Incidence of nontuberculous mycobacteria infections among persons with cystic fibrosis in the United States (2010–2019)

Marshall, Julia E.; Mercaldo, Rachel A.; Lipner, Ettie M.; Prevots, D. Rebecca

doi:10.1186/s12879-023-08468-6

Cited by 15 publications

(5 citation statements)

References 19 publications

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“…This study identified the East South Central Region (included in the Southeast) and the Northeast as having the highest proportion of positive MAC cultures in the U.S. [ 24 ]. This is consistent with our prior study, which found the Northeast had the highest burden of MAC in the cystic fibrosis population [ 8 ].…”

Section: Discussionsupporting

confidence: 93%

“…Exposure to pathogenic NTM species occurs primarily through drinking water, soil, and aerosols [ 1 ]. NTM risk and species-specific trends vary across the United States (U.S.) [ 4 – 7 ], but overall infection and disease incidence and prevalence are increasing in the United States [ 3 , 8 ]. This geographic variation is associated with differences in environmental factors [ 7 , 9 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some states, such as Florida and Hawaii, have been identified as NTM ‘hotspots’ [ 7 , 15 , 16 ]. NTM incidence and prevalence are increasing across U.S. regions [ 2 , 3 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Nontuberculous mycobacteria testing and culture positivity in the United States

Marshall,

Mercaldo,

Lipner

et al. 2024

BMC Infect Dis

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Background Nontuberculous mycobacteria (NTM) are environmental bacteria which may cause chronic lung disease. The prevalence of NTM pulmonary infection and disease has been increasing in the United States and globally. The predominant clinically relevant species of NTM in the United States are Mycobacterium avium complex (MAC) species and Mycobacterium abscessus. With the development of rapid species identification methods for NTM (e.g. PCR probes), more testing for NTM is being conducted through commercial labs, such as Laboratory Corporation of America (Labcorp), which provides deidentified real-time testing data to the Centers for Disease Control (CDC) pursuant to a data sharing agreement. Because NTM lung infections are not reportable in most states, other data sources are key to understanding NTM testing patterns, positivity rates, and species distributions to track infection trends and identify clinical care needs. Methods We obtained national Labcorp data for the period January 2019 through mid-April 2022. We subset the data to only respiratory samples sent for Acid Fast Bacilli (AFB) cultures. NTM positive results were defined as those which identified an NTM species and are not Mycobacterium tuberculosis, Mycobacterium bovis, or Mycobacterium gordonae. Results Overall, 112,528 respiratory samples were sent for AFB testing during the study period; 26.3% were from the Southeast U.S., identified as HSS Region IV in the Labcorp dataset, and 23.0% were from the Pacific and South Pacific region (Region IX). The culture positive prevalence ranged from 20.2% in the Southeast to 9.2% in the East North Central region (Region V). In the Southeast US, M. abscessus prevalence was 4.0%. For MAC, the highest prevalence was observed in the Mountain region (Region VII) (13.5%) and the lowest proportion was in the East South Central region (7.3%, Region III). Among positive tests, the proportion which was MAC varied from 61.8% to 88.9% and was highest in the Northeast U.S. The proportion of positive samples which were M. abscessus ranged from 3.8% to 19.7% and was highest in the Southeast. Conclusions The Southeastern region of the U.S. has the highest rate of culture positivity in Labcorp tests for total NTM and, of all positive tests, the highest proportion of M.abscessus. These estimates may underrepresent the true number of M.abscessus infections because M. absesscus-specific probes are not commercially available and not all NTM testing in the United States is done by Labcorp. Analysis of real-time testing data from commercial laboratories may provide insights into risk factors for NTM culture positivity in ‘hotspot’ areas.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Nontuberculous mycobacteria testing and culture positivity in the United States

Marshall,

Mercaldo,

Lipner

et al. 2024

BMC Infect Dis

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“…Global incidence rate of non-tuberculous mycobacteria (NTM) pulmonary disease has been increasing rapidly ( 1 , 2 ). In the United States, the infection rate and prevalence of NTM exceed those of tuberculosis (TB) ( 3-5 ).…”

Section: Introductionmentioning

confidence: 99%

CT‑based radiomics analysis of consolidation characteristics in differentiating pulmonary disease of non‑tuberculous mycobacterium from pulmonary tuberculosis

Yan,

Zhao,

Kong

et al. 2024

Exp Ther Med

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Global incidence rate of non-tuberculous mycobacteria (NTM) pulmonary disease has been increasing rapidly. In some countries and regions, its incidence rate is higher than that of tuberculosis. It is easily confused with tuberculosis. The topic of this study is to identify two diseases using CT radioomics. The aim in the present study was to investigate the value of CT-based radiomics to analyze consolidation features in differentiation of non-tuberculous mycobacteria (NTM) from pulmonary tuberculosis (TB). A total of 156 patients (75 with NTM pulmonary disease and 81 with TB) exhibiting consolidation characteristics in Shandong Public Health Clinical Center were retrospectively analyzed. Subsequently, 305 regions of interest of CT consolidation were outlined. Using a random number generated via a computer, 70 and 30% of consolidations were allocated to the training and the validation cohort, respectively. By means of variance threshold, when investigating the effective radiomics features, SelectKBest and the least absolute shrinkage and selection operator regression method were employed for feature selection and combined to calculate the radiomics score. K-nearest neighbor (KNN), support vector machine (SVM) and logistic regression (LR) were used to analyze effective radiomics features. A total of 18 patients with NTM pulmonary disease and 18 with TB possessing consolidation characteristics in Jinan Infectious Disease Hospital were collected for external validation of the model. A total of three methods was used in the selection of 52 optimal features. For KNN, the area under the curve (AUC; sensitivity, specificity) for the training and validation cohorts were 0.98 (0.93, 0.94) and 0.90 (0.88, 083), respectively; for SVM, AUC was 0.99 (0.96, 0.96) and 0.92 (0.86, 0.85) and for LR, AUC was 0.99 (0.97, 0.97) and 0.89 (0.88, 0.85). In the external validation cohort, AUC values of models were all >0.84 and LR classifier exhibited the most significant precision, recall and F1 score (0.87, 0.94 and 0.88, respectively). LR classifier possessed the best performance in differentiating diseases. Therefore, CT-based radiomics analysis of consolidation features may distinguish NTM pulmonary disease from TB.

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“…2 Hospitalizations from NTM, P. aeruginosa, and L. pneumophila account for 44%, 13%, and 9%, respectively, of waterborne infection hospitalizations in the U.S., and NTM is responsible for the greatest percentage of total deaths, 57% (note: these numbers are underestimated due to underreporting of actual infections emerging from the reporting process). 6 Despite a range in existing disinfection regimens, 5 there remains a growing number of reports attributing waterborne infectious disease outbreaks to DWPIs [7][8][9] with the incidence of legionellosis 7 and NTM 8 pulmonary diseases continuing to increase in the USA. As a result, L. pneumophila, Mycobacterium avium, Mycobacterium abscessus, and P. aeruginosa are on the current U.S. EPA's contaminant candidate list.…”

Section: Introductionmentioning

confidence: 99%