title: Geographical distribution and clinical relevance of non-tuberculous mycobacteria in Croatia.
abstract: METHODS
  The clinical relevance of non-tuberculous mycobacteria (NTM) in Croatia is unknown.
  
  
  OBJECTIVE
  To estimate the isolation rate of NTM, record geographical differences and assess the burden of pulmonary NTM disease in Croatia.
  
  
  METHODS
  Nationwide retrospective cohort study of all Croatian residents with NTM isolated by culture in the period from 2006 to 2010. Microbiological criteria of the American Thoracic Society were used to establish a laboratory-based case definition of possible and probable NTM disease.
  
  
  RESULTS
  Of 1187 individuals with pulmonary NTM isolates, 8.6% met the possible and 5.5% met the probable disease criteria. We estimated an annual incidence of probable pulmonary NTM disease of 0.23 per 100,000 population. This estimated annual incidence was 0.35/100,000 in the coastal region and 0.17/100,000 in the continental region. Species distribution differed between coastal and continental Croatia. NTM isolation frequency increased over the study period.
  
  
  CONCLUSIONS
  Geography plays an important role in NTM species distribution and possible disease. The overall burden of NTM pulmonary disease in Croatia is still low compared to that of tuberculosis, but it is higher in the coastal region compared to the continental region.
authors.affiliation: Department for Respiratory Diseases, University Hospital Centre, University of Zagreb Medical School, Zagreb, Croatia. mateja.jankovic@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Jankovic
authors.forename: M
authors.initials: M
authors.lastname: Samarzija
authors.forename: I
authors.initials: I
authors.lastname: Sabol
authors.forename: M
authors.initials: M
authors.lastname: Jakopovic
authors.forename: V
authors.initials: V
authors.lastname: Katalinic Jankovic
authors.forename: L
authors.initials: L
authors.lastname: Zmak
authors.forename: B
authors.initials: B
authors.lastname: Ticac
authors.forename: A
authors.initials: A
authors.lastname: Marusic
authors.forename: M
authors.initials: M
authors.lastname: Obrovac
authors.forename: J
authors.initials: J
authors.lastname: van Ingen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008171:Lung Diseases / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D012189:Retrospective Studies; D055815:Young Adult