Nontuberculous mycobacteria infection and pulmonary disease in bronchiectasis.

Background: Although interest in nontuberculous mycobacteria (NTM) infection has increased in the last decades, published data vary according to different geographical areas, diagnostic facilities and quality of study design. This study aims at assessing both prevalence and incidence of NTM infection and NTM pulmonary disease (NTM-PD) among adults with bronchiectasis, to describe patients' characteristics, therapeutic options and clinical outcomes. Methods: Bronchiectasis adults who had been tested for NTM were enrolled at the Bronchiectasis Program of the Policlinico Hospital in Milan, Italy, from 2016 to 2018. Results: Among the 373 patients enrolled, 26.1% had at least one respiratory sample positive for NTM and 12.6% reached a diagnosis of NTM-PD. Incidence rates for NTM infection and NTM-PD were 13 (95% CI 10-16) and 4 (95% CI 2-6) per 100 person-years, respectively. The most prevalent NTM species causing NTM-PD were M. intracellulare (38.3%), M. avium (34.0%), M. abscessus (8.5%) and M. kansasii (8.5%). Once treatment for NTM-PD was initiated, a favourable outcome was documented in 52.2% of the patients, while a negative outcome was recorded in 32.6%, including recurrence (17.4%), treatment failure (10.9%), re-infection (2.2%) and relapse (2.2%). Treatment halted was experienced in 11 (23.9%) patients. Conclusions: NTM infection is frequent in bronchiectasis patients and the presence of NTM-PD is relevant. The low success rate of NTM-PD treatment in bronchiectasis patients requires a call to action to identify new treatment modalities and new drugs to improve patients' outcomes.

ERS International Congress 2020: highlights from the Respiratory Infections assembly.

In the coronavirus disease 2019 (COVID-19) pandemic year 2020, the 30th European Respiratory Society (ERS) International Congress took place for the first time in a fully virtual format. Despite the challenging nature of the task to create and deliver an online event of this size and scope, it turned out to be a great success, welcoming over 33 000 delegates to the specially designed online platform and offering more than 450 scientific and educational sessions. Somewhat predictably, this year's ERS International Congress dedicated a full day to the topic of COVID-19, highlighting that infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a respiratory disease that is particularly important this year. In this article, the Early Career Members of the Assembly 10 (Respiratory Infections and Tuberculosis) review some of the most interesting sessions including presentations and posters on respiratory infections and tuberculosis that were deemed as important.

FACTORS AFFECTING THE FREQUENCY OF EXACERBATIONS IN ADULT PATIENTS WITH BRONCHIECTASIS.

OBJECTIVE: The aim: This study aims to determine specific predictive factors of bronchiectasis exacerbations. PATIENTS AND METHODS: Materials and methods: 47 patients with bronchiectasis were prospectively recruited into the study in Dnipro, Ukraine. Following the number of exacerbations during the previous year, they were divided into two groups: frequent exacerbators - ≥ 3 cases per year (n = 24) and non-frequent exacerbators - < 3 cases per year (n = 23). Demographic and anthropometric data, medical history, smoking status, shortness of breath by Modified Medical Research Council Dyspnea Scale, sputum culture, respiratory function by computed spirometry, disease severity by Bronchiectasis Severity index and FACED scales were evaluated in both groups. RESULTS: Results: The factors found to be independently associated with frequent exacerbations were: overweight, airway obstruction, longer duration of the disease, more severe dyspnea, greater number of involved pulmonary lobes and presence of one or more comorbid conditions. Non-influencing factors were: underweight, age, sex, smoking status and, unexpectedly, presence of Pseudomonas aeruginosa or other pathogens in sputum culture. CONCLUSION: Conclusions: Particular attention is required for patients with bronchiectasis who have overweight, airway obstruction, longer duration of the disease, more severe dyspnea, the greater number of involved pulmonary lobes and presence of one or more comorbid conditions in order to correct modifiable risk factors of future exacerbations.

Masterclass in airways disease: course report.

Participants attending the recent ERS course on airways disease share their experiences http://bit.ly/2lojSl3.