Factors associated with treatment outcomes of Mycobacterium abscessus pulmonary disease: a retrospective case-control study

doi:10.19982/j.issn.1000-6621.20260091

Abstract

Abstract:

Objective: To investigate the independent risk factors associated with treatment outcomes in patients with Mycobacterium abscessus pulmonary disease (MAB-PD) and provide evidence for clinical prognostic assessment and individualized therapy. Methods: This retrospective study included 197 patients diagnosed with MAB-PD at Beijing Chest Hospital, Capital Medical University between January 2015 and January 2025. Data on demographic characteristics, underlying diseases, laboratory parameters, and treatment regimens were collected. Patients were divided into a favorable outcome group (cured/treatment completed) and an unfavorable outcome group (treatment failure/death). Univariate and multivariate logistic regression models were employed to identify independent risk factors associated with treatment outcomes. Results: Among the 197 patients, 86 (43.6%) achieved favorable outcomes, 62 (31.5%) experienced unfavorable outcomes, and 49 (24.9%) were lost to follow-up. In univariable analysis, age (OR=1.049, 95%CI: 1.022-1.077; P<0.001) and educational level (university degree or above vs. junior college or below, OR=0.307, 95%CI: 0.133-0.732; P=0.008) were associated with treatment outcome. Multivariate logistic regression analysis revealed that age was the only independent risk factor for unfavorable outcomes in MAB-PD patients (OR=1.040, 95%CI: 1.011-1.070, P=0.007), with each additional year increase in age was associated with a 4.0% higher risk of unfavorable outcomes. The incidence of adverse events was 10.2% (20/197). Conclusion: Increased age is an independent risk factor for unfavorable treatment outcomes in MAB-PD patients, suggesting that comprehensive treatment management and nutritional support for older patients should be strengthened in clinical practice to improve prognosis.

Key words: Mycobacterium infections, Atypical bacterial forms, Treatment outcome, Factor analysis, statistical

CLC Number:

R563

Cheng Wen, Nie Wenjuan. Factors associated with treatment outcomes of Mycobacterium abscessus pulmonary disease: a retrospective case-control study[J]. Chinese Journal of Antituberculosis, 2026, 48(8): 1176-1183. doi: 10.19982/j.issn.1000-6621.20260091

Figures/Tables 5

References 28

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特征		例数	构成比(%)
人口学特征
性别	男性	68	34.5
	女性	129	65.5
体质量指数	低体质量^a	56	28.4
	非低体质量	141	71.6
民族	汉族	188	95.4
	少数民族	9	4.6
婚姻	未婚	17	8.6
	已婚	174	88.3
	离异/丧偶	2	1.0
	其他^b	4	2.1
文化程度	大学及以上	36	18.3
	大专及以下	112	56.9
	其他^c	49	24.8
职业	非脑力劳动者	90	45.7
	脑力劳动者	107	54.3
临床特征
免疫系统疾病	否	188	95.4
	是	9	4.6
奥马环素	否	187	94.9
	是	10	5.1
治疗结局	非良性结局	62	31.5
	良性结局	86	43.6
	失访	49	24.9
不良反应	否	177	89.8
	是	20	10.2

影响因素	赋值说明	β值	s${}_{\overline{\mathit{x}}}$值	Wald χ²值	OR(95%CI)值	P值
性别
男性		0.030	0.177	0.028	1.061(0.531~2.122)	0.867
女性	参照组				1.000
年龄	连续变量	0.048	0.013	12.885	1.049(1.022~1.077)	<0.001
婚姻
未婚		―4.356	133.300	0.001	0.364(0.020~6.187)	0.974
已婚		―2.899	133.300	0.001	1.562(0.138~17.656)	0.983
离异/丧偶^a		10.600	400.000	0.001	NA	0.980
其他^b	参照组				1.000
文化程度
大学及以上		―0.591	0.222	7.103	0.307(0.133~0.732)	0.008
大专及以下	参照组				1.000
民族
汉族		―0.443	0.375	1.396	0.412(0.095~1.793)	0.237
少数民族	参照组				1.000
职业
非脑力劳动者		0.115	0.115	0.169	1.260(0.650~2.440)	0.468
脑力劳动者	参照组				1.000
免疫疾病
是	参照组				1.000
否		―0.543	0.364	2.228	0.337(0.081~1.405)	0.136
体质量指数
低体质量		―0.069	0.185	0.138	0.872(0.423~1.797)	0.710
非低体质量	参照组				1.000
糖化血红蛋白	连续变量	0.004	0.168	0.001	1.004(0.722~1.397)	0.979
奥马环素
是	参照组				1.000
否		―0.173	0.364	0.227	0.707(0.170~2.944)	0.634

影响因素	赋值说明	β值	s${}_{\overline{\mathit{x}}}$值	Wald χ²值	调整后OR(95%CI)值	P值
年龄	连续变量	0.039	0.015	7.290	1.040(1.011~1.070)	0.007
性别
男性	参照组				1.000
女性		―0.249	0.436	0.325	0.780(0.332~1.833)	0.569
文化程度
大学及以上		―0.462	0.553	0.621	0.630(0.213~1.863)	0.457
大专及以下	参照组				1.000

影响因素	赋值说明	β值	s${}_{\overline{\mathit{x}}}$值	Wald χ²值	调整后OR(95%CI)值	P值
性别
男性		―0.409	0.290	1.985	0.441(0.141~1.377)	0.159
女性	参照组				1.000
年龄	连续变量	0.005	0.016	0.101	1.005(0.974~1.038)	0.751
婚姻
未婚		―10.418	325.000	0.001	<0.001	0.974
已婚		2.399	108.300	0.001	0.346(0.034~3.505)	0.982
离异/丧偶		4.559	108.400	0.002	3.000(0.084~107.447)	0.966
其他^a	参照组				1.000
文化程度
大学及以上		0.078	0.401	0.038	1.100(0.274~4.423)	0.846
大专及以下		―0.060	0.318	0.036	0.958(0.314~2.922)	0.850
其他^b	参照组				1.000
民族
汉族		6.112	217.900	0.001	>999.999	0.978
少数民族	参照组				1.000
职业
非脑力劳动者		―0.510	0.269	3.592	0.361(0.126~1.035)	0.058
脑力劳动者	参照组				1.000
免疫疾病
是	参照组				1.000
否		6.112	217.900	0.001	>999.999	0.978
体质量指数
低体质量		0.292	0.243	1.435	1.792(0.690~4.651)	0.231
非低体质量	参照组				1.000
糖化血红蛋白	连续变量	―0.908	0.762	1.421	0.403(0.091~1.795)	0.233
奥马环素
是	参照组				1.000
否		―0.719	0.580	1.538	0.487(0.127~1.235)	0.215

影响因素	赋值说明	β值	s${}_{\overline{\mathit{x}}}$值	Wald χ²值	调整后OR(95%CI)值	P值
年龄	连续变量	0.003	0.016	0.038	1.003(0.973~1.034)	0.084
职业
脑力劳动者	参照组				1.000
非脑力劳动者		-0.507	0.269	3.542	0.363(0.126~1.043)	0.060