Study finds nontuberculous mycobacteria lung disease on the rise in the United States
A research team led by epidemiologists at the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, analyzed hospital discharge records of patients in 11 states whose combined population accounts for 42 percent of the country. We reviewed the records database spans from 1998 to 2005, and identified more than 16,475 hospitalizations associated with pulmonary NTM in people without AIDS. Before the widespread availability of combination antiretroviral therapy, NTM pulmonary disease was a common opportunistic infection among people with AIDS in this study, the researchers limited their analysis to non-AIDS NTM disease.
Of the 11 states studied, Florida, New York and California had 62 percent of NTM pulmonary hospitalizations. The scientists chose these states to compare trends by geographic area. It was found that the annual prevalence of the disease increased significantly between men and women in Florida (3.2 percent per year for men and 6.5 percent per year for women) and among women in New York (4.6 percent per year). No significant changes occurred in California. If these geographic differences in prevalence are the result of exposure to NTM, or increasing concentrations of mycobacteria in certain environments, or both, is unclear. However, previous studies have found high prevalence of the disease in the southeastern United States, particularly in coastal regions of the Atlantic and Gulf coasts.
The results of the study show pulmonary NTM has increased in some geographical areas of the United States, and while the overall prevalence is higher in women, the prevalence increased for both sexes in the fifth or sixth decade of life. Further research is needed to define the prevalence of the disease in people hospitalized in the regions of the United States and to determine risk factors for disease susceptibility, including genetic and environmental factors.
More information: Hospitalizations associated with non-tuberculous mycobacterial lung disease, United States, 1998-2005. Emerging Infectious Diseases. DOI: 10:3201 / eid510.090196