The Occurrence of Nontuberculous Mycobacteria in the United States.

摘要

Although international data indicate that the prevalence of nontuberculous mycobacteria (NTM) disease is on the rise, data on the prevalence and patterns of disease in the United States are not readily available. The purpose of this study was to determine the frequency and geographic distribution of NTM diseases in the United States and to determine any comorbid conditions associated with NTM occurrence, including chronic obstructive pulmonary disease, bronchiectasis, Alpha-1 Antitrypsin deficiency, asthma, and scoliosis. The epidemiological triangle conceptual framework and a case control study design were used to determine the associations between geographical location, age, sex, comorbid conditions; and specific NTM diseases. Deidentified archived data (2008-2011) were acquired from the Laboratory Information System (LIS) SunquestRTM and the Electronic Medical Records (EMR). The LIS dataset (n = 3422) contained frequency and location and the EMR (n = 27030) contained comorbid conditions. Findings indicated that geography, age, and sex were all associated with NTM diagnosis and logistic regression analysis showed that the likelihood of having NTM disease increased with comorbid conditions including scoliosis, AAT deficiency, and bronchiectasis. The positive social change aspect of this study provides improved understanding of NTM epidemiology in the United States, including NTM infection likelihood with regards to comorbid conditions. This study also defines expected organism distribution within specific geographic regions. The results of this analysis should assist physicians when determining disease in patients, thereby resulting in progress toward a reduction in morbidity associated with NTM disease.