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. 2013 May 21:13:231.
doi: 10.1186/1471-2334-13-231.

Burden and trends of hospitalisations associated with pulmonary non-tuberculous mycobacterial infections in Germany, 2005-2011

Felix C Ringshausen  1 , Rosa-Marie Apel, Franz-Christoph Bange, Andrés de Roux, Mathias W Pletz, Jessica Rademacher, Hendrik Suhling, Dirk Wagner, Tobias Welte
Affiliations

Burden and trends of hospitalisations associated with pulmonary non-tuberculous mycobacterial infections in Germany, 2005-2011

Felix C Ringshausen et al. BMC Infect Dis. .

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.

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Figures

Figure 1
Figure 1
Data flow and data analysis diagram. APC = annual percentage change; PNTM = pulmonary non-tuberculous mycobacterial.
Figure 2
Figure 2
Age-specific and age-adjusted hospitalisation rate. (A) Average annual age-specific hospitalisation rate and (B) annual age-adjusted hospitalisation rate of pulmonary non-tuberculous mycobacterial infection as any hospital discharge diagnoses, by age group, sex and year.
Figure 3
Figure 3
Average annual percentage change of the rate of associated primary and secondary diagnoses per 1000 hospitalised patients with any diagnosis of pulmonary non-tuberculous mycobacterial infection. Bars indicate 95% confidence intervals calculated from Poisson log-linear regression (Wald statistics). Non-significant trends between 2005 and 2011 are not shown. *Statistical significance at p<0.001. #Statistical significance at p<0.01. §Statistical significance at p<0.05.
See this image and copyright information in PMC

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