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Epidemiology of nontuberculous mycobacteria isolations among central North Carolina residents, 2006-2010
Citation:
Smith, G., Andy Ghio, J. Stout, K. Messier, E. Hudgens, M. Murphy, S. Pfaller, J. Maillard, AND E Hilborn. Epidemiology of nontuberculous mycobacteria isolations among central North Carolina residents, 2006-2010. Journal of Infection. Elsevier B.V., Amsterdam, Netherlands, 72(6):678-86, (2016).
Impact/Purpose:
Mycobacterium avium is the representative nontuberculous mycobacterium included in all three Contaminant Candidate Lists, and M. avium is the most commonly detected nontuberculous mycobacterium (NTM) in the United States. However, NTM are not notifiable diseases in the US, so the public health burden associated with this group of pathogens is poorly defined. We performed laboratory-based surveillance for NTM isolations in central North Carolina over a five year period. We found that pulmonary isolations were most common, and generally increased with age. However, our report is unique in reporting higher rates of extrapulmonary isolations among middle-aged black men. This may be due to differences in underlying health status when compared to reports of NTM isolation from other geographic areas.
Description:
BACKGROUND: Nontuberculous mycobacteria (NTM) are environmental mycobacteria associated with a range of infections. Reports of NTM epidemiology have primarily focused on pulmonary infections and isolations, however extrapulmonary infections of the skin, soft tissues and sterile sites are less frequently described.METHODS: We comprehensively reviewed laboratory reports of NTM isolation from North Carolina residents of three counties during 2006-2010. We describe age, gender, and race of patients, and anatomic site of isolation for NTM species.RESULTS:Among 1033 patients, overall NTM isolation prevalence was 15.9/100,000 persons(13.7/100,000 excluding Mycobacterium gordonae). Prevalence was similar between genders and increased significantly with age. Extrapulmonary isolations among middle-aged black males and pulmonary isolations among elderly white females were most frequently detected. Most isolations from pulmonary sites and blood cultures were Mycobacterium avium complex; rapidly growing NTM (e.g. Mycobacterium chelonae, Mycobacterium fortuitum) were most often isolated from paranasal sinuses, wounds and skin.CONCLUSIONS: We provide the first characterization of NTM isolation prevalence in the Southeastern United States (U.S.). Variation in isolation prevalence among counties and races likely represent differences in detection, demographics and risk factors. Further characterization of NTM epidemiology is increasingly important as percentages of immunocompromised individuals and the elderly increase in the U.S.
