Epidemiology and Population Studies Section, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, USA.
Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
BMC Infect Dis. 2024 Oct 2;24(1):1094. doi: 10.1186/s12879-024-09965-y.
Nontuberculous mycobacteria (NTM) are ubiquitous environmental bacteria that cause chronic lung disease. Rates of NTM pulmonary disease (NTM PD) have increased over the last several decades, yet national estimates in the United States (US) have not been assessed since 2015.
We used a nationally representative population of Medicare beneficiaries aged ≥ 65 years to assess rates of NTM PD in a high-risk population from 2010 to 2019. Poisson generalized linear models were used to assess the annual percent change in incidence in the overall population and among key demographic groups such as sex, geography, and race/ethnicity. We evaluated the relative prevalence of various comorbid conditions previously found to be associated with NTM PD.
We identified 59,724 cases of incident NTM PD from 2010 to 2019 from an annual mean population of 29,687,097 beneficiaries, with an average annual incidence of 20.1 per 100,000 population. NTM PD incidence was overall highest in the South and among women, Asian individuals, and persons aged ≥ 80 years relative to other studied demographic groups. The annual percent change in NTM PD incidence was highest in the Northeast, at 6.5%, and Midwest, at 5.9%, and among women, at 6.5%. Several comorbid conditions were highly associated with concurrent NTM diagnosis, including allergic bronchopulmonary aspergillosis, bronchiectasis, and cystic fibrosis.
Here we provide current estimates of NTM PD incidence and prevalence and describe increasing trends in the US from 2010 to 2019. Our study suggests a need for improved healthcare planning to handle an increased future caseload, as well as improved diagnostics and therapeutics to better detect and treat NTM PD in populations aged ≥ 65 years.
非结核分枝杆菌（NTM）是普遍存在于环境中的细菌，可导致慢性肺部疾病。在过去几十年中，NTM 肺部疾病（NTM PD）的发病率有所增加，但自 2015 年以来，美国（US）尚未对全国估计数进行评估。
我们使用 Medicare 受益人的全国代表性人群，评估了 2010 年至 2019 年高风险人群中 NTM PD 的发病率。使用泊松广义线性模型评估了总人口和关键人群（如性别、地理位置和种族/族裔）中发病率的年百分比变化。我们评估了先前与 NTM PD 相关的各种合并症的相对流行率。
我们从 2010 年至 2019 年每年平均有 2968.7097 万受益人的人群中确定了 59724 例 NTM PD 新发病例，平均每年发病率为 20.1/10 万。与其他研究的人口统计学群体相比，NTM PD 的总体发病率在南部和女性、亚洲人和年龄≥80 岁的人群中最高。东北地区和中西部地区 NTM PD 发病率的年百分比变化最高，分别为 6.5%和 5.9%，而女性则为 6.5%。一些合并症与同时诊断的 NTM 高度相关，包括变应性支气管肺曲霉病、支气管扩张和囊性纤维化。
在这里，我们提供了 NTM PD 发病率和患病率的最新估计，并描述了 2010 年至 2019 年美国的上升趋势。我们的研究表明，需要改进医疗保健计划，以应对未来增加的病例数，以及改进诊断和治疗方法，以更好地检测和治疗年龄≥65 岁的人群中的 NTM PD。
