Epidemiology of Nontuberculous Mycobacteria Infection in Children and Young People With Cystic Fibrosis: Analysis of UK Cystic Fibrosis Registry

Gardner, Aaron; McClenaghan, Elliot; Saint, Gemma; McNamara, Paul; Brodlie, Malcolm; Thomas, Matthew F.

doi:10.1093/cid/ciy531

Cited by 34 publications

(26 citation statements)

References 24 publications

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“…Furthermore, it has been indicated that in humans the syndromes caused by NTM include progressive NTM pulmonary disease, superficial lymphadenitis, cutaneous disease and disseminated disease. Pulmonary NTM disease cases have been identified among patients with chronic obstructive pulmonary disease, asthma, cystic fibrosis, suspected pulmonary TB and chronic TB (Cadmus et al., 2016; Chanda‐Kapata et al., 2015; Gardner et al., 2019; Hoza et al., 2016; Nyamogoba et al., 2012; Shao et al., 2015). NTM are an important cause of disseminated infection and disease in people living with HIV.…”

Section: Discussionmentioning

confidence: 99%

Isolation, identification and associated risk factors of non‐tuberculous mycobacteria infection in humans and dromedary camels in Samburu County, Kenya

Asaava

Githui

Mwangi

et al. 2020

Zoonoses and Public Health

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Non‐tuberculous mycobacteria are of public health significance, and zoonotic infection is attributed to the sociocultural practice of consumption of raw milk and the close human–livestock contact in pastoral communities. This study aimed at isolation, identification of mycobacteria from human sputum and camel milk and risk factors assessment in Samburu East, Kenya. Six hundred and twelve camels and 48 people presumed to have tuberculosis (TB) from 86 households in Wamba and Waso regions were screened. Camels were categorized into Somali, Turkana and Rendile breeds. Single intradermal comparative tuberculin test (SICTT) was used as a herd‐screening test on lactating camels and a milk sample collected from reactive camels. Sputum samples were collected from eligible members of participating households. A standard questionnaire on possible risk factors for both humans and camels was administered to respective household heads or their representatives. Total camel skin test reactors were 238/612 (38.9%). Milk and sputum samples were analysed at KEMRI/TB research laboratory for microscopy, GeneXpert®, culture and identification. Isolates were identified using 16S rRNA gene sequencing at Inqaba biotec in South Africa. Sixty‐four isolates were acid‐fast bacilli (AFB) positive of which M. fortuitum (3), M. szulgai (20), M. monacense (5), M. lehmanni (4), M. litorale (4), M. elephantis (3), M. duvalii (3), M. brasiliensis (1), M. arcueilense (1) and M. lentiflavum (1) were from milk; M. fortuitum (1), M. szulgai (2) and M. litorale (1) were from humans. Risk factors included the following: Turkana breed (OR = 3.4; 95% CI: 1.2–9.3), replacements from outside the County (OR = 2.1; 95% CI: 0.3–12.3), presence of other domestic species (small stock; OR = 4.6) and replacement from within the herd (OR = 3.2; 95% CI: 0.7–14.7). Zoonotic risk practices included raw milk consumption, shared housing and handling camels. Monitoring of zoonotic NTM through surveillance and notification systems is required.

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Section: Discussionmentioning

confidence: 99%

Isolation, identification and associated risk factors of non‐tuberculous mycobacteria infection in humans and dromedary camels in Samburu County, Kenya

Asaava

Githui

Mwangi

et al. 2020

Zoonoses and Public Health

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“…[27]. Recently, a longitudinal study identified that NTM infection is increasing in prevalence in the UK pediatric CF population from 1.3% to 3.8% between 2010 and 2015 with a sample size of 5333 patients under 16 years of age [28]. One study performed in Israel found a significant association between Aspergillus species and NTM species in sputum cultures of CF patients [29].…”

