Surveillance of Extrapulmonary Nontuberculous Mycobacteria Infections, Oregon, USA, 2007–2012

Abstract

Limited data are available describing extrapulmonary nontuberculous mycobacteria (NTM) infections in the general population. We describe results from statewide population-based laboratory surveillance in Oregon, USA, during 2007–2012. We defined a case of extrapulmonary NTM infection as >1 isolate from skin/soft tissue, disseminated sites, lymph node, joint, or other sites. The annual incidence of extrapulmonary NTM infection (other than Mycobacterium gordonae) was stable, averaging 1.5 cases/100,000 population. Median age of the 334 patients was 51 years, and 53% of patients were female. Half of cases were caused by M. avium complex, but rapid-growing NTM species accounted for one third of cases. Most extrapulmonary NTM infections are skin/soft tissue. Compared with pulmonary NTM infection, more extrapulmonary infections are caused by rapid-growing NTM species. the designation of NTM as a reportable disease in Oregon in 2014 will result in better detection of changes in the incidence and patterns of disease in the future.

Epidemiology of Nontuberculous Mycobacteriosis

“…Additionally, while half of the cases identified had MAC, rapid-growing NTM species were identified at a much greater frequency than among PNTM patients within the state and represented a third of all cases. 80 These findings are similar to results from another recent study utilizing a large electronic medical record database, with linked laboratory, demographic, and clinical information for hospitalized patients from 156 hospitals throughout the United States between 2005 and 2015. 81 There, extrapulmonary NTM incidence was estimated at 1.9 cases per 100,000 persons, 55% of which represented skin and soft-tissue infections.…”

“…Individuals susceptible to extrapulmonary NTM infections, especially disseminated disease, typically include those with other comorbidities that result in a compromised immune system, such as underlying immunologic disorders and HIV infection. 80,81 Additionally, unlike PNTM disease, extrapulmonary NTM infections can be associated with medical or cosmetic procedures that expose a wound to sources contaminated with mycobacteria. 82 While population-based studies exist for PNTM, few current studies describe the epidemiology of extrapulmonary NTM in the United States.…”

“…One recent study in Oregon evaluated the prevalence of extrapulmonary NTM using statewide population-based laboratory surveillance data from 2007 to 2012. 80 These researchers estimated an annual incidence of extrapulmonary NTM infection of 1.5 cases per 100,000 population, which was stable over time. Extrapulmonary NTM patients were younger on average than PNTM patients, with a median age of 51 years.…”

Mycobacterium kumamotonense in the cervical region in an immunocompetent patient, clinical case report in Mexico

“…Clinically, these cases are characterized by presenting pulmonary symptoms and in the CAT scan nodular images, caverns and bronchiectasis are shown. Unlike what was found in the literature, our patient is male, under 35 years old, with extrapulmonary condition, without relevant risk factors and has no respiratory compromise [6,14].…”

“…The commonly involved agents are Mycobacterium avium complex, Mycobacterium gordonae and Mycobacterium xenopi [5]. Extrapulmonary forms predominate in the female gender with an average age of 50 years, and they are more frequent in skin and soft tissues, followed by disseminated disease and cervical lymphadenopathy [6].…”