Background: Nontuberculous mycobacteria (NTM) infections in hematopoietic stem cell transplant (HSCT) recipients can be associated with significant morbidity and mortality.

Methods: We identified all allogeneic HSCT recipients with NTM at a single center over a 16-year period. We performed matched case-control study (1:1) to identify the risk factors for disease; patients were matched for the time of transplant. One year-all-cause mortality after NTM isolation was assessed.

Results: Over the study period, 32 NTM were isolated from 1703 allogeneic HSCT recipients (1.9%), of which 15 were considered to have probable or definite infection (0.8%) and were treated. The mycobacterial species identified included Mycobacterium avium complex [n = 14], M. xenopi [n = 12], M. abscessus [n = 2], M. fortuitum [n = 2] and single isolate each of M. gordonae and M. lentiflavum. Co-pathogen with NTM were common and specifically Aspergillus species (n= 9). Only 6 of these patients met the criteria for the diagnosis of NTM Disease by American Thoracic Society (ATS). Median time to diagnosis was 330 days (11 months) following transplantation.

TBI: Total body irradiation, GVHD: graft versus host disease, CMV: cytomegalovirus, COPD: chronic obstructive pulmonary disease, BOS: bronchiolitis obliterans syndrome, Prednisone dose: cumulative prednisone dose over one month prior to NTM isolation (≥ 20 mg/day).

Preceding neutropenia and CMV infection was not associated with increased risk of NTM infection among allogeneic HSCT recipients. The one year-all-cause mortality after NTM isolation was 22% (7/32) in cases as compared to 28% (9/32) in controls, P value = 0.33.

Conclusion:

The use of TBI and prednisone, GVHD and BOS were found to be significant predictors for NTM infection in allogeneic HSCT recipients. One year-all-cause mortality was not significantly different among allogeneic HSCT recipients with or without NTM infection.

CITATION INFORMATION: Alghamdi A, Lipton J, Rotstein C, Kumar D, Humar A, Mazzulli T, Husain S. Nontuberculous Mycobacterial Infection Among Allogeneic Hematopoietic Stem Cell Transplant Recipients: A 16-Year Cohort Study. Am J Transplant. 2016;16 (suppl 3).

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