Department of Pediatrics.
Department of Pediatrics, University of California, San Francisco, San Francisco, California; and.
Ann Am Thorac Soc. 2023 Aug;20(8):1107-1115. doi: 10.1513/AnnalsATS.202205-425OC.
Population-based data on the epidemiology of nontuberculosis mycobacterial (NTM) infections are limited, particularly with respect to variation in NTM infection among racial groups and socioeconomic strata. Wisconsin is one of a handful of states where mycobacterial disease is notifiable, allowing large, population-based analyses of the epidemiology of NTM infection in this state. To estimate the incidence of NTM infection in Wisconsin adults, describe the geographic distribution of NTM infection across the state, identify the frequency and type of infection caused by different NTM species, and investigate associations between NTM infection and demographics and socioeconomic status. We conducted a retrospective cohort study using laboratory reports of all NTM isolates from Wisconsin residents submitted to the Wisconsin Electronic Disease Surveillance System from 2011 to 2018. For the analyses of NTM frequency, multiple reports from the same individual were enumerated as separate isolates when nonidentical, collected from different sites or collected more than one year apart. A total of 8,135 NTM isolates from 6,811 adults were analyzed. complex accounted for 76.4% of respiratory isolates. The group was the most common species isolated from skin and soft tissue. The annual incidence of NTM infection was stable over the study period (from 22.1 per 100,000 to 22.4 per 100,000). The cumulative incidence of NTM infection among Black (224 per 100,000) and Asian (244 per 100,000) individuals was significantly higher compared with that among their White counterparts (97 per 100,000). Total NTM infections were significantly more frequent ( < 0.001) in individuals from disadvantaged neighborhoods, and racial disparities in the incidence of NTM infection generally remained consistent when stratified by measures of neighborhood disadvantage. More than 90% of NTM infections were from respiratory sites, with the vast majority caused by complex. Rapidly growing mycobacteria predominated as skin and soft tissue pathogens and were important minor respiratory pathogens. We found a stable annual incidence of NTM infection in Wisconsin between 2011 and 2018. NTM infection occurred more frequently in non-White racial groups and in individuals experiencing social disadvantage, suggesting that NTM disease may be more frequent in these groups as well.
基于人群的非结核分枝杆菌（NTM）感染流行病学数据有限，特别是关于不同种族群体和社会经济阶层之间 NTM 感染的差异。威斯康星州是少数几个需要报告分枝杆菌病的州之一，这使得该州能够对 NTM 感染的流行病学进行大规模的基于人群的分析。为了估计威斯康星州成年人 NTM 感染的发病率，描述全州 NTM 感染的地理分布，确定不同 NTM 物种引起的感染频率和类型，并调查 NTM 感染与人口统计学和社会经济地位之间的关联。我们进行了一项回顾性队列研究，使用 2011 年至 2018 年期间从威斯康星州居民提交给威斯康星州电子疾病监测系统的所有 NTM 分离株的实验室报告。对于 NTM 频率的分析，当非同一、从不同部位采集或相隔一年以上采集时，同一人的多个报告被计为单独的分离株。共分析了来自 6811 名成年人的 8135 株 NTM 分离株。复合群占呼吸道分离株的 76.4%。组是从皮肤和软组织中分离出来的最常见的物种。NTM 感染的年发病率在研究期间保持稳定（从 22.1/100,000 人增加到 22.4/100,000 人）。与白人相比，黑人（224/100,000 人）和亚洲人（244/100,000 人）个体的 NTM 感染累积发病率明显更高（<0.001）。来自贫困社区的个体的总 NTM 感染明显更频繁（<0.001），而且当按社区劣势的衡量标准分层时，NTM 感染的发病率种族差异通常保持一致。超过 90%的 NTM 感染来自呼吸道部位，绝大多数由复合群引起。快速生长的分枝杆菌主要是皮肤和软组织病原体，也是重要的次要呼吸道病原体。我们发现 2011 年至 2018 年期间，威斯康星州 NTM 感染的年发病率稳定。非白人种族群体和社会经济地位较低的个体中 NTM 感染更为常见，这表明这些群体中 NTM 病可能更为常见。
