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

Abstract

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.

Boosting Effect of 2-Phenylquinoline Efflux Inhibitors in Combination with Macrolides against Mycobacterium smegmatis and Mycobacterium avium

“…The optimization strategy will aim at obtaining less toxic and more potent EPIs of NTMs to be used in combination with macrolides in particular against Mycobacterium avium complex, the causative agent of severe pulmonary infections in HIV co-infected, cystic fibrosis, and chronic obstructive pulmonary disease patients. 3 (Figure 1), the syntheses of which were previously described, were selected for their interesting efflux inhibitory activity against S. aureus NorA efflux pump from an in-house library of NorA EPIs.…”

Pulmonary Disease Caused by Non-Tuberculous Mycobacteria

“…In Denmark, the NTM-PD incidence increased from 0.6 to 1.5/100,000 population-years from 2003 to 2008 [39]. In Germany, the overall age-adjusted rates of pulmonary NTM infection-associated hospitalizations increased from 0.7 to 1.1/100,000 population [11]. Increases in the incidence of NTM-PD in different parts of Europe are likely related to demographic changes with accompanying risk factors for lung health [8].…”

“…Depending on the causative NTM species, the clinical course and treatment response of NTM pulmonary disease (NTM-PD) can be very variable [8]. During the last three decades, an increasing incidence of pulmonary NTM isolation has been observed in Europe and several other regions worldwide [8,9,10,11,12,13]. The increase seems to be associated with the declining incidence of TB in countries with a higher socioeconomic standard [14].…”

Nontuberculous mycobacterial pulmonary disease: an increasing burden with substantial costs

“…One prior analysis in Germany using national hospitalisation data found an increasing trend for NTM PD-associated hospitalisations during the period 2005-2011 [22], but no analysis that includes clinical information on outpatients or cost has been conducted in Germany or elsewhere in Europe. In the work by DIEL et al [21], more than 80 German companies provided administrative health insurance claims data from more than 7 million members.…”