Evidence of Mycobacterial Disease in Chronic Obstructive Pulmonary Disease Patients, the importance of Histological Assessment

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a prevalent respiratory condition often exacerbated by bacterial infections. However, atypical mycobacteria, which are opportunistic pathogens, can also significantly contribute to COPD exacerbations, particularly in individuals with pre-existing lung damage. Objective: To investigate the role of non-tuberculous mycobacteria (NTM) in COPD exacerbations and emphasize the importance of histological assessment in detecting and characterizing these infections. Methodology: The study employed a prospective cohort design involving 112 patients with chronic respiratory conditions. Comprehensive demographic and clinical data were collected, including occupational history and lifestyle factors. The diagnosis of NTM pulmonary disease adhered to American Thoracic Society guidelines, incorporating symptom assessment, imaging, and sputum cultures. Histopathological evaluation of lung tissue from bronchial lavage was performed to assess bronchiolectasis and inflammation. Standardized data collection and management ensured accuracy, and regular follow-ups were conducted to monitor disease progression and treatment outcomes. Results: The study on COPD patients with non-tuberculous mycobacterial infections involved 112 participants, including 69 males (61.98%) and 43 females (38.02%). Histopathological findings included bronchiolar inflammation in 62 patients (55.36%), bronchiolectasis in 54 patients (48.21%), peribronchiolar inflammation in 47 patients (41.96%), and granuloma formation in 33 patients (29.46%). Regarding treatment outcomes, 40 patients (35.71%) improved, 46 patients (41.07%) remained stable, and 26 patients (23.21%) worsened. Chi-square tests showed significant associations between NTM infections and persistent cough (χ² = 12.34, p = 0.0004), hemoptysis (χ² = 7.89, p = 0.0050), chest pain (χ² = 15.76, p < 0.0001), and dyspnea (χ² = 14.32, p = 0.0002). Conclusion: This study highlights the crucial role of histological assessment in accurately diagnosing and understanding non-tuberculous mycobacterial infections in COPD patients, emphasizing its impact on effective disease management.