Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link

Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Volume 30, Number 9—September 2024
Synopsis

Clinical Significance, Species Distribution, and Temporal Trends of Nontuberculous Mycobacteria, Denmark, 1991–2022

Victor Naestholt DahlComments to Author , Andreas Arnholdt Pedersen, Anders Norman, E. Michael Rasmussen, Jakko van Ingen, Aase Bengaard Andersen, Christian Morberg Wejse1, and Troels Lillebaek1
Author affiliations: Statens Serum Institut, Copenhagen, Denmark (V.N. Dahl, A. Norman, E.M. Rasmussen, T. Lillebaek); Aarhus University Hospital, Aarhus, Denmark (V.N. Dahl, C.M. Wejse); Aarhus University, Aarhus (V.N. Dahl, C.M. Wejse); Odense University Hospital, Odense, Denmark (A.A. Pedersen); Lillebaelt Hospital, Vejle, Denmark (A.A. Pedersen); Radboud University Medical Center, Nijmegen, the Netherlands (J. van Ingen); Rigshospitalet, Copenhagen (A.B. Andersen); University of Copenhagen, Copenhagen (T. Lillebaek)

Main Article

Figure 4

Annual absolute number of patients with a first culture positive for MAC, corresponding incidence rates, and annual incidence rates for the most frequent nontuberculous mycobacteria species for extrapulmonary and disseminated nontuberculous mycobacteria, Denmark, 1991–2022. Patients with samples from both pulmonary and extrapulmonary locations were categorized as having disseminated disease. A) Numbers of first MAC cases by year and annual incidence (infections/1 million persons). B) Annual incidence rates (infections/1 million persons) of the most frequent nontuberculous mycobacteria species. Species were grouped by using phylogenetic classifications described by Tortoli et al. (7). Other was defined as Mycobacteria spp. and species with <15 cases reported throughout the study period. MAC, Mycobacterium avium complex.

Figure 4. Annual absolute number of patients with a first culture positive for MAC, corresponding incidence rates, and annual incidence rates for the most frequent nontuberculous mycobacteria species for extrapulmonary and disseminated nontuberculous mycobacteria, Denmark, 1991–2022. Patients with samples from both pulmonary and extrapulmonary locations were categorized as having disseminated disease. A) Numbers of first MAC cases by year and annual incidence (infections/1 million persons). B) Annual incidence rates (infections/1 million persons) of the most frequent nontuberculous mycobacteria species. Species were grouped by using phylogenetic classifications described by Tortoli et al. (7). Other was defined as Mycobacteria spp. and species with <15 cases reported throughout the study period. MAC, Mycobacterium avium complex.

