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Volume 23, Number 3—March 2017
Research

Pulmonary Nontuberculous Mycobacteria–Associated Deaths, Ontario, Canada, 2001–2013

Theodore K. MarrasComments to Author , Michael A. Campitelli, Hong Lu, Hannah Chung, Sarah K. Brode, Alex Marchand-Austin, Kevin L. Winthrop, Andrea S. Gershon, Jeffrey C. Kwong1, and Frances B. Jamieson1
Author affiliations: Mount Sinai Hospital, Toronto, Ontario, Canada (T.K. Marras, S.K. Brode); University of Toronto, Toronto (T.K. Marras, S.K. Brode, A.S. Gershon, J.C. Kwong, F.B. Jamieson); University Health Network, Toronto (T.K. Marras, S.K. Brode, J.C. Kwong); Institute for Clinical Evaluative Sciences, Toronto (M.A. Campitelli, H. Lu, H. Chung, A.S. Gershon, J.C. Kwong); West Park Healthcare Centre, Toronto (S.K. Brode); Public Health Ontario, Toronto (A. Marchand-Austin, J.C. Kwong, F.B. Jamieson); Oregon Health and Science University, Portland, Oregon, USA (K.L. Winthrop); Sunnybrook Health Sciences Centre, Toronto (A.S. Gershon)

Main Article

Table 4

Survival estimates for patients with incident pulmonary NTM disease and with NTM isolation, Ontario, Canada, 2001–2013*

Species, group Total 1-y survival, % 5-y survival, % SMR† (95% CI) Crude HR (95% CI) Adjusted‡ HR (95% CI)
All
Disease 9,681 84.4 63.1 2.83 (2.74–2.92) 1.49 (1.42–1.56) 1.23 (1.17–1.28)
Isolation
 10,936
 89.7
 73.4
 2.30 (2.22–2.38)
 1.00 (ref)
 1.00 (ref)
MAC
Disease 6,323 85.7 64.7 2.59 (2.49–2.69) 1.40 (1.32–1.49) 1.16 (1.09–1.24)
Isolation
 5,756
 89.5
 73.2
 2.27 (2.16–2.38)
 1.00 (ref)
 1.00 (ref)
M. xenopi
Disease 2,263 80.2 56.8 3.49 (3.29–3.70) 1.71 (1.57–1.86) 1.39 (1.27–1.52)
Isolation
 2,932
 88.7
 71.9
 2.39 (2.23–2.55)
 1.00 (ref)
 1.00 (ref)
M. fortuitum
Disease 265 84.9 64.8 2.70 (2.21–3.18) 1.47 (1.17–1.85) 1.17 (0.92–1.48)
Isolation
 714
 89.8
 76.0
 2.63 (2.27–2.99)
 1.00 (ref)
 1.00 (ref)
M. abscessus
Disease 245 88.6 72.8 2.23 (1.71–2.74) 1.25 (0.87–1.80) 1.14 (0.76–1.72)
Isolation
 185
 91.4
 77.1
 2.10 (1.46–2.74)
 1.00 (ref)
 1.00 (ref)
M. kansasii
Disease 158 84.2 62.3 4.37 (3.37–5.37) 0.91 (0.65–1.29) 1.15 (0.78–1.68)
Isolation
 106
 82.1
 52.0
 3.97 (2.89–5.05)
 1.00 (ref)
 1.00 (ref)
Other
Disease 427 84.8 66.7 3.08 (2.62–3.55) 1.55 (1.29–1.87) 1.27 (1.04–1.55)
Isolation 1,243 92.8 77.6 1.94 (1.72–2.15) 1.00 (ref) 1.00 (ref)

*Comparisons between all registered Ontario residents with incident species-specific NTM isolation and NTM disease respectively; Matching not required for this analysis, and so adjustment was made for all covariates of interest. NTM disease was defined as >1 positive sputum for the same species or 1 positive bronchoscopic or biopsy specimen. NTM isolation was defined as 1 positive sputum sample for NTM. MAC, mycobacterium avium complex; NTM, nontuberculous mycobacterium; ref, reference; SMR, standardized mortality ratio.
†Standardized by sex and age in 5-y strata using data for the Ontario population.
‡Adjusted for sex, age, income quintile, location, Adjusted Clinical Group case mix system, baseline underlying conditions (asthma, chronic obstructive pulmonary disease, diabetes, HIV infection, rheumatoid arthritis, chronic kidney disease, gastresophageal reflux disease, bronchiectasis, interstitial lung disease, cystic fibrosis, prior tuberculosis, lung cancer, solid organ transplantation or bone marrow transplantation), health use (number of hospitalizations and emergency department visits in year before index date), and NTM disease diagnosis during follow-up as time-varying covariate (for NTM isolation group only).

Main Article

1These authors contributed equally to this article.

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