Abstract
Background: Nontuberculous mycobacteria (NTM) are increasingly identified in industrialized countries, and their role as pathogens is more frequently recognized. The relative prevalence of NTM strains shows an important geographical variability. Thus, establishing the local relative prevalence of NTM strains is relevant and useful for clinicians. Methods: Retrospective analysis (2015–2020) of a comprehensive database was conducted including all results of cultures for mycobacteria in a University Hospital (Geneva, Switzerland), covering a population of approximately 500,000 inhabitants. All NTM culture-positive patients were included in the analyses. Patients’ characteristics, NTM strains, and time to culture positivity were reported. Results: Among 38,065 samples analyzed during the study period, 411 were culture-positive for NTM, representing 236 strains, and 231 episodes of care which occurred in 222 patients. Patients in whom NTM were identified were predominantly female (55%), with a median age of 62 years, and a low BMI (median: 22.6 kg/m2). The Mycobacterium avium complex (MAC) was the most frequently identified group (37% of strains) followed by Mycobacterium gordonae (25%) and Mycobacterium xenopi (12%) among the slowly growing mycobacteria (SGM), while the Mycobacterium chelonae/abscessus group (11%) were the most frequently identified rapidly growing mycobacteria (RGM). Only 19% of all patients were treated, mostly for pulmonary infections: the MAC was the most frequently treated NTM (n = 19, 43% of cases in patients treated) followed by RGM (n = 15, 34%) and M. xenopi (n = 6, 14%). Among those treated, 23% were immunosuppressed, 12% had pulmonary comorbidities, and 5% systemic comorbidities. Cultures became positive after a median of 41 days (IQR: 23; 68) for SGM and 28 days (14; 35) for RGM. Conclusions: In Western Switzerland, M. avium and M. gordonae were the most prevalent NTM identified. Positive cultures for NTM led to a specific treatment in 19% of subjects. Patients with a positive culture for NTM were mostly female, with a median age of 62 years, a low BMI, and a low prevalence of immunosuppression or associated severe comorbidities.
References
1.
Turenne
CY
. Nontuberculous mycobacteria: insights on taxonomy and evolution
. Infect Genet Evol
. 2019
;72
:159
–68
. .2.
Hussein
Z
, Landt
O
, Wirths
B
, Wellinghausen
N
. Detection of non-tuberculous mycobacteria in hospital water by culture and molecular methods
. Int J Med Microbiol
. 2009
;299
(4
):281
–90
. .3.
Brown-Elliott
BA
, Philley
JV
. Rapidly growing mycobacteria
. Microbiol Spectr
. 2017
;5
(1
):1
–19
. .4.
To
K
, Cao
R
, Yegiazaryan
A
, Owens
J
, Venketaraman
V
. General overview of nontuberculous mycobacteria opportunistic pathogens: Mycobacterium avium and Mycobacterium abscessus
. J Clin Med
. 2020
;9
(8
):2541
. .5.
du Moulin
GC
, Stottmeier
KD
, Pelletier
PA
, Tsang
AY
, Hedley-Whyte
J
. Concentration of Mycobacterium avium by hospital hot water systems
. JAMA
. 1988
;260
(11
):1599
–601
. .6.
Gebert
MJ
, Delgado-Baquerizo
M
, Oliverio
AM
, Webster
TM
, Nichols
LM
, Honda
JR
, Ecological analyses of mycobacteria in showerhead biofilms and their relevance to human health
. mBio
. 2018
;9
(5
):e01614
–18
. .7.
Salmon
JH
, Direz
G
, Ziza
JM
, Desplaces
N
, Brochot
P
, Eschard
JP
. Discitis and sacroiliitis diagnosed 15 years after iatrogenic Mycobacterium xenopi inoculation
. Joint Bone Spine
. 2012
;79
(4
):409
–11
. .8.
Donnabella
V
, Salazar-Schicchi
J
, Bonk
S
, Hanna
B
, Rom
WN
. Increasing incidence of Mycobacterium xenopi at Bellevue hospital: an emerging pathogen or a product of improved laboratory methods?
Chest
. 2000
;118
(5
):1365
–70
. .9.
