THE ROLE OF MYCOBACTERIA OTHER THAN TUBERCULOSIS (MOTT) IN PATIENTS WITH CYSTIC-FIBROSIS

The purpose of this study was to estimate the frequency of and evaluat e the clinical impact of pulmonary mycobacterial infections among cyst ic fibrosis (CF) patients. 185 CF patients aged 2.2-38.5 years were sc reened by sputum samples and by intracutaneous skin tests against tube rculin and sensitins produced from Mycobacterium chelonae subsp. absce ssus, M. avium, M. intracellulare and M. scrofulaceum (the MAIS comple x). The skin tests towards the sensitins in BCG-vaccinated patients (n = 60) were significantly influenced by the vaccination. 26 of the rem aining 125 non-vaccinated patients had greater than or equal to 1 posi tive skin test (95% confidence limits 15-29%). The majority reacted ag ainst the MAIS complex, However, the reactions were similar to those o f healthy siblings and an age-matched control group. Moreover, the lun g function, growth and HbA1c were similar among skin test positive and negative patients. Three patients had repeated positive sputum cultur es, the point prevalence being 1.6% (M. intracellulare, n = 2 and M. c helonae subsp. abscessus, n = 1). During the subsequent 4 years, 4 add itional patients with M. chelonae subsp. abscessus were identified. Ba sed on clinical observations, 5 of the infected patients were consider ed asymptomatic, while 2 might have been symptomatic. In 1 patient, hi . chelonae subsp. abscessus disappeared spontaneously. Despite intensi ve treatment with new antibiotics against Mycobacteria Other Than Tube rculosis (MOTT) in 4 patients, the mycobacteria were not eradicated. I n conclusion, MOTT infection was rare and the clinical impact difficul t to prove. Treatment should focus on clinical improvement in the indi vidual patient suspected of suffering from significant symptomatic inf ection. Eradication of the bacteria should not be expected.