Abstract Background The prevalence of infections due to nontuberculous mycobacteria (NTM) is increasing worldwide, yet little is known about the epidemiology and pathophysiology of these ubiquitous environmental organisms. Pulmonary disease due to Mycobacterium avium complex is most prevalent, but many other NTM species can cause disease in virtually any organ system. As NTM becomes an increasingly common cause of morbidity and mortality, more information is needed about the epidemiology of NTM disease. Methods We conducted a retrospective chart review of all patients with cultures that grew NTM at a Midwestern tertiary hospital from 1996 to 2017. Information on demographics, medical history, clinical findings, treatment, and outcome was obtained from medical records of all NTM isolates. American Thoracic Society/Infectious Diseases Society of America criteria were used to define pulmonary NTM infections. Results We identified 1064 NTM isolates, 365 of which met criteria for NTM infection. Pulmonary cases predominated (185 of 365; 50.7%), followed by skin/soft tissue (56 of 365; 15.3%), disseminated (40 of 365; 11%), and lymphatic (28 of 365; 7.7%) disease. Mycobacterium avium complex was the most common species (184 of 365; 50.4%). Individuals aged >50 years were most affected (207 of 365; 56.7%). Common comorbidities included structural lung disease (116 of 365; 31.8%), use of immunosuppressive medications (78 of 365; 21.4%), malignancy (59 of 365; 16.2%), and human immunodeficiency virus (42 of 365; 11.5%). Conclusions This large cohort provides information on the demographics, risk factors, and disease course of patients with pulmonary and extrapulmonary NTM infections. Most patients had medical comorbidities that resulted in anatomic, genetic, or immunologic risk factors for NTM infection. Further population-based studies and increased disease surveillance are warranted to further characterize NTM infection prevalence and trends.

中文翻译：

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中西部三级医院非结核分枝杆菌感染的特征：365 例患者的回顾性研究

摘要背景由于非结核分枝杆菌 (NTM) 引起的感染率在全球范围内不断增加，但对这些无处不在的环境生物的流行病学和病理生理学知之甚少。由鸟分枝杆菌复合体引起的肺部疾病最为普遍，但许多其他 NTM 物种几乎可以在任何器官系统中引起疾病​​。随着 NTM 成为发病率和死亡率越来越普遍的原因，需要更多关于 NTM 疾病流行病学的信息。方法 我们对 1996 年至 2017 年在中西部一家三级医院培养出 NTM 的所有患者进行了回顾性图表审查。从所有 NTM 分离株的医疗记录中获得有关人口统计、病史、临床发现、治疗和结果的信息。美国胸科学会/美国传染病学会标准用于定义肺部 NTM 感染。结果 我们鉴定了 1064 株 NTM 分离株，其中 365 株符合 NTM 感染标准。肺部病例占主导地位（365 例中的 185 例；50.7%），其次是皮肤/软组织（365 例中的 56 例；15.3%）、播散性（365 例中的 40 例；11%）和淋巴（365 例中的 28 例；7.7%）疾病。鸟分枝杆菌复合体是最常见的物种（365 个中的 184 个；50.4%）。年龄 > 50 岁的个体受影响最大（365 人中的 207 人；56.7%）。常见的合并症包括结构性肺病（365 人中的 116 人；31.8%）、使用免疫抑制药物（365 人中的 78 人；21.4%）、恶性肿瘤（365 人中的 59 人；16.2%）和人类免疫缺陷病毒（365 人中的 42 人；11.5%） . 结论 这个大型队列提供了有关人口统计、风险因素、肺和肺外 NTM 感染患者的病程和病程。大多数患者有导致 NTM 感染的解剖学、遗传或免疫学危险因素的合并症。有必要进一步基于人群的研究和加强疾病监测来进一步描述 NTM 感染流行率和趋势。