Detecting clusters of high nontuberculous mycobacteria infection risk for persons with cystic fibrosis – An analysis of U.S. counties

Mercaldo, Rachel A.; Marshall, Julia E.; Prevots, D. Rebecca; Lipner, Ettie M.; French, Joshua P.

doi:10.1016/j.tube.2022.102296

Cited by 3 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that during the study period April 2019 through 2022 the prevalence of all NTM and M. abscessus isolates in respiratory cultures was highest in the Southeast U.S. We also found this region had the highest proportion of positive tests identified as M. abscessus . These findings are consistent with prior work which identified the southeastern states, namely Florida, as high-risk for NTM and as having a high burden of M. abscessus in the general population and in high-risk groups [ 4 , 7 – 9 , 16 , 22 , 23 ]. This work highlights the value of real-time data on NTM culture results, which can inform public health action and clinical needs planning.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Nontuberculous mycobacteria testing and culture positivity in the United States

Marshall,

Mercaldo,

Lipner

et al. 2024

BMC Infect Dis

Self Cite

View full text Add to dashboard Cite

Background Nontuberculous mycobacteria (NTM) are environmental bacteria which may cause chronic lung disease. The prevalence of NTM pulmonary infection and disease has been increasing in the United States and globally. The predominant clinically relevant species of NTM in the United States are Mycobacterium avium complex (MAC) species and Mycobacterium abscessus. With the development of rapid species identification methods for NTM (e.g. PCR probes), more testing for NTM is being conducted through commercial labs, such as Laboratory Corporation of America (Labcorp), which provides deidentified real-time testing data to the Centers for Disease Control (CDC) pursuant to a data sharing agreement. Because NTM lung infections are not reportable in most states, other data sources are key to understanding NTM testing patterns, positivity rates, and species distributions to track infection trends and identify clinical care needs. Methods We obtained national Labcorp data for the period January 2019 through mid-April 2022. We subset the data to only respiratory samples sent for Acid Fast Bacilli (AFB) cultures. NTM positive results were defined as those which identified an NTM species and are not Mycobacterium tuberculosis, Mycobacterium bovis, or Mycobacterium gordonae. Results Overall, 112,528 respiratory samples were sent for AFB testing during the study period; 26.3% were from the Southeast U.S., identified as HSS Region IV in the Labcorp dataset, and 23.0% were from the Pacific and South Pacific region (Region IX). The culture positive prevalence ranged from 20.2% in the Southeast to 9.2% in the East North Central region (Region V). In the Southeast US, M. abscessus prevalence was 4.0%. For MAC, the highest prevalence was observed in the Mountain region (Region VII) (13.5%) and the lowest proportion was in the East South Central region (7.3%, Region III). Among positive tests, the proportion which was MAC varied from 61.8% to 88.9% and was highest in the Northeast U.S. The proportion of positive samples which were M. abscessus ranged from 3.8% to 19.7% and was highest in the Southeast. Conclusions The Southeastern region of the U.S. has the highest rate of culture positivity in Labcorp tests for total NTM and, of all positive tests, the highest proportion of M.abscessus. These estimates may underrepresent the true number of M.abscessus infections because M. absesscus-specific probes are not commercially available and not all NTM testing in the United States is done by Labcorp. Analysis of real-time testing data from commercial laboratories may provide insights into risk factors for NTM culture positivity in ‘hotspot’ areas.

show abstract

Section: Discussionsupporting

confidence: 91%

“…This geographic variation is associated with differences in environmental factors [7,[9][10][11][12][13][14]. Some states, such as Florida and Hawaii, have been identified as NTM 'hotspots' [7,15,16]. NTM incidence and prevalence are increasing across U.S. regions [2,3,8].…”

Section: Introductionmentioning

confidence: 99%

Nontuberculous mycobacteria testing and culture positivity in the United States

Marshall,

Mercaldo,

Lipner

et al. 2024

BMC Infect Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…The performance in terms of misclassification was generally comparable across all methods. This similarity arose from the definition of misclassification in Equation (14), where the denominator represented the total population at risk. The breast cancer data set in Section 3 had a large total population size of n + = 29,535,210, contributing to the similarity in misclassification rates.…”

Section: Discussionmentioning

confidence: 99%

“…As such, the set of elliptical zones may not have enough versatility to cover non-elliptical clusters. The elliptic scan method has recently been used to identify high-risk clusters of paratuberculosis in sheep and goats in southern Spain [13], high-and low-risk clusters of breast and cervical cancer-related mortality in Brazil, and clusters of high nontuberculous mycobacteria infection risk for persons with cystic fibrosis in United States counties [14].…”

Section: Introductionmentioning

confidence: 99%

Flexible-Elliptical Spatial Scan Method

Meysami,

French,

Lipner

2023

Mathematics

Self Cite

View full text Add to dashboard Cite

The detection of disease clusters in spatial data analysis plays a crucial role in public health, while the circular scan method is widely utilized for this purpose, accurately identifying non-circular (irregular) clusters remains challenging and reduces detection accuracy. To overcome this limitation, various extensions have been proposed to effectively detect arbitrarily shaped clusters. In this paper, we combine the strengths of two well-known methods, the flexible and elliptic scan methods, which are specifically designed for detecting irregularly shaped clusters. We leverage the unique characteristics of these methods to create candidate zones capable of accurately detecting irregularly shaped clusters, along with a modified likelihood ratio test statistic. By inheriting the advantages of the flexible and elliptic methods, our proposed approach represents a practical addition to the existing repertoire of spatial data analysis techniques.

show abstract