Epidemiology of Infection by Nontuberculous Mycobacteria:<i>Mycobacterium avium, Mycobacterium intracellulare</i>, and<i>Mycobacterium scrofulaceum</i>in Acid, Brown-Water Swamps of the Southeastern United States and Their Association with Environmental Variables

Kirschner, Richard A.; Parker, Barry; Falkinham, Joseph O.

doi:10.1164/ajrccm/145.2_pt_1.271

Cited by 204 publications

(159 citation statements)

References 12 publications

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“…The higher prevalence of disease among older adults living in southeastern and western states is consistent with prior reports of higher human exposure and observed prevalence (5,37,38) and with studies isolating greater numbers of mycobacteria from southeastern states than from other locations surveyed (39). Although regional variation in medicare practices relevant to PNTM may exist, the strength of our findings indicates that these results are unlikely to be explained by differences in regional practices alone.…”

Section: Discussionsupporting

confidence: 91%

Prevalence of Nontuberculous Mycobacterial Lung Disease in U.S. Medicare Beneficiaries

Adjemian

Olivier

Seitz

et al. 2012

Am J Respir Crit Care Med

583

466

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Rationale: Pulmonary nontuberculous mycobacteria (PNTM) are an important cause of morbidity among older adults in the United States, but national prevalence estimates are lacking. Objectives: To describe the prevalence and trends of PNTM disease among adults aged 65 years or older throughout the United States. Methods: A nationally representative 5% sample of Medicare Part B beneficiaries was analyzed from 1997 to 2007. Demographic and medical claims data were compiled and prevalence estimates for PNTM and selected comorbidities were calculated and trends over time evaluated. Logistic regression was used to identify demographic and geographic factors associated with PNTM. Measurements and Main Results: From 1997 to 2007, the annual prevalence significantly increased from 20 to 47 cases/100,000 persons, or 8.2% per year. The period prevalence was 112 cases/100,000 persons, although prevalence was twofold higher among Asians/Pacific Islanders than among whites (228 vs. 116 cases/100,000 persons). Western states had the highest period prevalence at 149 cases/ 100,000 persons, with Hawaii having the highest prevalence at 396 cases/100,000 persons, followed by southeastern states, which had a period prevalence of 131 cases/100,000 persons. PNTM cases had more comorbid conditions than noncases and were 40% more likely to die than noncases. Women were 1.4 times more likely to be a PNTM case than men. Relative to whites, Asians/Pacific Islanders were twice as likely to be a case, whereas blacks were half as likely. Conclusions: The prevalence of PNTM is increasing across all regions of the United States and among both men and women. Significant racial/ethnic and geographic differences suggest important geneenvironment interactions.Keywords: nontuberculous mycobacteria; pulmonary; epidemiology; prevalence; United States Nontuberculous mycobacteria (NTM) have been increasingly recognized as an important cause of morbidity in the United States. NTM are ubiquitous in the environment, frequently detected in soil and water samples as well as in biofilms that form in municipal water sources (1). Exposure is typically believed to originate from exposure to environmental sources (2). Although severe infection can affect the lymph nodes, skin, soft tissues, bones, and joints, the vast majority of disease is pulmonary (3). More than 140 NTM species have been identified, although approximately 80% of pulmonary NTM (PNTM) infections in the United States are associated with Mycobacterium avium complex, and prevalence varies by geographic region (4).Recent studies suggest that the prevalence of PNTM disease is increasing throughout the United States (4, 5), especially among older adults (4, 5). Women appear to bear a disproportionate burden of PNTM disease (4, 6), with several studies identifying physical correlates of risk for PNTM (7). Although the increased risk of PNTM among older adults is well established, disease prevalence estimates vary widely by geographic region. Characterizing PNTM disease distribution by region, sex, age,...

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Section: Discussionsupporting

confidence: 91%

Prevalence of Nontuberculous Mycobacterial Lung Disease in U.S. Medicare Beneficiaries

Adjemian

Olivier

Seitz

et al. 2012

Am J Respir Crit Care Med

583

466

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“…Both M. avium and M. intracellulare are recovered more frequently from pipe surfaces in biofilms, than in the planktonic phase 65,66 . However, M. intracellulare forms biofilms more readily than the less hydrophobic M. avium, which is more commonly found in the bulk water 65,67 Despite the global distribution and use of 3T HCUs, whole genome analysis has demonstrated a lack of genetic diversity between isolates 2, 4 . In Australia, M. chimaera was recovered from 10 HCUs across four different hospitals 2 .…”