Main Article

References
  1. Dahl  VN, Mølhave  M, Fløe  A, van Ingen  J, Schön  T, Lillebaek  T, et al. Global trends of pulmonary infections with nontuberculous mycobacteria: a systematic review. Int J Infect Dis. 2022;125:12031. DOIPubMedGoogle Scholar
  2. Griffith  DE, Aksamit  T, Brown-Elliott  BA, Catanzaro  A, Daley  C, Gordin  F, et al.; ATS Mycobacterial Diseases Subcommittee; American Thoracic Society; Infectious Disease Society of America. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175:367416. DOIPubMedGoogle Scholar
  3. Daley  CL, Iaccarino  JM, Lange  C, Cambau  E, Wallace  RJ Jr, Andrejak  C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Eur Respir J. 2020;56:2000535. DOIPubMedGoogle Scholar
  4. Andréjak  C, Thomsen  VO, Johansen  IS, Riis  A, Benfield  TL, Duhaut  P, et al. Nontuberculous pulmonary mycobacteriosis in Denmark: incidence and prognostic factors. Am J Respir Crit Care Med. 2010;181:51421. DOIPubMedGoogle Scholar
  5. Hermansen  TS, Ravn  P, Svensson  E, Lillebaek  T. Nontuberculous mycobacteria in Denmark, incidence and clinical importance during the last quarter-century. Sci Rep. 2017;7:6696. DOIPubMedGoogle Scholar
  6. Winthrop  KL, McNelley  E, Kendall  B, Marshall-Olson  A, Morris  C, Cassidy  M, et al. Pulmonary nontuberculous mycobacterial disease prevalence and clinical features: an emerging public health disease. Am J Respir Crit Care Med. 2010;182:97782. DOIPubMedGoogle Scholar
  7. Tortoli  E, Fedrizzi  T, Meehan  CJ, Trovato  A, Grottola  A, Giacobazzi  E, et al. The new phylogeny of the genus Mycobacterium: The old and the news. Infect Genet Evol. 2017;56:1925. DOIPubMedGoogle Scholar
  8. Thomsen  VO, Andersen  AB, Miörner  H. Incidence and clinical significance of non-tuberculous mycobacteria isolated from clinical specimens during a 2-y nationwide survey. Scand J Infect Dis. 2002;34:64853. DOIPubMedGoogle Scholar
  9. Kwak  N, Dalcolmo  MP, Daley  CL, Eather  G, Gayoso  R, Hasegawa  N, et al. M ycobacterium abscessus pulmonary disease: individual patient data meta-analysis. Eur Respir J. 2019;54:1801991. DOIPubMedGoogle Scholar
  10. Diel  R, Ringshausen  F, Richter  E, Welker  L, Schmitz  J, Nienhaus  A. Microbiological and clinical outcomes of treating non–Mycobacterium avium complex nontuberculous mycobacterial pulmonary disease: a systematic review and meta-analysis. Chest. 2017;152:12042. DOIPubMedGoogle Scholar
  11. Diel  R, Nienhaus  A, Ringshausen  FC, Richter  E, Welte  T, Rabe  KF, et al. Microbiologic outcome of interventions against Mycobacterium avium complex pulmonary disease: a systematic review. Chest. 2018;153:888921. DOIPubMedGoogle Scholar
  12. van Ingen  J, Bendien  SA, de Lange  WC, Hoefsloot  W, Dekhuijzen  PN, Boeree  MJ, et al. Clinical relevance of non-tuberculous mycobacteria isolated in the Nijmegen-Arnhem region, The Netherlands. Thorax. 2009;64:5026. DOIPubMedGoogle Scholar
  13. Vande Weygaerde  Y, Cardinaels  N, Bomans  P, Chin  T, Boelens  J, André  E, et al. Clinical relevance of pulmonary non-tuberculous mycobacterial isolates in three reference centres in Belgium: a multicentre retrospective analysis. BMC Infect Dis. 2019;19:1061. DOIPubMedGoogle Scholar
  14. Al-Mahruqi  SH, van-Ingen  J, Al-Busaidy  S, Boeree  MJ, Al-Zadjali  S, Patel  A, et al. Clinical relevance of nontuberculous Mycobacteria, Oman. Emerg Infect Dis. 2009;15:2924. DOIPubMedGoogle Scholar
  15. Schiff  HF, Jones  S, Achaiah  A, Pereira  A, Stait  G, Green  B. Clinical relevance of non-tuberculous mycobacteria isolated from respiratory specimens: seven year experience in a UK hospital. Sci Rep. 2019;9:1730. DOIPubMedGoogle Scholar
  16. Simons  S, van Ingen  J, Hsueh  PR, Van Hung  N, Dekhuijzen  PN, Boeree  MJ, et al. Nontuberculous mycobacteria in respiratory tract infections, eastern Asia. Emerg Infect Dis. 2011;17:3439. DOIPubMedGoogle Scholar
  17. Jankovic  M, Samarzija  M, Sabol  I, Jakopovic  M, Katalinic Jankovic  V, Zmak  L, et al. Geographical distribution and clinical relevance of non-tuberculous mycobacteria in Croatia. Int J Tuberc Lung Dis. 2013;17:83641. DOIPubMedGoogle Scholar
  18. Gerogianni  I, Papala  M, Kostikas  K, Petinaki  E, Gourgoulianis  KI. Epidemiology and clinical significance of mycobacterial respiratory infections in Central Greece. Int J Tuberc Lung Dis. 2008;12:80712.PubMedGoogle Scholar
