P-796. The Deadly Raise of NTM : An Observational Study on Clinical profile and Outcome Of NTM Disease

Abstract Background NTM is ubiquitously present in the environment. When these microorganisms shed, they produce biofilms that increase the likelihood of infection. CLINICAL AND RADIOLOGICAL FEATURES OF NTM Methods STUDY PERIOD: 1 YEAR STUDY DESIGN: Cross-sectional observational study STATISTICAL ANALYSIS: Categorical variables will be expressed as % NTM VARIOUS CLINICAL SITES Results 25 cases were selected for analysis. Out of 25 (40% ) were port site infection and 12 % pulmonary. Most common symptom was discharge (60%) . Empirical antibiotics were started in 100% . ID referral was sent in all .RF were seen in 40%. Scans was showing sinus tract formation or deep seated abscess among (80%); . AFB stain was positive in 80% cases and CB-NAAT negative in 100% cases. Culture positivity in 56% , among 15 samples sent for PCR it was positive in 10 (66.6%); among 10 cases sent for sequencing 8(80%) cases were positive. Rapid growers 92% and then slow growers were seen in 8% cases. most common species was M.chelonae (28.5%) followed by M.fortuitum and abscessus (21.4%); among 3 species of abscessus sub species were able to identify in one case and it was boleti 33.3%. slow growers MAC and kansasi were identified 7% each. NTM culture was given positive but species identification was not done in 14.2% cases. Culture was negative in 44% of cases. DST was done in 14 cases and genotypic was able to do in 5 cases and erm gene detected (40%) cases. Phenotypic DST was done in all culture positive isolates(n=14), among them cotrimoxazole (92.8%); Amikacin and linezolid was sensitive in 85.7% isolates, imipenem,levofloxacin and tigecycline in 71.4% and macrolide was sensitive in 57.1% cases only. Various combination regimens were used and most common combination used were amikacin,levofloxacin,macrolide and amikacin,linezolid,levofloxacin and amikacin,levofloxacin,cotrimoxazole in 24% cases; and 1 case had treatment with amikacin,linezolid,tigecycline . 40 % cases used combination treatment for 1 year or longer;20 % cases only used 6 months of therapy. Side effects like GIT intolerance in 80% cases; renal toxicity was seen in 40% cases. Upon follow up death in 8%; resolution in 76% , culture negativity 71.4% non-resolving/recurrence 16% Conclusion Most of the patients with NTM are misdiagnosed and are treated as tuberculosis ANTIBIOTIC SUSCEPTIBILITIES AMONG VARIOUS NTM ISOLATED NTM IMAGE 4 Disclosures All Authors: No reported disclosures