BACKGROUND Current guidelines recommend at least once yearly screening for nontuberculous mycobacteria (NTM) in Cystic Fibrosis (CF), however screening practices remain widely variable. This study evaluates current practices among United States CF centers with specific focus on clinical predictive factors for NTM screening. METHODS The CF Patient Registry (CFFPR) was queried for CF patients ages 10 and older with NTM cultures completed between 2010-2014. Predictors for screening were assessed using univariate and multivariate logistic regression. Centers were evaluated by groups based on screening rates for analysis of clinical drivers of screening. RESULTS From 2010-2014 a total of 22,739 patients were identified with 17,177 (75.5%) tested for NTM during this time. In the overall cohort, those who were tested for NTM had lower pulmonary function (70.7% vs 83.9%), higher annual average of visits with pulmonary exacerbations (1.0 vs 0.3), and higher rate of coinfection with Pseudomonas aeruginosa (PA) as well as Methicillin resistant Staphylococcus aureus (MRSA). Among CF centers, pulmonary function, exacerbations, and coinfections with PA and MRSA were predictive of NTM screening in the lower screening cohort while pulmonary function was not predictive of screening in the highest screening cohort. Those programs who screened at a higher rate were successful in identifying NTM in more CF patients. CONCLUSION NTM screening practices vary widely among United States CF centers with many centers testing only on clinical changes. With higher rates of testing shown as successful in identifying more patients with NTM, routine screening should be emphasized in CF care going forward.

中文翻译：

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美国囊性纤维化中心的非结核分枝杆菌筛查实践

背景 目前的指南建议对囊性纤维化 (CF) 中的非结核分枝杆菌 (NTM) 至少每年筛查一次，但筛查实践仍然存在很大差异。本研究评估了美国 CF 中心的当前做法，特别关注 NTM 筛查的临床预测因素。方法 在 CF 患者登记 (CFFPR) 中查询 10 岁及以上且在 2010 年至 2014 年期间完成 NTM 培养的 CF 患者。使用单变量和多变量逻辑回归评估筛选预测因子。中心根据筛查率进行分组评估，以分析筛查的临床驱动因素。结果 从 2010 年到 2014 年，总共确定了 22,739 名患者，其中 17,177 名 (75.5%) 在此期间接受了 NTM 检测。在整个队列中，接受 NTM 检测的患者的肺功能较低（70.7% 对 83.9%），肺部恶化的年平均就诊率较高（1.0 对 0.3），同时感染铜绿假单胞菌 (PA) 和耐甲氧西林金黄色葡萄球菌的比率较高(MRSA)。在 CF 中心，肺功能、急性加重和 PA 和 MRSA 合并感染可预测较低筛查队列中的 NTM 筛查，而肺功能不能预测最高筛查队列中的筛查。那些筛查率较高的项目成功地在更多 CF 患者中识别出 NTM。结论 美国 CF 中心的 NTM 筛查实践差异很大，许多中心仅测试临床变化。随着更高的测试率显示成功识别出更多的 NTM 患者，