Mycobacterial Testing Trends, United States, 2009–20151

Dean, Samantha; Ricotta, Emily; Fintzi, Jonathan; Lai, Yanhao; Kadri, Sameer S; Olivier, Kenneth N.; Zelazny, Adrian M.; Prevots, D. Rebecca

doi:10.3201/eid2609.200749

Cited by 15 publications

(6 citation statements)

References 11 publications

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“…Nontuberculous mycobacteria (NTM) are ubiquitous environmental bacteria which are increasingly associated with pulmonary infections (PI) in both the general population and in high-risk groups [ 1 , 2 ]. Persons with cystic fibrosis (pwCF) are at particularly high risk for NTM PI in the United States (U.S.).…”

Section: Introductionmentioning

confidence: 99%

“…The Institutional Review Board (IRB) of the NIH follows all international ethics rules, regulations, and standards. This research protocol was reviewed by NIH OHSRP, which determined that analyses of CFFPR data was “not human subjects research”, under the 2018 HHS Common Rule (45 CFR 46.102(e)[ 1 ](ii), 45 CFR 46.116 (b)[ 9 ](i)), because of the use of deidentified data and, accordingly, exempt from IRB review. For inclusion in the CFFPR, written informed consent was obtained from all subjects and their legal guardian(s) by accredited CF care centers.…”

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confidence: 99%

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

Marshall¹,

Mercaldo²,

Lipner³

et al. 2023

BMC Infect Dis

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Background Nontuberculous mycobacteria (NTM) are ubiquitous, environmental bacteria that can cause chronic lung disease. Persons with cystic fibrosis (pwCF) are at high risk for NTM. Approximately 1 in 5 pwCF in the United States (U.S.) is affected by pathogenic NTM species, and incidence rates of NTM have been increasing among pwCF as well as in the general population. Prevalence of NTM pulmonary infections (PI) varies widely across the United States because of geographic variation in environmental exposures. This study will present updated region-level incidence of NTM infections in the cystic fibrosis (CF) population in the U.S. Methods We used the Cystic Fibrosis Foundation Patient Registry (CFFPR) data for the period 2010 through 2019. Our study population comprised persons with CF ≥ 12 years of age who had been tested for NTM PI. We included only registry participants with NTM culture results. We defined incident cases as persons with one positive mycobacterial culture preceded by ≥ two negative mycobacterial cultures. We defined non-cases as persons with ≥ two negative mycobacterial cultures. We estimated average annual NTM PI incidence by region. Using quasi-Poisson models, we calculated annual percent change in incidence by region. Results We identified 3,771 incident NTM infections. Of these cases, 1,816 (48.2%) were Mycobacterium avium complex (MAC) infections and 960 (25.5%) were Mycobacterium abscessus infections. The average annual incidence of NTM PI among pwCF in the U.S. was 58.0 cases per 1,000 persons. The Northeast had the highest incidence of MAC (33.5/1,000 persons tested) and the South had the highest incidence of M. abscessus (20.3/1,000 persons tested). From 2010 to 2019, the annual incidence of total NTM PI increased significantly by 3.5% per year in the U.S. Conclusions NTM PI incidence is increasing among pwCF. Identifying high risk areas and increasing trends is important for allocating public health and clinical resources as well as evaluating interventions.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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

Marshall¹,

Mercaldo²,

Lipner³

et al. 2023

BMC Infect Dis

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“…Nontuberculous mycobacteria (NTM) are highly prevalent in the environment, and pathogenic species can cause chronic lung disease [1][2][3]. Two highly prevalent, clinically relevant species in the United States (U.S.) are Mycobacterium avium complex (MAC) species and Mycobacterium abscessus species.…”

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%

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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“…Non-tuberculous mycobacteria (NTM) can cause opportunistic infection and present a threat to public health ( 1 ). To date, more than 270 species/subspecies of NTM have been identified ( http://www.bacterio.net/mycobacterium.html ), and up to 60 NTM species have been proved to be human pathogens ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Trends and Species Diversity of Non-tuberculous Mycobacteria Isolated From Respiratory Samples in Northern China, 2014–2021

Sun

Yan

Liao

et al. 2022

Front. Public Health

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BackgroundPulmonary non-tuberculous mycobacteria (NTM) infection has become a public health concern in China and around the world. The objective of this study was to describe the longitudinal changes in the frequency and diversity of NTM in northern China.MethodsWe retrospectively analyzed data on mycobacterium species in Beijing Chest Hospital from January 2014 to December 2021. The isolates were identified to species level by targeted DNA sequencing.ResultsAfter excluding duplicates, 1,755 NTM strains were analyzed, which were from 27 provinces in China over 8 years. Among all mycobacteria, the proportion of NTM increased each year, from 4.24% in 2014 to 12.68% in 2021. Overall, 39 different NTM species were identified, including 23 slow growing mycobacteria (SGM) and 16 rapid growing mycobacteria (RGM). The most common species were M. intracellulare (51.62%), M. abscessus (22.22%), M. kansasii (8.32%), M. avium (7.75%) and M. fortuitum (2.05%). The number of NTM species identified also increased each year from 9 in 2014 to 26 in 2021. Most species showed stable isolation rates over the years; however, the proportion of M. avium increased from 3.85 to 10.42% during the study period. Besides, 81 non-mycobacteria strains, including Gordonia (21 isolates), Nocardia (19 isolates) and Tsukamurella (17 isolates), etc., were also discovered.ConclusionThe proportion of NTM and species diversity increased considerably in northern China from 2014 to 2021. M. intracellulare was the most common NTM isolated among respiratory specimens, followed by M. abscessus and M. kansasii. Rare NTM species and non-mycobacteria pathogens also need attention.

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Mycobacterial Testing Trends, United States, 2009–20151

Cited by 15 publications

References 11 publications

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

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

Nontuberculous mycobacteria testing and culture positivity in the United States

Trends and Species Diversity of Non-tuberculous Mycobacteria Isolated From Respiratory Samples in Northern China, 2014–2021

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