Mycobacterium avium complex Pulmonary Disease in Patients Without HIV Infection

Field, Stephen K.; Fisher, Dina; Cowie, Robert L.

doi:10.1378/chest.126.2.566

Cited by 284 publications

(212 citation statements)

References 131 publications

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“…Although other studies have estimated the prevalence of PNTM within specific geographic areas in the United States (4-6), this is the first study to provide nationally representative estimates among older adults from all 50 states plus the District of Columbia and across various racial/ethnic groups. The ability to define the burden of PNTM across an 11-year period is important given the often chronic nature of this disease (12,13).…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…However, M. avium and other NTM can cause pulmonary disease in healthy people, as well as those predisposed to pulmonary infection. In many centers, NTM now outnumber M. tuberculosis detections in clinical mycobacteriology labs (39,40). Risk factors associated with NTM pulmonary infection include smoking, chronic lung disease, alcoholism, and pulmonary or immune genetic defects (5,40).…”

Section: Discussionmentioning

confidence: 99%

Opportunistic pathogens enriched in showerhead biofilms

Feazel

Baumgartner²,

Peterson³

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

483

364

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The environments we humans encounter daily are sources of exposure to diverse microbial communities, some of potential concern to human health. In this study, we used culture-independent technology to investigate the microbial composition of biofilms inside showerheads as ecological assemblages in the human indoor environment. Showers are an important interface for human interaction with microbes through inhalation of aerosols, and showerhead waters have been implicated in disease. Although opportunistic pathogens commonly are cultured from shower facilities, there is little knowledge of either their prevalence or the nature of other microorganisms that may be delivered during shower usage. To determine the composition of showerhead biofilms and waters, we analyzed rRNA gene sequences from 45 showerhead sites around the United States. We find that variable and complex, but specific, microbial assemblages occur inside showerheads. Particularly striking was the finding that sequences representative of non-tuberculous mycobacteria (NTM) and other opportunistic human pathogens are enriched to high levels in many showerhead biofilms, >100-fold above background water contents. We conclude that showerheads may present a significant potential exposure to aerosolized microbes, including documented opportunistic pathogens. The health risk associated with showerhead microbiota needs investigation in persons with compromised immune or pulmonary systems.bioaerosols ͉ Mycobacterium avium complex ͉ Non-tuberculous mycobacteria ͉ public health ͉ rRNA metagenomics

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“…Despite ubiquitous in the environment, MAC infections occur rarely in immunocompetent hosts, affecting mostly those with depressed immunity or with underlying lung diseases [102] . MAC is the most common cause of lung nontuberculosis and its rate of infection is globally increasing, especially in Japan [103] .…”

Section: Pulmonary Mac Infectionmentioning

confidence: 99%

HLA Loci and Respiratory Infectious Diseases

Spínola

2016

Journal of Respiratory Research

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The HLA system harbour a wide set of genes that plays an important role in the regulation and action of the immune system against invading pathogens, making them natural candidates for research on the genetic susceptibility for respiratory infections. Thus, along past decades, this topic has been subject to intense research and, consequently, several alleles of those loci have been implicated in the ability, more or less effective, to tackle and control invading pathogens in the respiratory system. Current editorial introduce, revise, summarize and comment the major advances in the role of HLA genes for the development of, and protection against, respiratory infectious disease. A general picture is drawn and new challenges on the field are relocated, especially those that might enlighten respiratory diseases aetiology and, thus, contribute in advances for diagnosis and treatment.

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Mycobacterium avium complex Pulmonary Disease in Patients Without HIV Infection

Cited by 284 publications

References 131 publications

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

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

Opportunistic pathogens enriched in showerhead biofilms

HLA Loci and Respiratory Infectious Diseases

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