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Epidemiology of Nontuberculous Mycobacterial Lung Disease and Tuberculosis, Hawaii, USA

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ABSTRACT

Previous studies found Hawaiians and Asian-Americans/Pacific Islanders to be independently at increased risk for nontuberculous mycobacterial pulmonary disease (NTMPD) and tuberculosis (TB). To better understand NTM infection and TB risk patterns in Hawaii, USA, we evaluated data on a cohort of patients in Hawaii for 2005–2013. Period prevalence of NTMPD was highest among Japanese, Chinese, and Vietnamese patients (>300/100,000 persons) and lowest among Native Hawaiians and Other Pacific Islanders (50/100,000). Japanese patients were twice as likely as all other racial/ethnic groups to have Mycobacterium abscessus isolated (adjusted odds ratio 2.0, 95% CI 1.2–3.2) but were not at increased risk for infection with other mycobacteria species. In contrast, incidence of TB was stable and was lowest among Japanese patients (no cases) and highest among Filipino, Korean, and Vietnamese patients (>50/100,000). Substantial differences exist in the epidemiology of NTMPD by race/ethnicity, suggesting behavioral and biologic factors that affect disease susceptibility.

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Occurrence of nontuberculous mycobacteria species identified from pulmonary specimens obtained among a cohort of Kaiser Permanente Hawaii patients, Hawaii, 2005–2013. Other pathogenic nontuberculous mycobacteria species identified (n = 21) were Mycobacterium flavescens, M. immunogenum, M. mucogenicum, M. neoaurum, M. scrofulaceum, M. simiae, and undifferentiated M. chelonae/abscessus. NTM, nontuberculous mycobacteria.
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Figure 1: Occurrence of nontuberculous mycobacteria species identified from pulmonary specimens obtained among a cohort of Kaiser Permanente Hawaii patients, Hawaii, 2005–2013. Other pathogenic nontuberculous mycobacteria species identified (n = 21) were Mycobacterium flavescens, M. immunogenum, M. mucogenicum, M. neoaurum, M. scrofulaceum, M. simiae, and undifferentiated M. chelonae/abscessus. NTM, nontuberculous mycobacteria.

Mentions: During 2005–2013, a total of 373,168 patients were enrolled in KPH, representing nearly one third of the Hawaii population (15); the demographic distribution of our study population was similar to that for the state, with slightly more white patients (Table 1) (15,17). Of the patient total, 2,197 (0.6%) had >1 mycobacterial culture performed on a respiratory specimen; 1,086 (49%) of those had only 1 culture performed (range 1–29 cultures/patient). Of patients who had culture performed, 455 (21%) had pathogenic NTM isolated: 201 (44%) had 1 positive culture, and 254 (56%) had >2 positive cultures (NTMPD cases) (Table 1). The most frequently isolated species were MAC (n = 290; 64%), M. fortuitum group (n = 109; 24%), and M. abscessus (n = 87; 19%) (Figure 1); 91 (20%) patients had >1 NTM species identified. A higher proportion of patients with M. abscessus isolated (30%) were positive for >2 years in the database, compared with those with MAC (16%) or M. fortuitum group (6%).


Epidemiology of Nontuberculous Mycobacterial Lung Disease and Tuberculosis, Hawaii, USA
Occurrence of nontuberculous mycobacteria species identified from pulmonary specimens obtained among a cohort of Kaiser Permanente Hawaii patients, Hawaii, 2005–2013. Other pathogenic nontuberculous mycobacteria species identified (n = 21) were Mycobacterium flavescens, M. immunogenum, M. mucogenicum, M. neoaurum, M. scrofulaceum, M. simiae, and undifferentiated M. chelonae/abscessus. NTM, nontuberculous mycobacteria.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5382761&req=5

Figure 1: Occurrence of nontuberculous mycobacteria species identified from pulmonary specimens obtained among a cohort of Kaiser Permanente Hawaii patients, Hawaii, 2005–2013. Other pathogenic nontuberculous mycobacteria species identified (n = 21) were Mycobacterium flavescens, M. immunogenum, M. mucogenicum, M. neoaurum, M. scrofulaceum, M. simiae, and undifferentiated M. chelonae/abscessus. NTM, nontuberculous mycobacteria.
Mentions: During 2005–2013, a total of 373,168 patients were enrolled in KPH, representing nearly one third of the Hawaii population (15); the demographic distribution of our study population was similar to that for the state, with slightly more white patients (Table 1) (15,17). Of the patient total, 2,197 (0.6%) had >1 mycobacterial culture performed on a respiratory specimen; 1,086 (49%) of those had only 1 culture performed (range 1–29 cultures/patient). Of patients who had culture performed, 455 (21%) had pathogenic NTM isolated: 201 (44%) had 1 positive culture, and 254 (56%) had >2 positive cultures (NTMPD cases) (Table 1). The most frequently isolated species were MAC (n = 290; 64%), M. fortuitum group (n = 109; 24%), and M. abscessus (n = 87; 19%) (Figure 1); 91 (20%) patients had >1 NTM species identified. A higher proportion of patients with M. abscessus isolated (30%) were positive for >2 years in the database, compared with those with MAC (16%) or M. fortuitum group (6%).

View Article: PubMed Central - PubMed

ABSTRACT

Previous studies found Hawaiians and Asian-Americans/Pacific Islanders to be independently at increased risk for nontuberculous mycobacterial pulmonary disease (NTMPD) and tuberculosis (TB). To better understand NTM infection and TB risk patterns in Hawaii, USA, we evaluated data on a cohort of patients in Hawaii for 2005–2013. Period prevalence of NTMPD was highest among Japanese, Chinese, and Vietnamese patients (>300/100,000 persons) and lowest among Native Hawaiians and Other Pacific Islanders (50/100,000). Japanese patients were twice as likely as all other racial/ethnic groups to have Mycobacterium abscessus isolated (adjusted odds ratio 2.0, 95% CI 1.2–3.2) but were not at increased risk for infection with other mycobacteria species. In contrast, incidence of TB was stable and was lowest among Japanese patients (no cases) and highest among Filipino, Korean, and Vietnamese patients (>50/100,000). Substantial differences exist in the epidemiology of NTMPD by race/ethnicity, suggesting behavioral and biologic factors that affect disease susceptibility.

No MeSH data available.


Related in: MedlinePlus