The influence of environmental exposure on the response to antimicrobial treatment in pulmonary Mycobacterial avium complex disease (BMC Infectious Diseases)

Background: Environmental exposure is a likely risk factor for the development of pulmonary Mycobacterium avium complex (MAC) disease. The influence of environmental exposure on the response to antimicrobial treatment and relapse is unknown. Methods: We recruited 72 patients with pulmonary MAC disease (male [female], 18 [54]; age, 61.7 +/- 10.3 years) who initiated and completed standard three-drug regimens for more than 12 months between January 2007 and December 2011. The factors associated with sputum conversion, relapse and treatment success without relapse were retrospectively evaluated after adjustments for confounding predictors. Results: Fifty-two patients (72.2%) demonstrated sputum conversion, and 15 patients (28.8%) relapsed. A total of 37 patients (51.4%) demonstrated treatment success. Sputum conversion was associated with negative smears (odds ratio [OR], 2.80; 95% confidence interval [CI], 1.02-7.83; P = 0.045) and the absence of cavities or a cavity size of