Epidemiology of Pulmonary and Extrapulmonary Nontuberculous Mycobacteria Infections at 4 US Emerging Infections Program Sites: A 6-Month Pilot.

Background: Nontuberculous mycobacteria (NTM) cause pulmonary (PNTM) and extrapulmonary (ENTM) disease. Infections are difficult to diagnose and treat, and exposures occur in healthcare and community settings. In the United States, NTM epidemiology has been described largely through analyses of microbiology data from health departments, electronic health records, and administrative data. We describe findings from a multisite pilot of active, laboratory- and population-based NTM surveillance.
Methods: The Centers for Disease Control and Prevention's Emerging Infections Program conducted NTM surveillance at 4 sites (Colorado, 5 counties; Minnesota, 2 counties; New York, 2 counties; and Oregon, 3 counties [PNTM] and statewide [ENTM]) from 1 October 2019 through 31 March 2020. PNTM cases were defined using published microbiologic criteria. ENTM cases required NTM isolation from a nonpulmonary specimen, excluding stool and rectal swabs. Patient data were collected via medical record review.
Results: Overall, 299 NTM cases were reported (PNTM: 231, 77%); Mycobacterium avium complex was the most common species group. Annualized prevalence was 7.5/100 000 population (PNTM: 6.1/100 000; ENTM: 1.4/100 000). Most patients had signs or symptoms in the 14 days before positive specimen collection (ENTM: 62, 91.2%; PNTM: 201, 87.0%). Of PNTM cases, 145 (62.8%) were female and 168 (72.7%) had underlying chronic lung disease. Among ENTM cases, 29 (42.6%) were female, 21 (30.9%) did not have documented underlying conditions, and 26 (38.2%) had infection at the site of a medical device or procedure.
Conclusions: Active, population-based NTM surveillance will provide data for monitoring the burden of disease and characterize affected populations to inform interventions.
Competing Interests: Potential conflicts of interest. EIP site coauthors' institutions received funding from the CDC. E. H. reports receipt of consulting fees and serving on advisory boards for AN2 Therapeutics and the MannKind Corporation. K. L. W. reports receipt of grants or contracts and consulting fees from Insmed, Paratek, Red Hill Biopharma, AN2 Therapeutics, Renovion, and Spero and participation on a data and safety monitoring board or advisory board for Red Hill Biopharma. R. L. reports service on the program committee for IDWeek and receipt of travel support for conference planning and for the conference; service as associate editor for the American Academy of Pediatrics (AAP) Red Book; receipt of fees for editorial work that were donated to the Minnesota Department of Health; receipt of support to attend the AAP Committee on Infectious Disease meetings; service on the Council of State and Territorial Epidemiologists (CSTE) Executive Board and receipt of travel support to attend CSTE meetings; and service on the board of the National Foundation of Infectious Disease (NFID) and receipt of travel support to attend NFID meetings. D. R. P. reports support for this work and support for attending meetings and/or travel from the Division of Intramural Research, NIAID, NIH. All remaining authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
(Published by Oxford University Press on behalf of Infectious Diseases Society of America 2023.)