Section: Determining the Source Of Infections Related To Hcusmentioning

confidence: 99%

Microbiological problems and biofilms associated with Mycobacterium chimaera in heater–cooler units used for cardiopulmonary bypass

Walker

Moore

Collins

et al. 2017

Journal of Hospital Infection

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Summary:The role of heater cooler units (HCUs) in the transmission of Mycobacterium chimaera during open heart surgery has been recognised since 2013. Subsequent investigations uncovered a remarkable global outbreak reflecting the wide distribution of implicated devices. HCUs are an essential component of cardiopulmonary bypass operations and their withdrawal would severely affect capacity for life-saving cardiac surgery. However, studies have demonstrated that many HCUs are contaminated with a wide range of microorganisms, including M. chimaera and complex biofilms. Whole genome sequencing of M. chimaera isolates recovered from one manufacturer's HCUs, worldwide, has demonstrated a high level of genetic similarity, for which the most plausible hypothesis is a point source contamination of the devices. Dissemination of bioaerosols through breaches in the HCU water tanks is the most likely route of transmission and airborne bacteria have been shown to have reached the surgical field even with the use of ultraclean theatre ventilation. Controlling the microbiological quality of the water circulating in HCUs and reducing biofilm formation has been a major challenge for many hospitals. However, enhanced decontamination strategies have been recommended by manufacturers and while not always effective in eradicating M. chimaera from HCUs, UK hospitals have not reported any new cases of M. chimaera infection, since implementing these mitigation strategies. Water safety groups in hospitals should be aware that water in medical devices such as HCUs can act as a vector in the transmission of potentially fatal water-borne infections.

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“…The objective of this study was to make the molecular characterization of environmental mycobacteria strains in Côte d`Ivoire. The high sediment contamination identified in the study highlight the fast growing of mycobacteria (Kirschner et al, 1992). The risk of transmission of cutaneous mycobacteriosis would therefore also be present in non-endemic sites like in the endemic locations as demonstrated by Williamson et al (2008) in the case of Buruli ulcer.…”

Section: Discussionmentioning

confidence: 71%

Microbiological and molecular characterization of environmental mycobacterium strains isolated from the Buruli ulcer endemic and non-endemic zones in Cte dIvoire

Vakou¹,

Julien²,

Kakou-Ngazoa³

et al. 2016

Afr. J. Microbiol. Res.

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Mycobacterium ulcerans (MU), the causative agent of Buruli ulcer (BU), skin disease, is considered to be an environmental pathogen. The pathogenic virulence of MU is being linked to the expression of toxin called Mycolactone. Genetic analyses have shown the high diversity with variable number tandem repeats (VNTR) and mycobacterial interspersed repetitive units (MIRU) in M. ulcerans and in mycolactone producing Mycobacteria (MPMs). The purpose of this study is the molecular characterization of potentially pathogenic environmental mycobacteria strain, apart from the M. ulcerans, from aquatic environments in Côte d'Ivoire. A total of 473 samples were collected comprising of 251 water and 222 sediment based on sampling sites. The sediments were the most contaminated by mycobacteria with 60% as against 43.3% in water samples from the hyper endemic areas. In hypoendemic areas, water was the most contaminated with 53.57% against 43.24% in sediment. Microscopy by Ziehl-Neelsen-staining, and PCR diagnostics using IS2404 and KR were performed on strains. 20% fast growing isolated mycobacteria species including Mycobacterium mucogenicum, Mycobacterium peregrinum and Mycobacterium sp. was found carrying the IS2404 gene previously found in M. ulcerans. 9.23% of strains carry the ketoreductase (KR) genes, one of the synthesis of mycolactone enzymes. In terms of genetic analysis using the MIRU/VNTR, the MIRU 1 was the most amplified sequence, and LOCUS 6 less amplified; no known profile have been identified in this study. This study is the first step taken in order to understand different skin infections encountered in Côte d'Ivoire.

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Epidemiology of Infection by Nontuberculous Mycobacteria:Mycobacterium avium, Mycobacterium intracellulare, andMycobacterium scrofulaceumin Acid, Brown-Water Swamps of the Southeastern United States and Their Association with Environmental Variables

Cited by 204 publications

References 12 publications

Prevalence of Nontuberculous Mycobacterial Lung Disease in U.S. Medicare Beneficiaries

Prevalence of Nontuberculous Mycobacterial Lung Disease in U.S. Medicare Beneficiaries

Microbiological problems and biofilms associated with Mycobacterium chimaera in heater–cooler units used for cardiopulmonary bypass

Microbiological and molecular characterization of environmental mycobacterium strains isolated from the Buruli ulcer endemic and non-endemic zones in Cte dIvoire

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