Incidence of nontuberculous mycobacterial disease in New Zealand, 2004

Incidence of nontuberculous mycobacterial disease in New Zealand, 2004,Joshua Freeman,Arthur Morris,Timothy Blackmore,David Hammer,Sean Munroe,Leo McK

Incidence of nontuberculous mycobacterial disease in New Zealand, 2004   (Citations: 2)
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Aim To record the incidence and clinical significance of nontuberculous mycobacteria (NTM) infection in New Zealand (NZ) in 2004. Method In 2004 each of NZ's mycobacterium reference laboratories collected data on NTM isolates. The clinical significance of isolates was decided by contacting the requesting clinician. American Thoracic Society criteria were used to assign clinical significance to respiratory isolates. Results 368 patients had NTM isolated from various sites. 21% (78/368) were clinically significant (15% (47/316) of respiratory isolates, 100% (17/17) lymph node and 89% (8/9) of soft tissue isolates). Of the significant isolates, Mycobacterium avium intracellulare complex (MAIC) was the most common, accounting for 83%, 88%, and 44% of respiratory, lymph node, and soft tissue infections respectively. Rapidly growing mycobacteria (RGM) were the second most common cause of significant infection. Of 47 patients with significant respiratory isolates 79% were female and 83% had underlying lung disease. The incidence of disease caused by NTM in NZ in 2004 was 1.92/100,000 population. The specific incidence of pulmonary, lymph node and soft tissue infections was 1.17, 0.39, and 0.24 per 100,000 population respectively. Conclusion The incidence of NTM respiratory disease in NZ during 2004 is approximately twice that recorded for Australia in 2000 (0.56/100,000). MAIC is the most common pathogen, followed by RGM. Both organisms most commonly cause respiratory infections in elderly female patients with underlying lung disease. Nontuberculous mycobacteria (NTM) are mycobacteria other than those contained within the Mycobacterium tuberculosis complex. Over 95 species exist, of which approximately 30 have been associated with human disease. Common sites of disease include lymph nodes, soft tissue, and lung. Pulmonary infection may cause worsening of underlying lung disease or primary disease in previously healthy adults. This latter group tend to be elderly, non-smoking females and it has been suggested that there has been a shift in the epidemiology of NTM disease towards this group. 1 NTM are common in aquatic environments, dust, soil, and air; and are frequently isolated from domestic water supplies. Different species have been associated with disease in different geographic locations. For example, M. xenopi is commonly isolated in Europe and Canada whereas M. kansasii is more common in the USA. The incidence of disease has been reported to be increasing in several European countries, North America, and Japan. 2
Published in 2007.
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