  19. Dabó  H, Santos  V, Marinho  A, Ramos  A, Carvalho  T, Ribeiro  M, et al. Nontuberculous mycobacteria in respiratory specimens: clinical significance at a tertiary care hospital in the north of Portugal. J Bras Pneumol. 2015;41:2924. DOIPubMedGoogle Scholar
  20. Al-Harbi  A, Al-Jahdali  H, Al-Johani  S, Baharoon  S, Bin Salih  S, Khan  M. Frequency and clinical significance of respiratory isolates of non-tuberculous mycobacteria in Riyadh, Saudi Arabia. Clin Respir J. 2016;10:198203. DOIPubMedGoogle Scholar
  21. Brode  SK, Marchand-Austin  A, Jamieson  FB, Marras  TK. Pulmonary versus nonpulmonary nontuberculous mycobacteria, Ontario, Canada. Emerg Infect Dis. 2017;23:1898901. DOIPubMedGoogle Scholar
  22. Russell  CD, Claxton  P, Doig  C, Seagar  AL, Rayner  A, Laurenson  IF. Non-tuberculous mycobacteria: a retrospective review of Scottish isolates from 2000 to 2010. Thorax. 2014;69:5935. DOIPubMedGoogle Scholar
  23. Prevots  DR, Shaw  PA, Strickland  D, Jackson  LA, Raebel  MA, Blosky  MA, et al. Nontuberculous mycobacterial lung disease prevalence at four integrated health care delivery systems. Am J Respir Crit Care Med. 2010;182:9706. DOIPubMedGoogle Scholar
  24. Wetzstein  N, Dahl  VN, Lillebaek  T, Lange  C. Clinical spectrum and relevance of Mycobacterium malmoense: Systematic review and meta-analysis of 859 patients. J Infect. 2024;89:106203. DOIPubMedGoogle Scholar
  25. Jankovic  M, Sabol  I, Zmak  L, Jankovic  VK, Jakopovic  M, Obrovac  M, et al. Microbiological criteria in non-tuberculous mycobacteria pulmonary disease: a tool for diagnosis and epidemiology. Int J Tuberc Lung Dis. 2016;20:93440. DOIPubMedGoogle Scholar
  26. Marras  TK, Nelson  P, Peci  A, Richard-Greenblatt  M, Brode  S, Sullivan  A, et al. Pulmonary nontuberculous mycobacteria, Ontario, Canada, 2020. Emerg Infect Dis. 2023;29:14159. DOIPubMedGoogle Scholar
  27. van Ingen  J. Microbiological diagnosis of nontuberculous mycobacterial pulmonary disease. Clin Chest Med. 2015;36:4354. DOIPubMedGoogle Scholar
  28. Yan  M, Brode  SK, Marras  TK. Treatment of the less common nontuberculous mycobacterial pulmonary disease. Clin Chest Med. 2023;44:799813. DOIPubMedGoogle Scholar
  29. Dahl  VN, Laursen  LL, He  Y, Zhang  YA, Wang  MS. Species distribution among patients with nontuberculous mycobacteria pulmonary disease in Europe. J Infect. 2023;87:46972. DOIPubMedGoogle Scholar
  30. Hoefsloot  W, van Ingen  J, Andrejak  C, Angeby  K, Bauriaud  R, Bemer  P, et al.; Nontuberculous Mycobacteria Network European Trials Group. The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples: an NTM-NET collaborative study. Eur Respir J. 2013;42:160413. DOIPubMedGoogle Scholar
  31. Hoefsloot  W, Boeree  MJ, van Ingen  J, Bendien  S, Magis  C, de Lange  W, et al. The rising incidence and clinical relevance of Mycobacterium malmoense: a review of the literature. Int J Tuberc Lung Dis. 2008;12:98793.PubMedGoogle Scholar
  32. Zweijpfenning  SMH, Ingen  JV, Hoefsloot  W. Geographic distribution of nontuberculous mycobacteria isolated from clinical specimens: a systematic review. Semin Respir Crit Care Med. 2018;39:33642. DOIPubMedGoogle Scholar
  33. Prevots  DR, Marshall  JE, Wagner  D, Morimoto  K. Global epidemiology of nontuberculous mycobacterial pulmonary disease: a review. Clin Chest Med. 2023;44:675721. DOIPubMedGoogle Scholar
  34. Dahl  VN, Fløe  A, Wejse  C. Nontuberculous mycobacterial infections in a Danish region between 2011 and 2021: evaluation of trends in diagnostic codes. Infect Dis (Lond). 2023;55:43943. DOIPubMedGoogle Scholar
  35. Pedersen  AA, Løkke  A, Fløe  A, Ibsen  R, Johansen  IS, Hilberg  O. Nationwide increasing incidence of nontuberculous mycobacterial diseases among adults in Denmark: eighteen years of follow-up. Chest. 2024;S0012-3692(24)00393-3.
  36. Mejia-Chew  C, Yaeger  L, Montes  K, Bailey  TC, Olsen  MA. Diagnostic accuracy of health care administrative diagnosis codes to identify nontuberculous mycobacteria disease: a systematic review. Open Forum Infect Dis. 2021;8:ofab035. DOIPubMedGoogle Scholar
  37. Loebinger  MR, Quint  JK, van der Laan  R, Obradovic  M, Chawla  R, Kishore  A, et al. Risk factors for nontuberculous mycobacterial pulmonary disease: a systematic literature review and meta-analysis. Chest. 2023;164:111524. DOIPubMedGoogle Scholar

Main Article

1These authors contributed equally to this article.

Page created: July 08, 2024
Page updated: August 09, 2024
Page reviewed: August 09, 2024
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external