Nontuberculous Pulmonary Mycobacteriosis in Denmark: Incidence and Prognostic Factors

Few population-based data are available regarding nontuberculous mycobacteria (NTM) pulmonary disease epidemiology and prognosis. To examine NTM pulmonary colonization incidence, disease incidence, and prognostic factors. All adults in Denmark with at least one NTM-positive pulmonary specimen during...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine Vol. 181; no. 5; pp. 514 - 521
Main Authors: Andrejak, Claire, Thomsen, Vibeke O, Johansen, Isik S, Riis, Anders, Benfield, Thomas L, Duhaut, Pierre, Sorensen, Henrik T, Lescure, Francois-Xavier, Thomsen, Reimar W
Format: Journal Article
Language:English
Published: New York, NY Am Thoracic Soc 01.03.2010
American Thoracic Society
Subjects:
Adolescent
Adult
Age
Age Factors
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cardiovascular Diseases - complications
Cardiovascular Diseases - microbiology
Comorbidity
Denmark - epidemiology
Disease
Epidemiology
Female
Health care
Humans
Incidence
Intensive care medicine
Male
Medical prognosis
Medical sciences
Middle Aged
Mortality
Mycobacterium Infections, Nontuberculous - complications
Mycobacterium Infections, Nontuberculous - epidemiology
Mycobacterium Infections, Nontuberculous - microbiology
Mycobacterium Infections, Nontuberculous - mortality
Nontuberculous Mycobacteria
Patients
Pneumology
Prognosis
Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases
Sex Factors
Survival Analysis
Tuberculosis, Pulmonary - complications
Tuberculosis, Pulmonary - epidemiology
Tuberculosis, Pulmonary - microbiology
Tuberculosis, Pulmonary - mortality
Young Adult
Denmark
Europe
epidemiological study
Lung disease
atypical mycobacteria
Intensive care
Prognosis
Respiratory disease
Mortality
Epidemiology
Lung mycobacteriosis
Resuscitation
Incidence
ISSN:1073-449X, 1535-4970, 1535-4970
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Description
Summary:Few population-based data are available regarding nontuberculous mycobacteria (NTM) pulmonary disease epidemiology and prognosis. To examine NTM pulmonary colonization incidence, disease incidence, and prognostic factors. All adults in Denmark with at least one NTM-positive pulmonary specimen during 1997 to 2008 were identified using national medical databases and were categorized as having possible or definite NTM disease or colonization. We calculated annual age-standardized NTM incidence rates and adjusted hazard ratios (HR) of death associated with patient age, sex, comorbidity, NTM species, and NTM disease status. Of 1,282 adults with 2,666 NTM-positive pulmonary specimens, 335 (26%) had definite NTM disease, 238 (19%) possible disease, and 709 (55%) colonization only. NTM incidence rates decreased until 2002, followed by an increase from 2003 to 2008 (mean annual rate per 100,000 person-years: NTM colonization, 1.36; NTM disease, 1.08). Five-year mortality after definite NTM disease was 40.1%. After controlling for potential confounders, 5-year mortality for definite NTM disease was slightly higher than for NTM colonization (adjusted hazard ratio [HR], 1.15; 95% confidence interval [CI], 0.90-1.51). Mycobacterium xenopi was associated with worse prognosis (adjusted HR, 1.51; 95% CI, 0.99-2.33) than the reference Mycobacterium avium complex. High comorbidity level (HR, 2.97), age greater than or equal to 65 years (HR, 9.17), and male sex (female sex HR, 0.73) were predictors of death. NTM disease incidence has remained unchanged in Denmark over the past 12 years. Patients with NTM colonization and disease have similarly poor prognosis. Negative prognostic factors include high levels of comorbidity, advanced age, male sex, and M. xenopi.
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ISSN:1073-449X
1535-4970
1535-4970
DOI:10.1164/rccm.200905-0778OC