Nontuberculous mycobacteria. I: multicenter prevalence study in cystic fibrosis.
Nontuberculous mycobacteria (NTM) are potential respiratory pathogens in cystic fibrosis (CF). To assess the species-specific prevalence and risk factors for acquisition, we conducted a prospective, cross-sectional study of the prevalence of NTM and clinical features of patients at 21 U.S. centers. Almost 10% of patients with CF who were 10 years or older were included (n = 986). The overall prevalence of NTM in sputum was 13.0% (range by center, 7-24%). Mycobacterium avium complex (72%) and Mycobacterium abscessus (16%) were the most common species. When compared with patients with CF without NTM, culture-positive subjects were older (26 vs. 22 years, p < 0.001), had a higher FEV1 (60 vs. 54%, p < 0.01), higher frequency of Staphylococcus aureus (43 vs. 31%, p < 0.01), and lower frequency of Pseudomonas aeruginosa (71 vs. 82%, p < 0.01). Molecular typing revealed that almost all patients within each center had unique NTM strains. In summary, NTM are common in patients with CF, but neither person-to-person nor nosocomial acquisition explained the high prevalence. Older age was the most significant predictor for isolation of NTM. The clinical significance of NTM in CF is incompletely defined, but patients with these organisms should be monitored with repeat cultures.
Olivier
Kenneth N
KN
The Cystic Fibrosis/Pulmonary Research and Treatment Center, the Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. kenneth.olivier@lackland.af.mil
Weber
David J
DJ
Wallace
Richard J
RJ
Faiz
Ali R
AR
Lee
Ji-Hyun
JH
Zhang
Yansheng
Y
Brown-Elliot
Barbara A
BA
Handler
Allison
A
Wilson
Rebecca W
RW
Schechter
Michael S
MS
Edwards
Lloyd J
LJ
Chakraborti
Subha
S
Knowles
Michael R
MR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015373:Bacterial Typing Techniques; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000635:transmission; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000235:genetics; D011159:Population Surveillance; D011237:Predictive Value of Tests; D015995:Prevalence; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000209:etiology; D011550:Pseudomonas aeruginosa; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology; D013211:Staphylococcus aureus; D014481:United States / Q000453:epidemiology