United States Environmental Protection Agency, 26 W. Martin Luther King Dr. Mail Stop 587, Cincinnati, Ohio, 45268, USA.
BMC Infect Dis. 2018 Apr 10;18(1):163. doi: 10.1186/s12879-018-3043-7.
Nontuberculous Mycobacteria (NTM) are environmental microorganisms that can affect human health. A 2009-2010 occurrence survey of NTM in potable tap water samples indicated an increased recovery rate for many clinically significant species such as M. avium (30%) and M. abscessus (12%). To determine if these trends by species were mirrored in human infections, isolation rates of NTM species identified in clinical laboratory reports from four states were evaluated.
Clinical laboratory reports from the Mississippi, Missouri, Ohio, and Wisconsin Health Departments were used to investigate the species of NTM isolated from human specimens in 2014. The NTM positive specimen reports were tabulated for each species and complex/group. The number of reports by month were used to investigate seasonal trends. The 2014 isolation rates were compared to historic values to examine longitudinal trends.
The positive rate of NTM specimens increased from 8.2 per 100,000 persons in 1994 to 16 per 100,000 persons in 2014 (or 13.3 per 100,000 after excluding Mycobacterium gordonae). Changes in NTM diversity were observed in complex/groups known to be clinically significant. Between 1994 and 2014 the rate implicating M. abscesses-chelonae group and M. avium complex increased by 322 and 149%, respectively.
Based on public health data supplied by the four State's Health Departments and the 2014 U.S. population, 50,976 positive NTM specimen reports per year were projected for the nation; serving as an indicator for the national potential disease burden that year.
非结核分枝杆菌(NTM)是一种环境微生物,可影响人类健康。2009-2010 年对饮用水样本中 NTM 的发生情况进行的调查表明,许多具有临床意义的物种(如鸟分枝杆菌(30%)和脓肿分枝杆菌(12%))的回收率有所增加。为了确定这些种间趋势是否反映在人类感染中,评估了来自四个州临床实验室报告中鉴定的 NTM 种的分离率。
使用密西西比州、密苏里州、俄亥俄州和威斯康星州卫生部门的临床实验室报告,调查了 2014 年从人体标本中分离出的 NTM 种。对每个种和复合群的 NTM 阳性标本报告进行了列表。按月份报告的数量用于调查季节性趋势。将 2014 年的分离率与历史值进行比较,以检查纵向趋势。
NTM 标本的阳性率从 1994 年的每 10 万人 8.2 例增加到 2014 年的每 10 万人 16 例(排除戈登分枝杆菌后为每 10 万人 13.3 例)。在已知具有临床意义的复合群/组中观察到 NTM 多样性的变化。1994 年至 2014 年间,涉及脓肿分枝杆菌-chelonae 群和鸟分枝杆菌复合群的比率分别增加了 322%和 149%。
根据四个州卫生部门提供的公共卫生数据和 2014 年美国人口数据,预计全国每年有 50976 例 NTM 阳性标本报告;这是当年全国潜在疾病负担的一个指标。