Lung Disease Due to the More Common Nontuberculous Mycobacteria

Field, Stephen K.; Cowie, Robert L.

doi:10.1378/chest.129.6.1653

Cited by 190 publications

(138 citation statements)

References 234 publications

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“…Although other studies have estimated the prevalence of PNTM within specific geographic areas in the United States (4-6), this is the first study to provide nationally representative estimates among older adults from all 50 states plus the District of Columbia and across various racial/ethnic groups. The ability to define the burden of PNTM across an 11-year period is important given the often chronic nature of this disease (12,13).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Nontuberculous Mycobacterial Lung Disease in U.S. Medicare Beneficiaries

Adjemian

Olivier

Seitz

et al. 2012

Am J Respir Crit Care Med

594

466

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Rationale: Pulmonary nontuberculous mycobacteria (PNTM) are an important cause of morbidity among older adults in the United States, but national prevalence estimates are lacking. Objectives: To describe the prevalence and trends of PNTM disease among adults aged 65 years or older throughout the United States. Methods: A nationally representative 5% sample of Medicare Part B beneficiaries was analyzed from 1997 to 2007. Demographic and medical claims data were compiled and prevalence estimates for PNTM and selected comorbidities were calculated and trends over time evaluated. Logistic regression was used to identify demographic and geographic factors associated with PNTM. Measurements and Main Results: From 1997 to 2007, the annual prevalence significantly increased from 20 to 47 cases/100,000 persons, or 8.2% per year. The period prevalence was 112 cases/100,000 persons, although prevalence was twofold higher among Asians/Pacific Islanders than among whites (228 vs. 116 cases/100,000 persons). Western states had the highest period prevalence at 149 cases/ 100,000 persons, with Hawaii having the highest prevalence at 396 cases/100,000 persons, followed by southeastern states, which had a period prevalence of 131 cases/100,000 persons. PNTM cases had more comorbid conditions than noncases and were 40% more likely to die than noncases. Women were 1.4 times more likely to be a PNTM case than men. Relative to whites, Asians/Pacific Islanders were twice as likely to be a case, whereas blacks were half as likely. Conclusions: The prevalence of PNTM is increasing across all regions of the United States and among both men and women. Significant racial/ethnic and geographic differences suggest important geneenvironment interactions.Keywords: nontuberculous mycobacteria; pulmonary; epidemiology; prevalence; United States Nontuberculous mycobacteria (NTM) have been increasingly recognized as an important cause of morbidity in the United States. NTM are ubiquitous in the environment, frequently detected in soil and water samples as well as in biofilms that form in municipal water sources (1). Exposure is typically believed to originate from exposure to environmental sources (2). Although severe infection can affect the lymph nodes, skin, soft tissues, bones, and joints, the vast majority of disease is pulmonary (3). More than 140 NTM species have been identified, although approximately 80% of pulmonary NTM (PNTM) infections in the United States are associated with Mycobacterium avium complex, and prevalence varies by geographic region (4).Recent studies suggest that the prevalence of PNTM disease is increasing throughout the United States (4, 5), especially among older adults (4, 5). Women appear to bear a disproportionate burden of PNTM disease (4, 6), with several studies identifying physical correlates of risk for PNTM (7). Although the increased risk of PNTM among older adults is well established, disease prevalence estimates vary widely by geographic region. Characterizing PNTM disease distribution by region, sex, age,...

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Section: Discussionmentioning

confidence: 99%

Prevalence of Nontuberculous Mycobacterial Lung Disease in U.S. Medicare Beneficiaries

Adjemian

Olivier

Seitz

et al. 2012

Am J Respir Crit Care Med

594

466

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“…chest radiograph and CT), will probably provide the first clues in investigating these diseases, however, it is often difficult to distinguish them based on those tests alone. MAC infections typically manifest either cavitary lesions or fibronodular bronchiectasis in radiological examinations, with the latter being predominant among elderly women without immunosuppression [5]. The radiological manifestations of the present patient fall into this category, although nodules and masses were prominent.…”

Section: Discussionmentioning

confidence: 55%

“…Transbronchial lung biopsy specimens obtained from the left S 1+2 demonstrated granulomatous lesions accompanied by multinucleated giant cells, suggesting mycobacterial infection. Since M. intracellulare was identified by PCR in the bronchial washings recovered in the same examination, she was diagnosed as having pulmonary MAC infection [1,5]. Cytology was negative in the specimen.…”

Section: Case Reportmentioning

confidence: 99%

Concurrent Lung Cancer in Non-Tuberculous Mycobacteriosis: Case Report

Koga¹,

Sato²,

Kamimura³

et al. 2011

Kurume Med. J.

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Summary:An 82-year-old woman was admitted to our hospital after multiple round opacities were detected in chest X-rays performed during a routine health screening. Mycobacterium avium complex (MAC) was found in sputum cultures, and compatible pathological findings on biopsy confirmed pulmonary MAC infection, whereas biopsies from another opacity revealed adenocarcinoma of the lung. Curative surgery for the lung cancer confirmed a concurrence of lung cancer and pulmonary MAC infection. Since the prevalence of both of these lung diseases is increasing, suspicion of concurrence is critical to provide appropriate care.

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“…Previously, only a few experts worldwide had compiled empirical data and disseminated knowledge on the subject, which was based upon meticulous observations in small series or case studies from the 1950s onwards [3]. These studies demonstrated the manifold particularities of M. avium complex disease and others as compared with tuberculosis, and also showed how even nontuberculous mycobacterial lung diseases alone, quite apart from manifestations in other organs, appear in widely varying forms.…”

mentioning

confidence: 99%

“…Rapid and precise recognition of species using fluid cultures and the methods of molecular biology has already become routine. New drugs, such as clarithromycin and moxifloxacin, but not so much rifabutin, should improve treatment results in daily practice [3,15]. In future, we may also expect to obtain faster and more differentiated information on the properties of nontuberculous mycobacterial strains with the aid of microarray techniques [16].…”

mentioning

confidence: 99%

The mycobacterial mystery

Schönfeld¹

2006

Eur Respir J

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Lung Disease Due to the More Common Nontuberculous Mycobacteria

Cited by 190 publications

References 234 publications

Prevalence of Nontuberculous Mycobacterial Lung Disease in U.S. Medicare Beneficiaries

Prevalence of Nontuberculous Mycobacterial Lung Disease in U.S. Medicare Beneficiaries

Concurrent Lung Cancer in Non-Tuberculous Mycobacteriosis: Case Report

The mycobacterial mystery

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