Aging, COPD, and Other Risk Factors Do Not Explain the Increased Prevalence of Pulmonary Mycobacterium avium Complex in Ontario

Al-Houqani, Mohammed; Jamieson, Frances; Mehta, Mauli; Chedore, Pamela; May, Kevin; Marras, Theodore K.

doi:10.1378/chest.11-0089

Cited by 51 publications

(39 citation statements)

References 31 publications

(14 reference statements)

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“…Furthermore, in agreement with other US studies we found that the prevalence of PNTM infection was most significantly increasing among females [3,9,13,16]. In fact, males carried the major burden of PNTM-associated hospitalisations in our study, whereas elderly women with nodular bronchiectatic disease have been considered as the predominant patient population outside Europe [3,14,16,22]. This finding supports the existence of a unique epidemiology of PNTM infections in accordance with the distinct distribution of NTM species isolated from respiratory samples within Europe and recent reports from other European countries [6,11,15,19,20,23], where PNTM infections appear to be .…”

Section: Discussionsupporting

confidence: 92%

“…Thirdly, we were unable to account for readmissions, which may have had an impact on hospitalisation rates, though a substantial overestimation appears unlikely. Fourthly, several previous studies have suggested that the epidemiology of PNTM infections may be influenced by environmental, geographical and sociodemographic patterns [22,24,27,28]. However, we did not analyse the data stratified for individual federal states or urban and rural areas, mainly due to the potential bias related to regional differences of health care utilisation of medical services, and the unavailability of information on NTM species.…”

Section: Discussionmentioning

confidence: 99%

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Burden and trends of hospitalisations associated with pulmonary non-tuberculous mycobacterial infections in Germany, 2005–2011

et al. 2013

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BackgroundRepresentative population-based data on the epidemiology of pulmonary non-tuberculous mycobacterial (PNTM) infections in Europe are limited. However, these data are needed in order to optimise patient care and to facilitate the allocation of healthcare resources. The aim of the present study was to investigate the current burden and the trends of PNTM infection-associated hospitalisations in Germany.MethodsInternational Classification of Diseases, 10th revision (ICD-10) discharge diagnosis codes were extracted from the official nationwide diagnosis-related groups (DRG) hospital statistics in order to identify PNTM infection-associated hospitalisations (ICD-10 code A31.0) between 2005 and 2011. Poisson log-linear regression analysis was used to assess the significance of trends.ResultsOverall, 5,959 records with PNTM infection as any hospital discharge diagnosis were extracted from more than 125 million hospitalisations. The average annual age-adjusted rate was 0.91 hospitalisations per 100,000 population. Hospitalisation rates increased during the study period for both males and females, with the highest rate of 3.0 hospitalisations per 100,000 population among elderly men, but the most pronounced average increase of 6.4%/year among females, particularly those of young and middle age, and hospitalisations associated with cystic fibrosis. Overall, chronic obstructive pulmonary disease (COPD) was the most frequent PNTM infection-associated condition in 28.9% of hospitalisations and also showed a significant average annual increase of 4.8%.ConclusionsThe prevalence of PNTM infection-associated hospitalisations is steadily increasing in Germany. COPD is currently the most important associated condition. Our population-based study provides evidence of a changing epidemiology of PNTM infections and highlights emerging clinical implications.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Burden and trends of hospitalisations associated with pulmonary non-tuberculous mycobacterial infections in Germany, 2005–2011

et al. 2013

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“…[22] In fact, the current increase in NTM disease in North America and the world could be explained, in part, by aging populations. [23].…”

Section: Discussionmentioning

confidence: 99%

Nontuberculous Mycobacterial Disease Mortality in the United States, 1999–2010: A Population-Based Comparative Study

et al. 2014

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BackgroundEnvironmental nontuberculous mycobacteria (NTM) are ubiquitous organisms with which humans commonly interact. The epidemiologic characteristics of NTM diseases including mortality rate and its associated factors remain largely unknown. In this study, we explored the geographical area of exposure and mortality and comorbid conditions of affected persons to determine environment, host, and host-pathogen interactive factors.MethodsWe analyzed mortality related to nontuberculous mycobacterial infections from 1999 through 2010 by examining multiple-cause-of-death data from the National Center for Health Statistics. Among those who died with these diseases, we analyzed age-adjusted mortality rates, trends, associations with demographic variables, and comorbid conditions and correlated this information with similar data for tuberculosis-related mortality during the same time.Measurements and Mean ResultsFrom 1999 through 2010, nontuberculous mycobacterial disease was reported as an immediate cause of death in 2,990 people in the United States with a combined overall mean age-adjusted mortality rate of 0.1 per 100,000 person-years. A significant increase in the number of NTM related deaths was seen from 1999 through 2010 (R2 = 0.72, p<0.0001), but it was not significant after adjustment for age. Persons aged 55 years and older, women, those living in Hawaii and Louisiana, and those of non-Hispanic, white ethnicity had higher mortality rates. Compared to tuberculosis-related mortality, chronic obstructive pulmonary disease, bronchiectasis, HIV, interstitial lung diseases, and tobacco use were significantly more common in persons with nontuberculous mycobacteria-related deaths.ConclusionsNontuberculous mycobacteria-related death numbers are rising and are unevenly distributed. The strong association of nontuberculous mycobacterial disease with age suggests that its prevalence will increase as the United States population ages.

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“…Al-Houqani et al demonstrated in a population-based study in Ontario, Canada that MAC lung disease increased substantially with age; from 1 in 100,000 in people <50 years old to 48 in100,000 in people over 79 years old [30]. …”

Section: Methodsmentioning

confidence: 99%

Management of nontuberculous mycobacterial infection in the elderly

Mirsaeidi

Farshidpour

Ebrahimi

et al. 2014

European Journal of Internal Medicine

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The incidence of nontuberculous mycobacteria (NTM) has increased over the last decades. Elderly people are more susceptible to NTM and experience increased morbidities. NTM incidence is expected to rise due to an increasing elderly population at least up to 2050. Given the importance of NTM infection in the elderly, an increasing interest exists in studying NTM characteristics in aged population. In this review, we summarize the characteristics of NTM infection among elderly patients. We focus on epidemiology, clinical presentation, and treatment options of NTM in this age group. We highlight the differences in the diagnosis and treatment between rapid and slow growing mycobacterial infections. The current recommendation for treatment of NTM is discussed. We debate if in vitro susceptibility testing has a role in treatment of NTM. Drug-drug interaction between antibiotics used to treat NTM and other medications, particularly warfarin, is another important issue that we discuss. Finally, we review the prognosis of NTM disease in elderly patients.

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Aging, COPD, and Other Risk Factors Do Not Explain the Increased Prevalence of Pulmonary Mycobacterium avium Complex in Ontario

Cited by 51 publications

References 31 publications

Burden and trends of hospitalisations associated with pulmonary non-tuberculous mycobacterial infections in Germany, 2005–2011

Burden and trends of hospitalisations associated with pulmonary non-tuberculous mycobacterial infections in Germany, 2005–2011

Nontuberculous Mycobacterial Disease Mortality in the United States, 1999–2010: A Population-Based Comparative Study

Management of nontuberculous mycobacterial infection in the elderly

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