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Free Content Pulmonary Mycobacterium xenopi infection in non-HIV-infected patients: a systematic review [Review article]

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SETTING: The incidence of Mycobacterium xenopi infections is increasing worldwide. The characteristics and optimal management of patients with pulmonary M. xenopi infections have not been well established.

METHODS: Systematic review of English- and French-language studies reporting at least two cases of microbiologically confirmed M. xenopi lung infection. Studies were independently reviewed by two reviewers. We described the risk factors and clinical presentation of advanced infection, and examined the impact on clinical success and mortality of including individual antimycobacterial drugs in the treatment regimen.

RESULTS: A total of 48 studies reporting on 1255 subjects were included. The majority were retrospective case series. There was marked heterogeneity among the studies. Patients were generally middle-aged men with a history of obstructive lung disease or prior tuberculosis, presenting with an upper lobe cavitary infection. There was no clear association between administration of particular drugs and clinical success or mortality.

CONCLUSION: We could not demonstrate any advantage of specific drugs in the treatment of pulmonary M.xenopi infection. Observations from the pooled data are likely subject to significant confounding and selection biases. The inability to make firm conclusions on the optimal management of this increasingly common infection strongly underscores the need for further research.

Keywords: Mycobacterium xenopi; characteristics; drug; systematic review; treatment

Document Type: Review Article

Affiliations: 1: Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada 2: Department of Medicine, University of Toronto, University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada

Publication date: 2009-10-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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