title: Burden and trends of hospitalisations associated with pulmonary non-tuberculous mycobacterial infections in Germany, 2005-2011.
abstract: BACKGROUND
  Representative population-based data on the epidemiology of pulmonary non-tuberculous mycobacterial (PNTM) infections in Europe are limited. However, these data are needed in order to optimise patient care and to facilitate the allocation of healthcare resources. The aim of the present study was to investigate the current burden and the trends of PNTM infection-associated hospitalisations in Germany.
  
  
  METHODS
  International Classification of Diseases, 10th revision (ICD-10) discharge diagnosis codes were extracted from the official nationwide diagnosis-related groups (DRG) hospital statistics in order to identify PNTM infection-associated hospitalisations (ICD-10 code A31.0) between 2005 and 2011. Poisson log-linear regression analysis was used to assess the significance of trends.
  
  
  RESULTS
  Overall, 5,959 records with PNTM infection as any hospital discharge diagnosis were extracted from more than 125 million hospitalisations. The average annual age-adjusted rate was 0.91 hospitalisations per 100,000 population. Hospitalisation rates increased during the study period for both males and females, with the highest rate of 3.0 hospitalisations per 100,000 population among elderly men, but the most pronounced average increase of 6.4%/year among females, particularly those of young and middle age, and hospitalisations associated with cystic fibrosis. Overall, chronic obstructive pulmonary disease (COPD) was the most frequent PNTM infection-associated condition in 28.9% of hospitalisations and also showed a significant average annual increase of 4.8%.
  
  
  CONCLUSIONS
  The prevalence of PNTM infection-associated hospitalisations is steadily increasing in Germany. COPD is currently the most important associated condition. Our population-based study provides evidence of a changing epidemiology of PNTM infections and highlights emerging clinical implications.
authors.affiliation: Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany. Ringshausen.Felix@mh-hannover.de
authors.forename: Felix C
authors.initials: FC
authors.lastname: Ringshausen
authors.forename: Rosa-Marie
authors.initials: RM
authors.lastname: Apel
authors.forename: Franz-Christoph
authors.initials: FC
authors.lastname: Bange
authors.forename: Andrés
authors.initials: A
authors.lastname: de Roux
authors.forename: Mathias W
authors.initials: MW
authors.lastname: Pletz
authors.forename: Jessica
authors.initials: J
authors.lastname: Rademacher
authors.forename: Hendrik
authors.initials: H
authors.lastname: Suhling
authors.forename: Dirk
authors.initials: D
authors.lastname: Wagner
authors.forename: Tobias
authors.initials: T
authors.lastname: Welte
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence