Changing epidemiology of nontuberculous mycobacterial lung disease over the last two decades in a region of the Basque country

Abstract

Recent studies suggest an increasing prevalence of nontuberculous mycobacteria (NTM) lung disease. The aim of the present study was to describe incidence rates of NTM lung disease and trends therein in our area over a 20-year period.This was a retrospective study of all cases of NTM lung disease between 1997 and 2016 that met the 2007 American Thoracic Society criteria. We analysed the annual incidence rates, species of mycobacteria isolated, trends over time and annual mortality in 327 patients.Mycobacterium kansasii was the most common mycobacterium isolated (84%), followed by Mycobacterium avium complex (MAC) (13%). We compared two periods: 1997–2006 (257 cases, 79%) and 2007–2016 (70 cases, 21%). The incidence rates tended to decrease across these years, with a peak of incidence in 2000 with 10.6 cases per 100 000. There was a clearly decreasing trend in M. kansasii infection, not only in the first period (incident rate ratio (IRR) 0.915, 95% CI 0.88–0.90; p<0.0001) but also in the second (IRR 0.869, 95% CI 0.780–1.014; p=0.080), reaching 1.8 per 100 000 in 2016. In contrast, MAC infection tended to increase across the two periods (IRR 1.251, 95% CI 1.081–1.447; p=0.003).In our region, the incidence of NTM lung disease has notably decreased in recent years. M. kansasii had high incidence rates in the first decade but clearly decreased in the second decade.

Efficacy and Mechanisms of Flavonoids against the Emerging Opportunistic Nontuberculous Mycobacteria

“…The diseases of NTM are often found in developed nations, where the peak occurrence rates was 10.6 cases per 100,000 individuals in 2000 [25]. Based on pulmonary research by various experts, the respiratory NTM are projected to be at least 15 times more common than TB with at least 200,000 cases per year in the USA [25]. In South Korea, the occurrence of NTM infections have been augmented to 39.6 cases/100,000 people in 2016 and yearly occurrence could be 19.0 cases/100,000 people.…”

Analysis of the incidence and epidemiology of non-tuberculous mycobacterial infections in the health area III of Aragón

“…En numerosos trabajos publicados sobre MNT, nacionales e internacionales, se ha constatado un cambio de tendencia en la proporción de aislamientos de MNT respecto a los de MTB [ 4 - 6 , 13 ]. En nuestra investigación, pese a que parece intuirse que ocurre algo similar, no logramos evidencia estadísticamente significativa para respaldar esta afirmación (p=0,1359).…”

“…Al analizar los datos por grupos de edad y sexo, sí encontramos similitudes con múltiples publicaciones. La infección por MNT se detecta más en personas con edades avanzadas, específicamente en > 70 años, hecho objetivado previamente en múltiples trabajos [ 1 - 6 , 13 ]. Al poner el foco en el sexo, observamos que se aíslan más MNT en hombres que en mujeres, dato compartido con los de trabajos de otros autores realizados en diferentes áreas geográficas [ 1 , 6 ], pero que contrasta con los de otras zonas [ 3 - 5 , 14 ].…”

“…Esta falta de consenso la encontramos, incluso aún mayor, al acercar el foco al territorio español. Si bien comunidades autónomas como Madrid y Asturias han objetivado un incremento en la incidencia de infecciones por MNT en las últimas décadas, lo contrario se ha observado en País Vasco [ 4 - 6 ].…”