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Series of Case Patients with Nontuberculous Mycobacteria Isolation, Central North Carolina, 2006-2010
Citation:
Smith, G., J. Stout, K. Messier, Andy Ghio, AND E Hilborn. Series of Case Patients with Nontuberculous Mycobacteria Isolation, Central North Carolina, 2006-2010. Presented at International Society for Environmental Epidemiology Conference, Seattle, WA, August 24 - 28, 2014.
Impact/Purpose:
Mycobacterium avium is the most common nontuberculous mycobacteria (NTM) in the United States. It has been included on all three Contaminant Candidate Lists. NTM has a poorly characterized association with drinking water distribution systems. This abstract describes initial information about NTM isolation in human samples in three counties in NC. Preliminary results suggest that people served by surface sources of drinking water are more likely to experience NTM colonization or infection.
Description:
Nontuberculous mycobacteria (NTM) infection/colonization, associated with human morbidity/mortality, is linked to drinking water and drinking water distribution systems. To characterize rates and distribution of NTM isolation among residents living in three North Carolina counties with defined drinking water sources, we conducted population-based surveillance using microbiology laboratory reports of NTM isolation during 2006 – 2010. Isolation reports from hospitals, laboratories, and the state health department included unique identifiers, date of isolation, anatomic site of isolation, residence, age, gender, and race. Drinking water source was obtained by overlaying water service area polygons on geocoded patient residential addresses. U.S. census data (2010) was used to calculate rates. Positive NTM cultures were received from 759 patients in Wake, Durham, and Orange counties. Patients included 395 (53.6%) males and 345 (46.5%) females; 61.5% White, 24.8% Black, and 13.8% Other (36.8% missing). Mean age was 54 years (range 0-107). Among a subset of patients with location of residence (n=364), 22.0% used private wells; 78.0% received public drinking water. While the race distribution of patients was comparable to the population base, the age of patients was skewed towards the elderly. The study population of 53.6% males was higher than the base population (48.4% male). The overall prevalence (9.71/100,000) was higher than other studies, however it is unknown if this is due to differences in population, case ascertainment, or case definition. Pulmonary site isolation rates also increased with age but were not higher among whites or women, as observed in previous studies. The prevalence of isolation was lowest in black females. Additional studies identifying host susceptibility, drinking water source and other environmental risk factors are warranted to further characterize this potentially chronic infection. This abstract does not reflect EPA policy.