Nontuberculous mycobacterial lung disease prevalence at four integrated health care delivery systems.
BACKGROUND
Single-site clinic-based studies suggest an increasing prevalence of pulmonary nontuberculous mycobacteria (NTM) disease, but systematic data are lacking.


OBJECTIVE
To describe prevalence and trends for NTM lung disease at four geographically diverse integrated heath care delivery systems in the United States.


METHODS
We abstracted mycobacterial culture results from electronic laboratory databases and linked to other datasets containing clinical and demographic information. Possible cases were defined as a single positive NTM pulmonary isolate, and definite cases were defined as two positive sputum cultures, or one positive culture from a bronchoalveolar lavage or lung biopsy. Annual prevalence was calculated using United States census data; average annual prevalence is presented for 2004-2006. Poisson regression models were used to estimate the annual percent change in prevalence.


RESULTS
A total of 28,697 samples from 7,940 patients were included in the analysis. Of these, 3,988 (50%) were defined as possible cases, and 1,865 (47%) of these were defined as definite cases. Average annual (2004-2006) site-specific prevalence ranged from 1.4 to 6.6 per 100,000. Prevalence was 1.l- to 1.6-fold higher among women relative to men across sites. The prevalence of NTM lung disease was increasing significantly at the two sites where trends were studied, by 2.6% per year among women and 2.9% per year among men. Among persons aged greater than or equal to 60 years, annual prevalence increased from 19.6 per 100,000 during 1994-1996 to 26.7 per 100,000 during 2004-2006.


CONCLUSIONS
The epidemiology of nontuberculous mycobacterial lung disease is changing, with a predominance of women and increasing prevalence at the sites studied.
Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA. rprevots@niaid.nih.gov
D Rebecca
DR
Prevots
Pamela A
PA
Shaw
Daniel
D
Strickland
Lisa A
LA
Jackson
Marsha A
MA
Raebel
Mary Ann
MA
Blosky
Ruben
R
Montes de Oca
Yvonne R
YR
Shea
Amy E
AE
Seitz
Steven M
SM
Holland
Kenneth N
KN
Olivier
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002478:Cells, Cultured; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008171:Lung Diseases / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000453:epidemiology*; D016012:Poisson Distribution; D015995:Prevalence; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology