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. 2024 Mar;30(3):548-554.
doi: 10.3201/eid3003.231162.

Geographic Variation and Environmental Predictors of Nontuberculous Mycobacteria in Laboratory Surveillance, Virginia, USA, 2021-20231

Brendan Mullen, Eric R Houpt, Josh Colston, Lea Becker, Sharon Johnson, Laura Young, Jasie Hearn, Joe Falkinham 3rd, Scott K Heysell

Geographic Variation and Environmental Predictors of Nontuberculous Mycobacteria in Laboratory Surveillance, Virginia, USA, 2021-20231

Brendan Mullen et al. Emerg Infect Dis. 2024 Mar.

Abstract

Because epidemiologic and environmental risk factors for nontuberculous mycobacteria (NTM) have been reported only infrequently, little information exists about those factors. The state of Virginia, USA, requires certain ecologic features to be included in reports to the Virginia Department of Health, presenting a unique opportunity to study those variables. We analyzed laboratory reports of Mycobacterium avium complex (MAC) and M. abscessus infections in Virginia during 2021-2023. MAC/M. abscessus was isolated from 6.19/100,000 persons, and 2.37/100,000 persons had MAC/M. abscessus lung disease. M. abscessus accounted for 17.4% and MAC for 82.6% of cases. Saturated vapor pressure was associated with MAC/M. abscessus prevalence (prevalence ratio 1.414, 95% CI 1.011-1.980; p = 0.043). Self-supplied water use was a protective factor (incidence rate ratio 0.304, 95% CI 0.098-0.950; p = 0.041). Our findings suggest that a better understanding of geographic clustering and environmental water exposures could help develop future targeted prevention and control efforts.

Keywords: Mycobacterium abscessus; Mycobacterium avium complex; United States; Virginia; epidemiology; nontuberculous mycobacteria; respiratory infections; tuberculosis and other mycobacteria; water vapor.

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Figures

Figure 1
Figure 1
Prevalence of Mycobacterium avium complex (MAC), M. abscessus, or both (MAC/M. abscessus), categorized by age and sex, Virginia, USA, 2021–2023.
Figure 2
Figure 2
Geographic distribution and variables of interest for Mycobacterium avium complex (MAC) and Mycobacterium abscessus infections, Virginia, USA, 2021–2023. County-level prevalence (cases/100,000 person-years) of A) MAC/M. abscessus; C) MAC; and E) M. abscessus. B) M. abscessus distribution as a percentage of total MAC/M. abscessus infections. D) Percentage of residents using self-supplied water. F) Saturated water vapor pressure in millibars.
See this image and copyright information in PMC

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