Global prevalence of non-tuberculous mycobacteria in adults with non-cystic fibrosis bronchiectasis 2006–2021: a systematic review and meta-analysis

Abstract

ObjectiveTo accurately estimate the global prevalence of non-tuberculous mycobacteria (NTM) in adults with non-cystic fibrosis (non-CF) bronchiectasis and to determine the proportion of NTM species and subspecies in clinical patients from 2006 to 2021.DesignSystematic review and meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesMedline, Embase, Cochrane Library and Web of Science were searched for articles published between 2006 and 2021.Eligibility criteria for selecting studiesWe included all the prospective or retrospective studies without language restrictions and all patients were adults (≥18 years of age) with non-CF bronchiectasis. The studies estimated the effect size of the prevalence of NTM with a sample size ≥40, and patients were registered in and after 2006.Data extraction and synthesisTwo reviewers screened the titles, abstracts and full texts independently. Relevant information was extracted and curated into tables. Risk of bias was evaluated following the Cochrane Collaboration’s tool. Meta-analysis was performed with software R Statistics V.3.6.3 using random effect model with 95% CI. I2 index and Q statistics were calculated to assess the heterogeneity, and mixed-effects meta-regression analyses were performed to identify the sources of heterogeneity. The proportions of NTM subspecies were examined using Shapiro-Wilk normality test in R.ResultsOf all the 2014 studies yielded, 24 met the inclusion criteria. Of these, 14 were identified to be randomised controlled studies and included for an accurate estimation. The global prevalence of NTM in adults with non-CF bronchiectasis from 2006 to 2021 was estimated to be approximately 10%, with great variations primarily due to geographical location. Mycobacterium avium complex was the most common subspecies, followed by Mycobacterium simiae and Mycobacterium gordonae.ConclusionsThe prevalence of NTM in adults with non-CF bronchiectasis has been on the rise and the most common subspecies changed greatly in recent years. More cohort studies should be done in many countries and regions for future estimates.PROSPERO registration numberCRD42020168473.

Prevalence of Non-Tuberculosis Mycobacterium Pulmonary Disease in HIV-1 Patients with Presumptive Pulmonary Tuberculosis in Western Kenya

“…Consistent with previous studies on M. avium complex (MAC), a slow-growing mycobacterium has been reported to be the most prevalent ( 31 ). This bacteria has been shown to account for the majority of cases in patients with NTMPD ( 32 , 33 ). Additionally, M. fortuitum was the second most abundant NTM at 26.7% (95%, 6.8 - 10.4 CI).…”

Bacteriophage infection and killing of intracellular Mycobacterium abscessus

“…Mycobacterium abscessus ( M. abscessus ), a nontuberculous mycobacteria (NTM), is a highly drug-resistant bacterial pathogen in need of effective therapies. M. abscessus cases are increasing worldwide, and they are a particular concern for people with compromised immune systems and those with muco-obstructive lung diseases such as cystic fibrosis (CF), chronic obstructive pulmonary disease, and non-CF bronchiectasis ( 14 – 18 ). Due to its inherent and acquired antibiotic resistance, M. abscessus is extremely difficult to treat ( 19 – 23 ).…”

Lady Windermere syndrome with haemoptysis: suspected pulmonary aspergilloma and MAC pulmonary disease

“…It might be associated with connective tissue disorders like pectus excavatum, mitral prolapse, tall stature or scoliosis 3. The incidence and prevalence of NTM infections are rising in the USA and worldwide; however, exact numbers are unknown as disease is not notifiable 4. This condition is challenging to diagnose, and the treatment requires a complex multidrug regimen over an extended period of time, which is often poorly tolerated.…”