Comparing Mycobacterium massiliense and Mycobacterium abscessus lung infections in cystic fibrosis patients

Background: Mycobacterium massiliense is closely related to Mycobacterium abscessus and is also a frequent cause of mycobacterial lung disease in patients with cystic fibrosis (CF). There has been no previous investigation of possible differences between M. massiliense and M. abscessus infections in the setting of CF. Methods: We studied a prospective cohort of 16 M. massiliense and 27 M abscessus lung infection cases with CF, with a mean follow-up of 6 years. Results: M. massiliense cases were younger than M. abscessus cases (mean age: 12.8 vs 17.1 years; p = 0.02) at the time of the first mycobacterial isolation and also had lower body mass index values (mean: 16.4 vs 19.3 kg/m(2), p = 0.002). All M massiliense cases, except one, had negative BMI Z-score values at the time of the first mycobacterial isolation (11/12 vs 16/23 M. abscessus cases, p = 0.04). Clarithromycin-based combination therapies led to mycobacterial eradication in 100% of M massiliense cases but only in 27% of M. abscessus cases (p = 0.009). Conclusion: Our data show a particular link between M. massiliense and malnutrition specifically in CF patients. Unlike M. abscessus, the bacteriological response of M. massiliense to combination antibiotic therapies containing clarithromycin was excellent. Distinguishing between M. massiliense and M. abscessus has major clinical implications for CF patients. (C) 2014 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.