Serial sputum induction in nontuberculous mycobacterial pulmonary disease
Michael R.Â Holt, Shannon H.Â Kasperbauer,Â Charles L.Â Daley
European Respiratory JournalÂ 2020Â 55:Â 1902196;Â DOI:Â 10.1183/13993003.02196-2019
The recommended procedure for diagnosis of nontuberculous mycobacterial pulmonary disease (NTM-PD) is collection of three sputum samples on separate days. Sputum induction is suggested for patients unable to expectorate spontaneously. These recommendations align with evidence-based guidelines for pulmonary tuberculosis (TB) but literature supporting their applicability to NTM-PD is lacking. In addition, the clinical utility of colony counts on solid media requires clarification. Early changes in semiquantitative colony counts are predictive of clinical and radiological improvement and treatment success but the relationships of colony count with disease markers, such as smear status, have not been reported.
Incremental detection yields of serial induced sputum samples support collection of three samples for detection of nontuberculous mycobacteria. In addition, higher colony counts on solid media are associated with markers of disease severity.Â http://bit.ly/2Tn14Qa
Thank you to Douglas C. Everett (Division of Biostatistics and Bioinformatics, National Jewish Health) for advice regarding the statistical analysis.
Conflict of interest: M.R. Holt has been an investigator in Insmed studies, outside the submitted work.
Conflict of interest: S.H. Kasperbauer reports personal fees for advisory board work and lectures from Insmed, outside the submitted work.
Conflict of interest: C.L. Daley has nothing to disclose.
Support statement: Data used for this study were downloaded from the National Jewish Health Research Database, supported by National Jewish Health.
- ReceivedÂ November 13, 2019.
- AcceptedÂ February 15, 2020.
- Copyright Â©ERS 2020