Increasing Non-tuberculous Mycobacteria Infections in Veterans With COPD and Association With Increased Risk of Mortality

Abstract

Background: There are limited data on the epidemiology of Non-tuberculous mycobacteria (NTM) infections among patients with COPD, particularly in the veteran population. This study examined the prevalence, incidence, and mortality of pulmonary NTM infections among veterans with COPD population in the United States.Methods: We analyzed nationwide data from Veterans Affairs Hospitals from 2001 to 2015. First, we determined the incidence and prevalence rates and geographic distribution of NTM infections among veterans with COPD and then we evaluated the association between NTM infections with mortality among veterans with COPD. Pulmonary NTM and COPD diagnosis were defined based on charting claims for each condition on ≥2 occasions and ≥30 days apart. COPD diagnoses had to precede diagnosis of NTM. Cox Proportional-Hazards Regression was performed to determine the dependency of survival time of COPD patients with NTM.Results: The incidence and prevalence rates of NTM rose over the study period, with a sharp rise in incidence after 2012. The areas with the highest NTM period prevalence were Puerto Rico (370), followed by Florida (351) and District of Columbia (309) in 100,000 COPD population. Mortality registered for those patients with COPD Patients and NTM infection was 1.43 times higher compared to those that were uninfected.Conclusions: NTM rates have been increasing in veterans with COPD since 2012. NTM infection is associated with increased risk of mortality. This highlights the importance of identifying preventable risk factors associated with NTM infections in subjects with COPD.

Pulmonary nontuberculous mycobacterial disease in Florida and association with large-scale natural disasters

“…Mycobacteria are commonly found in water or moist soil environments. Pre-existing lung diseases (bronchiectasis, chronic obstructive pulmonary disease (COPD), and asthma), immunocompromised conditions, and certain genetic disorders [ 2 – 4 ], increase human susceptibility to NTM related disease.…”

“…In recent years, the incidence of pulmonary NTM disease has gradually increased in the United States (U.S.) [ 5 ] up to 8% each year [ 6 , 7 ]. The prevalence of pulmonary NTM disease varies regionally, with higher rates in coastal areas [ 4 ]. The cause of this rise in some of the states can be attributed to favorable environmental conditions which promotes the survival of mycobacterium [ 8 ].…”

Different source of sample strains corresponds to different characteristics of patients with non-tuberculous mycobacterium

“…The association between COPD and pulmonary NTM disease has been increasingly reported, but whether NTM infection increases the risk of COPD or COPD results in high risk of NTM infection has not been clearly clari ed [2,[16][17][18][19]. Patients with COPD are more susceptible to NTM infection than those with other chronic pulmonary diseases [20,21] (except cystic brosis), and inhaled corticosteroids increase the risk of NTM infection [19].…”

Non-Tuberculous Mycobacteria in Respiratory Specimens of Patients with Obstructive Lung Diseases—Colonization or Disease?

“…Nevertheless, NTM-LD worsens life quality and expectancy in COPD patients and thus it should be diagnosed and treated, if possible [13]. The treatment result depends, among others, on the type of mycobacteria and susceptibility to recommended drugs [1].…”