Sniadack
DH
, Ostroff
SM
, Karlix
MA
, Smithwick
RW
, Schwartz
B
, Sprauer
MA
, A nosocomial pseudo-outbreak of Mycobacterium xenopi due to a contaminated potable water supply: lessons in prevention
. Infect Control Hosp Epidemiol
. 1993
;14
(11
):636
–41
. .10.
Cai
SS
, Chopra
K
, Lifchez
SD
. Management of Mycobacterium abscessus infection after medical tourism in cosmetic surgery and a review of literature
. Ann Plast Surg
. 2016
;77
(6
):678
–82
. .11.
Vinh
DC
, Rendina
A
, Turner
R
, Embil
JM
. Breast implant infection with Mycobacterium fortuitum group: report of case and review
. J Infect
. 2006
;52
(3
):e63
–7
. .12.
Kohler
P
, Kuster
SP
, Bloemberg
G
, Schulthess
B
, Frank
M
, Tanner
FC
, Healthcare-associated prosthetic heart valve, aortic vascular graft, and disseminated Mycobacterium chimaera infections subsequent to open heart surgery
. Eur Heart J
. 2015
;36
(40
):2745
–53
. .13.
Griffith
DE
, Aksamit
T
, Brown-Elliott
BA
, Catanzaro
A
, Daley
C
, Gordin
F
, An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases
. Am J Respir Crit Care Med
. 2007
;175
(4
):367
–416
. .14.
Adjemian
J
, Olivier
KN
, Prevots
DR
. Epidemiology of pulmonary nontuberculous mycobacterial sputum positivity in patients with cystic fibrosis in the United States, 2010–2014
. Ann Am Thorac Soc
. 2018
;15
(7
):817
–26
. .15.
Wagner
D
, van Ingen
J
, van der Laan
R
, Obradovic
M
, Ntm
NET
. Non-tuberculous mycobacterial lung disease in patients with bronchiectasis: perceived risk, severity and guideline adherence in a European physician survey
. BMJ Open Respir Res
. 2020
;7
(1
):e000498
. .16.
Berra
G
, Plojoux
J
, Soccal
PM
, Janssens
JP
. Identification of non-tuberculous mycobacteria in COPD patients undergoing lung volume reduction: more frequent than expected?
Respiration
. 2019
;98
(3
):279
–80
. .17.
Wassilew
N
, Hoffmann
H
, Andrejak
C
, Lange
C
. Pulmonary disease caused by non-tuberculous mycobacteria
. Respiration
. 2016
;91
(5
):386
–402
. .18.
Hoefsloot
W
, van Ingen
J
, Magis-Escurra
C
, Reijers
MH
, van Soolingen
D
, Dekhuijzen
RP
, Prevalence of nontuberculous mycobacteria in COPD patients with exacerbations
. J Infect
. 2013
;66
(6
):542
–5
. .19.
Andrejak
C
, Nielsen
R
, Thomsen
VO
, Duhaut
P
, Sorensen
HT
, Thomsen
RW
. Chronic respiratory disease, inhaled corticosteroids and risk of non-tuberculous mycobacteriosis
. Thorax
. 2013
;68
(3
):256
–62
.20.
Adjemian
J
, Olivier
KN
, Seitz
AE
, Holland
SM
, Prevots
DR
. Prevalence of nontuberculous mycobacterial lung disease in US Medicare beneficiaries
. Am J Respir Crit Care Med
. 2012
;185
(8
):881
–6
. .21.
Brode
SK
, Daley
CL
, Marras
TK
. The epidemiologic relationship between tuberculosis and non-tuberculous mycobacterial disease: a systematic review
. Int J Tuberc Lung Dis
. 2014
;18
(11
):1370
–7
. .22.
Ringshausen
FC
, Wagner
D
, de Roux
A
, Diel
R
, Hohmann
D
, Hickstein
L
, Prevalence of nontuberculous mycobacterial pulmonary disease, Germany, 2009–2014
. Emerg Infect Dis
. 2016
;22
(6
):1102
–5
. .23.
du Moulin
GC
, Sherman
IH
, Hoaglin
DC
, Stottmeier
KD
. Mycobacterium avium complex, an emerging pathogen in Massachusetts
. J Clin Microbiol
. 1985
;22
(1
):9
–12
. .24.