Section: M Abscessus and Cystic Fibrosismentioning

confidence: 99%

Mycobacterium abscessus: Environmental Bacterium Turned Clinical Nightmare

et al. 2019

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Mycobacteria are a large family of over 100 species, most of which do not cause diseases in humans. The majority of the mycobacterial species are referred to as nontuberculous mycobacteria (NTM), meaning they are not the causative agent of tuberculous (TB) or leprosy, i.e., Mycobacterium tuberculous complex and Mycobacterium leprae, respectively. The latter group is undoubtedly the most infamous, with TB infecting an estimated 10 million people and causing over 1.2 million deaths in 2017 alone TB and leprosy also differ from NTM in that they are only transmitted from person to person and have no environmental reservoir, whereas NTM infections are commonly acquired from the environment. It took until the 1950′s for NTM to be recognised as a potential lung pathogen in people with underlying pulmonary disease and another three decades for NTM to be widely regarded by the medical community when Mycobacterium avium complex was identified as the most common group of opportunistic pathogens in AIDS patients. This review focuses on an emerging NTM called Mycobacterium abscessus (M. abs). M. abs is a rapidly growing NTM that is responsible for opportunistic pulmonary infections in patients with structural lung disorders such as cystic fibrosis and bronchiectasis, as well as a wide range of skin and soft tissue infections in humans. In this review, we discuss how we came to understand the pathogen, how it is currently treated and examine drug resistance mechanisms and novel treatments currently in development. We highlight the urgent need for new and effective treatments for M. abs infection as well as improved in vivo methods of efficacy testing.

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“…The full texts of the remaining 38 records were read in full; 19 articles were excluded-seven because of the absence of a control group, one because of the small sample size (<6 NTM-positive patients), and 11 because of the lack of data on risk factors. A total of 19 studies 5,12,19,20,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] were finally included (Figure 1), totaling 23 418 patients, of whom 1421 (6%) patients were diagnosed as NTM positive.…”

Section: Study Selectionmentioning

confidence: 99%

“…The publication date of the included studies ranged from 1992 to 2019. Ten studies were conducted in Europe, 19,25,[27][28][29][30]32,33,35,37 seven in North America 5,12,24,26,34,36,38 and two in the Middle East 3,20 ( Table 1). Among the seven case-control studies, five were matched on age and sex, 19,24,27,29,32 one on respiratory function, 39 and one on cystic fibrosis transmembrane conductance regulator (CFTR) mutation.…”

Section: Description Of the Studiesmentioning

confidence: 99%

Risk factors for nontuberculous mycobacterial isolation in patients with cystic fibrosis: A meta‐analysis

Reynaud

Bricca

Cavalli

et al. 2020

Pediatric Pulmonology

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Background To better understand the mechanisms of infection with nontuberculous mycobacteria (NTM) in patients with cystic fibrosis (CF), we explore different risk factors associated with NTM positivity in a meta‐analysis. Methods Studies published before 31 July 2019 were selected from MEDLINE. Combined odds ratios (ORs) were calculated by pooling the ORs of each study. The weighted mean difference (WMD) was used for continuous numerical measurements. Summary data were pooled using fixed‐ or random‐effects models according to the presence of heterogeneity (P < .1 or I2 > 50%). Results Nineteen studies with a total of 23 418 patients, of whom 1421 (6%) were diagnosed as NTM positive, were included. Older age was significantly associated with NTM positivity (WMD = 2.12, 95% confidence interval [CI]: 1.11‐3.13; P < .01, fixed‐effects model). The OR for Staphylococcus aureus colonization was 1.66 (95% CI: 1.21‐2.26; P = .001) in 11 studies (8091 patients), the OR for Aspergillus fumigatus colonization was 3.59 (95% CI: 3.05‐4.23; P < .001) in 11 studies (20 480 patients), and the OR for Stenotrophomonas maltophilia colonization was 3.41 (95% CI: 2.66‐4.39; P < .01) in seven studies (14 935 patients). Oral corticosteroids were significantly associated with NTM positivity (OR = 1.98, 95% CI: 1.24‐3.16; P < .01, 6 studies, 1936 patients). No other factor showed a significant association. Conclusion Older age, S. aureus, S. maltophilia, and A. fumigatus chronic colonization, and oral corticosteroids were significantly associated with an increased risk of NTM positivity. CF patients with more severe conditions should be closely monitored for NTM.

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Epidemiology of Nontuberculous Mycobacteria Infection in Children and Young People With Cystic Fibrosis: Analysis of UK Cystic Fibrosis Registry

Abstract: NTM infection is of increasing prevalence in the UK paediatric CF population. This study highlights the urgent need for work to establish effective treatment and prevention strategies for NTM infection in young people with CF.

Cited by 34 publications

References 24 publications

Isolation, identification and associated risk factors of non‐tuberculous mycobacteria infection in humans and dromedary camels in Samburu County, Kenya

Isolation, identification and associated risk factors of non‐tuberculous mycobacteria infection in humans and dromedary camels in Samburu County, Kenya

Mycobacterium abscessus: Environmental Bacterium Turned Clinical Nightmare

Risk factors for nontuberculous mycobacterial isolation in patients with cystic fibrosis: A meta‐analysis

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