Authors (including presenting author) :
Wong WY(1), Shing KK(1), Wong TC(1), Chan PF(2), Yip CW(1), Wong HS(1), Lee YL(1)
Affiliation :
(1) Department of Medicine, Haven of Hope Hospital (HHH), (2) Department of Family Medicine and Primary Health Care, Kowloon East Cluster (KEC)
Introduction :
There is an increasing prevalence of NTM-PD worldwide. As the NTM can be found in environment, persons with positive sputum culture for NTM can be true infection, colonization or contamination. Since 2018, HHH had accepted referrals from all KEC GOPCs for patients with clinically suspected NTM-PD. Patients who were seen in GOPCs with persistent respiratory symptoms and had either 1) 2 out of 3 positive specimen culture NTM or 1 positive specimen culture for NTM and radiological abnormality suspecting NTM-PD could be referred to HHH SOPC for further management.
Objectives :
To investigate the incidence of NTM-PD in patients referred from GOPCs
Methodology :
From 1st Jan 2020 to 31st Dec 2022, all patients referred from GOPCs for suspected NTM-PD and attended HHH SOPC were reviewed. The data being collected included age, sex, symptoms, computed tomography (CT) results and final diagnosis.
Result & Outcome :
During the study period, a total of 166 patients were seen in HHH SOPC. Eighty-eight patients (53.0%) were male and the median age was 70 years old (range 29-97). Majority of them presented with cough as main symptom (142, 85.5%), followed by hemoptysis (17, 10.3%) and dyspnea (7, 4.2%). One hundred and six patients (61.4%) had CT thorax done. Ten patients had 2 NTM species detected in their sputum specimen. The most common mycobacterium species being cultured were M. fortuitum (53, 30.1%) followed by M. abscessus (30,17.0%) and M. avium complex (MAC) (20, 11.4%). Among the 166 patients, only 5 patient (2.3%) were confirmed to have NTM-PD (4 MAC and 1 M.abscessus). For the remaining 161 patients, 62 (37.3%) were treated as chronic respiratory diseases including 25 asthma, 17 COPD, 15 bronchiectasis, 4 interstitial lung disease and 1 silicosis. Three patients were diagnosed with malignancy including 2 carcinoma of lung and 1 nasopharyngeal carcinoma. Other diagnoses included postnasal dripping, allergic rhinitis, drug induced cough and post COVID cough. The remaining 80 patients had minimal symptoms or improved symptoms on follow up.
Outcome: In our cohort, the incidence of NTM-PD was low. Patients should be investigated for other causes after NTM-PD was excluded since a significant proportion of these patients might have other underlying lung diseases.