Winthrop
KL
, Marras
TK
, Adjemian
J
, Zhang
H
, Wang
P
, Zhang
Q
. Incidence and prevalence of nontuberculous mycobacterial lung disease in a large US managed care health plan
. Ann Am Thorac Soc
. 2020
;17
(2
):178
–85
.25.
Prevots
DR
, Shaw
PA
, Strickland
D
, Jackson
LA
, Raebel
MA
, Blosky
MA
, Nontuberculous mycobacterial lung disease prevalence at four integrated health care delivery systems
. Am J Respir Crit Care Med
. 2010
;182
(7
):970
–6
. .26.
Zweijpfenning
SMH
, Ingen
JV
, Hoefsloot
W
. Geographic distribution of nontuberculous mycobacteria isolated from clinical specimens: a systematic review
. Semin Respir Crit Care Med
. 2018
;39
(3
):336
–42
. .27.
Hoefsloot
W
, van Ingen
J
, Andrejak
C
, Angeby
K
, Bauriaud
R
, Bemer
P
, The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples: an NTM-NET collaborative study
. Eur Respir J
. 2013
;42
(6
):1604
–13
. .28.
Adjemian
J
, Daniel-Wayman
S
, Ricotta
E
, Prevots
DR
. Epidemiology of nontuberculous mycobacteriosis
. Semin Respir Crit Care Med
. 2018
;39
(3
):325
–35
. .29.
Andrejak
C
, Thomsen
VO
, Johansen
IS
, Riis
A
, Benfield
TL
, Duhaut
P
, Nontuberculous pulmonary mycobacteriosis in Denmark: incidence and prognostic factors
. Am J Respir Crit Care Med
. 2010
;181
(5
):514
–21
.30.
Adjemian
J
, Frankland
TB
, Daida
YG
, Honda
JR
, Olivier
KN
, Zelazny
A
, Epidemiology of nontuberculous mycobacterial lung disease and tuberculosis, Hawaii, USA
. Emerg Infect Dis
. 2017
;23
(3
):439
–47
. .31.
Daley
CL
, Iaccarino
JM
, Lange
C
, Cambau
E
, Wallace
RJ
Jr, Andrejak
C
, Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline
. Eur Respir J
. 2020
;56
(1
):2000535
. .32.
Schnabel
D
, Esposito
DH
, Gaines
J
, Ridpath
A
, Barry
MA
, Feldman
KA
, Multistate US outbreak of rapidly growing mycobacterial infections associated with medical tourism to the Dominican Republic, 2013–2014(1)
. Emerg Infect Dis
. 2016
;22
(8
):1340
–7
. .33.
Cusumano
LR
, Tran
V
, Tlamsa
A
, Chung
P
, Grossberg
R
, Weston
G
, Rapidly growing Mycobacterium infections after cosmetic surgery in medical tourists: the Bronx experience and a review of the literature
. Int J Infect Dis
. 2017
;63
:1
–6
. .34.
Newman
MI
, Camberos
AE
, Clynes
ND
, Ascherman
JA
. Outbreak of atypical mycobacteria infections in US patients traveling abroad for cosmetic surgery
. Plast Reconstr Surg
. 2005
;115
(3
):964
–5
. .35.
Engdahl
R
, Cohen
L
, Pouch
S
, Rohde
C
. Management of Mycobacterium abscessus post abdominoplasty
. Aesthetic Plast Surg
. 2014
;38
(6
):1138
–42
. .36.
Zosso
C
, Lienhard
R
, Siegrist
HH
, Malinverni
R
, Clerc
O
. Post liposuction infections by rapidly growing mycobacteria
. Infect Dis
. 2015
;47
(2
):69
–72
. .37.
Johnson
MM
, Odell
JA
. Nontuberculous mycobacterial pulmonary infections
. J Thorac Dis
. 2014
;6
(3
):210
–20
. .38.
Hongler
J
, Musaazi
J
, Ledergerber
B
, Eberhard
N
, Sekaggya-Wiltshire
C
, Keller
PM
, Comparison of Löwenstein-Jensen and BACTEC MGIT 960 culture for Mycobacterium tuberculosis in people living with HIV
. HIV Med
. 2018
;19
(9
):654
–61
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