title: Epidemiology of nontuberculous mycobacteria (NTM) amongst individuals with cystic fibrosis (CF).
abstract: Infection by nontuberculous mycobacteria (NTM) in patients with cystic fibrosis (CF) is often associated with significant morbidity. Limited, conflicting results are published regarding risk factors for pulmonary NTM disease. We analysed factors potentially associated with NTM in a large population of European patients with CF.
  
  
  
  We investigated associations between presence of NTM and various factors for patients registered in the European Cystic Fibrosis Society Patient Registry.
  
  
  
  374 (2.75%) of 13,593 patients studied had at least one positive NTM culture within the study year. Age- and FEV1-adjusted odds of NTM infection was more than 2.5 times higher (95%CI: 1.79; 3.60) in patients infected by Stenotrophomonas maltophilia than in patients not infected (p<0.0001), 2.36 times higher (95%CI: 1.80;3.08) in patients with ABPA than without (p<0.0001), 1.79 times higher (95%CI: 1.34; 2.38) in patients who use bronchodilators than in patients who don't (p<0.0001), 1.49 times higher (95%CI: 1.18; 1.89) in patients who use inhaled antibiotics than in patients who don't (p=0.001), and 1.30 times higher (95%CI: 1.02; 1.66) in patients who use rhDNase than in patients who don't (p=0.032).
  
  
  
  NTM-positive cultures in individuals with CF are associated with distinct clinical variables. Improved data collection identifying risk factors for NTM infection will allow more focused screening strategies, and influence therapeutic choices and infection control measures in high-risk patients.
authors.affiliation: Dipartimento di Scienze cliniche e di comunità, University of Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Viviani
authors.affiliation: Cambridge Centre for Lung Infection, Papworth Hospital, Cambridge, UK.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Harrison
authors.affiliation: Dipartimento di Scienze cliniche e di comunità, University of Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Zolin
authors.affiliation: Cambridge Centre for Lung Infection, Papworth Hospital, Cambridge, UK.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Haworth
authors.affiliation: Cambridge Centre for Lung Infection, Papworth Hospital, Cambridge, UK; Cambridge Institute for Medical Research, University of Cambridge, UK. Electronic address: arf27@cam.ac.uk.
authors.forename: R Andres
authors.initials: RA
authors.lastname: Floto
mesh_terms: D003550:Cystic Fibrosis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000453:epidemiology; D020380:Needs Assessment; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D058996:Quality Improvement; D012042:Registries / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
keywords: Cystic fibrosis; Epidemiology; Nontuberculous mycobacteria; Patient registry; Risk factors