Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 22;77(4):629-637.
doi: 10.1093/cid/ciad214.

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

Cheri Grigg  1 , Kelly A Jackson  1 , Devra Barter  2 , Christopher A Czaja  2 , Helen Johnston  2 , Ruth Lynfield  3 , Paula Snippes Vagnone  3 , Laura Tourdot  3 , Nancy Spina  4 , Ghinwa Dumyati  5 , P Maureen Cassidy  6 , Rebecca Pierce  6 , Emily Henkle  7 , D Rebecca Prevots  8 , Max Salfinger  9 , Kevin L Winthrop  7 , Nadege Charles Toney  1 , Shelley S Magill  1
Affiliations

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

Cheri Grigg et al. Clin Infect Dis. .

Abstract

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.

Keywords: epidemiology; nontuberculous mycobacteria; surveillance.

PubMed Disclaimer

Conflict of interest statement

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.

Figures

Figure 1.
Figure 1.
Pulmonary and extrapulmonary nontuberculous mycobacteria annualized prevalence per 100 000 population by site, sex at birth, race, and age group. NH*: Not known to be Hispanic; records indicated either ethnicity was non-Hispanic or ethnicity was not known. Abbreviations: CO, Colorado; MN, Minnesota; NY, New York; OR, Oregon.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Centers for Disease Control and Prevention . Nontuberculous mycobacteria (NTM) infections. 2019. Available at:https://www.cdc.gov/hai/organisms/nontuberculous-mycobacteria.html. Accessed 8 March 2023.
    1. Lipner EM, French JP, Falkinham JO, et al. . Nontuberculous mycobacteria infection risk and trace metals in surface water: a population-based ecologic epidemiologic study in Oregon. Ann Am Thorac Soc 2022; 19:543–50. - PMC - PubMed
    1. Adjemian J, Olivier KN, Seitz AE, Falkinham JO, Holland SM, Prevots DR. Spatial clusters of nontuberculous mycobacterial lung disease in the United States. Am J Respir Crit Care Med 2012; 186:553–8. - PMC - PubMed
    1. Shih DC, Cassidy PM, Perkins KM, Crist MB, Cieslak PR, Leman RL. Extrapulmonary nontuberculous mycobacterial disease surveillance–Oregon, 2014–2016. MMWR Morb Mortal Wkly Rep 2018; 67:854–7. - PMC - PubMed
    1. Fjällbrant H, Akerstrom M, Svensson E, Andersson E. Hot tub lung: an occupational hazard. Eur Respir Rev 2013; 22:88–90. - PMC - PubMed

Publication types