Nontuberculous Mycobacterial Lung Infections in Ontario, Canada: Clinical and Microbiological Characteristics

Marras, Theodore K.; Mehta, Mauli; Chedore, Pamela; May, Kevin; Al-Houqani, Mohammed; Jamieson, Frances

doi:10.1007/s00408-010-9241-8

Cited by 48 publications

(42 citation statements)

References 37 publications

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“…Among Oregon residents with PNTM, only 16% had bronchiectasis (42), and in a study of non-AIDS PNTM-associated hospitalizations, 15% also had bronchiectasis (5), although these studies both included patients less than 65 years old. Among patients in Canada more than 56 years old meeting ATS criteria for NTM infection, 62% had nodular bronchiectasis (43). Although bronchiectasis may increase susceptibility to NTM infection, infection with NTM likely also exacerbates bronchiectasis.…”

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

581

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

581

466

View full text Add to dashboard Cite

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“…Studies from Ontario, Oregon and Denmark showed that both populations look strikingly similar in terms of socio-demographic and clinical characteristics and both have poor survival. 24,42,43 Among Danish patients (mean age about 60 years), the 5-year mortality was 33.5% in NTM colonization and 40.1% in NTM disease with no statistical difference. 24 While NTM species and disease severity contribute to mortality, 44,45 deaths are predominately caused by comorbidities rather than the NTM infection.…”

Section: Discussionmentioning

confidence: 99%

Health‐related quality of life, comorbidities and mortality in pulmonary nontuberculous mycobacterial infections: A systematic review

et al. 2016

Self Cite

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Nontuberculous mycobacterial (NTM) infections are increasing in disease frequency worldwide. This systematic review examines health-related quality of life (HRQOL), comorbidities and mortality associated with pulmonary NTM disease. We searched MEDLINE, EMBASE, CINAHL, Scopus Life Sciences, conference proceedings and Google (earliest date available to February 2015) for primary studies. Eligible studies compared populations with and without pulmonary NTM disease in high-income jurisdictions. We excluded studies on HIV/AIDS. All languages were accepted. Two reviewers followed MOOSE and PRISMA reporting guidelines and independently appraised quality using STROBE. All studies were summarized qualitatively regardless of quality. Of 3193 citations screened, we included 17 studies mostly from Taiwan (n = 5) and the USA (n = 4). Two studies assessed HRQOL; one assessed comorbidities, 11 assessed mortality, and three assessed multiple outcomes. Populations with pulmonary NTM reported significantly worse or similar HRQOL than the general population, depending on the instruments used. Some suggested greater prevalence of having bronchiectasis (n =2) and greater risk of developing pulmonary tuberculosis (n = 1). Most (n = 7) suggested no difference in mortality, although only one was agematched and gender-matched to the general population. Four suggested NTM populations had higher mortality-two of which compared with the general population and were deemed of high quality, while two compared with non-NTM patients from hospital. High clinical heterogeneity in study design may explain discordant results. Bias assessments and controlling for confounding were carried out poorly. No consistent trends were observed although there is suggestion of an increased health burden from respiratory diseases and increased mortality associated with pulmonary NTM disease.

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“…Still, PPV of stricter microbiologic criteria was considerably higher when compared to ATS/IDSA microbiologic criteria (93.3% vs. 59.8%). 4,17,18 Thus, to prevent unwarranted diagnoses and treatment of NTM disease, as well as unnecessary diagnostic delay, it could be helpful to use separate, more stringent criteria for species of low relevance, and less stringent criteria for species considered to be of high clinical relevance in the local setting. This aspect should be covered in the upcoming diagnostic criteria.…”

Section: Criteria Correlationmentioning

confidence: 99%

Microbiological criteria in non-tuberculous mycobacteria pulmonary disease: a tool for diagnosis and epidemiology

Janković¹,

Sabol²,

Žmak³

et al. 2016

int j tuberc lung dis

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Nontuberculous Mycobacterial Lung Infections in Ontario, Canada: Clinical and Microbiological Characteristics

Abstract: Women comprised a small majority with disease. Nodular bronchiectasis in women was most common, but significant proportions of each gender with each radiographic type were observed. NTM isolation, particularly MAC, was frequently associated with disease.

Cited by 48 publications

References 37 publications

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

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

Health‐related quality of life, comorbidities and mortality in pulmonary nontuberculous mycobacterial infections: A systematic review

Microbiological criteria in non-tuberculous mycobacteria pulmonary disease: a tool for diagnosis and epidemiology

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