Mirsaeidi Mehdi, Machado Roberto F, Garcia Joe G N, Schraufnagel Dean E
Division of Pulmonary and Critical Care, University of Illinois at Chicago, Chicago, Illinois, United States of America.
Department of Medicine, University of Arizona, Tucson, Arizona, United States of America.
PLoS One. 2014 Mar 14;9(3):e91879. doi: 10.1371/journal.pone.0091879. eCollection 2014.
Environmental nontuberculous mycobacteria (NTM) are ubiquitous organisms with which humans commonly interact. The epidemiologic characteristics of NTM diseases including mortality rate and its associated factors remain largely unknown. In this study, we explored the geographical area of exposure and mortality and comorbid conditions of affected persons to determine environment, host, and host-pathogen interactive factors.
We analyzed mortality related to nontuberculous mycobacterial infections from 1999 through 2010 by examining multiple-cause-of-death data from the National Center for Health Statistics. Among those who died with these diseases, we analyzed age-adjusted mortality rates, trends, associations with demographic variables, and comorbid conditions and correlated this information with similar data for tuberculosis-related mortality during the same time.
From 1999 through 2010, nontuberculous mycobacterial disease was reported as an immediate cause of death in 2,990 people in the United States with a combined overall mean age-adjusted mortality rate of 0.1 per 100,000 person-years. A significant increase in the number of NTM related deaths was seen from 1999 through 2010 (R(2) = 0.72, p<0.0001), but it was not significant after adjustment for age. Persons aged 55 years and older, women, those living in Hawaii and Louisiana, and those of non-Hispanic, white ethnicity had higher mortality rates. Compared to tuberculosis-related mortality, chronic obstructive pulmonary disease, bronchiectasis, HIV, interstitial lung diseases, and tobacco use were significantly more common in persons with nontuberculous mycobacteria-related deaths.
Nontuberculous mycobacteria-related death numbers are rising and are unevenly distributed. The strong association of nontuberculous mycobacterial disease with age suggests that its prevalence will increase as the United States population ages.
环境非结核分枝杆菌（NTM）是人类普遍接触的广泛存在的生物体。NTM疾病的流行病学特征，包括死亡率及其相关因素，在很大程度上仍不清楚。在本研究中，我们探讨了受影响人群的暴露地理区域、死亡率和合并症，以确定环境、宿主以及宿主与病原体的相互作用因素。
我们通过检查国家卫生统计中心的多死因数据，分析了1999年至2010年与非结核分枝杆菌感染相关的死亡率。在死于这些疾病的人群中，我们分析了年龄调整死亡率、趋势、与人口统计学变量的关联以及合并症，并将这些信息与同一时期结核病相关死亡率的类似数据进行了关联。
1999年至2010年期间，在美国有2990人报告非结核分枝杆菌病为直接死因，综合总体年龄调整死亡率为每10万人年0.1例。1999年至2010年期间，NTM相关死亡人数显著增加（R² = 0.72，p<0.0001），但在调整年龄后不显著。55岁及以上的人群、女性、居住在夏威夷和路易斯安那州的人群以及非西班牙裔白人的死亡率较高。与结核病相关死亡率相比，慢性阻塞性肺疾病、支气管扩张、HIV、间质性肺疾病和吸烟在非结核分枝杆菌相关死亡人群中明显更为常见。
非结核分枝杆菌相关死亡人数正在上升且分布不均。非结核分枝杆菌病与年龄的密切关联表明，随着美国人口老龄化，其患病率将会增加。
