycobacterium avium Complex Pulmonary Disease in a Brazilian Amazon Cohort

  AUTHORS: Jose Tadeu Colares Monteiro, Adriana Rodrigues Barretto, Ruan Seguin Azevedo Quaresma, Bianca Miranda Gouveia, Ismari Perini Furlaneto, Victória Menezes da Costa, Yan Corrêa Rodrigues, Layana Rufino Ribeiro, Ricardo J. de Paula Souza e Guimarães, Alex Brito Souza, Ana Roberta Fusco da Costa, Karla Valéria Batista Lima

  KEYWORDS: MACDP, Nontuberculous Mycobacteria, Mycobacterium avium Lung Disease

  JOURNAL NAME: Advances in Microbiology, Vol.14 No.6, June 7, 2024

  ABSTRACT: The incidence of Mycobacterium avium complex pulmonary disease (MACPD) has been globally increasing. The present study aims to provide a comprehensive analysis of clinical characteristics and treatment response among patients in the Amazon region of Brazil and conduct a retrospective cohort study at a prominent referral hospital in the State of Pará, Brazil, from 2012 to 2020. The M. avium group represented 58.9% of cases, followed by M. intracellulare (35.7%), M. colombiense (3.6%), and M. chimaera (1.8%). The majority of patients (73.2%) were female and with an average age of 63 years. Primary clinical manifestations included persistent cough and sputum production. The Charlson comorbidity index (CCI) averaged 2.47, with 36.3% of patients having a CCI score equal to higher than 3. Notably, over 70% of patients had received treatment for pulmonary tuberculosis before initiating treatment for MAC infection. The fibrocavitary radiologic form was the most prevalent (55.4%), frequently exhibiting a bilateral distribution (53.6%). Antimicrobial susceptibility revealed a significant prevalence of MAC resistance to drugs in the therapeutic regimen. Despite this, most of the patients experienced clinical improvement (50%). In conclusion, this study highlights a higher prevalence of MAC infections among middle-aged women, with a history of pulmonary tuberculosis treatment and presenting the fibrocavitary radiological form was predominant.