scholarly journals Characteristics of Nontuberculous Mycobacterial Infections at a Midwestern Tertiary Hospital: A Retrospective Study of 365 Patients

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Claire E Hannah ◽  
Bradley A Ford ◽  
Jina Chung ◽  
Dilek Ince ◽  
Karolyn A Wanat
Keyword(s):  
Risk Factors ◽  
Mycobacterium Avium ◽  
Disease Surveillance ◽  
Mycobacterium Avium Complex ◽  
Retrospective Chart Review ◽  
Common Species ◽  
Tertiary Hospital ◽  
Population Based ◽  
Clinical Findings ◽  
Infection Prevalence

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.

scholarly journals Sepsis Incidence: A Population-Based Study

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Lisa Mellhammar ◽  
Sven Wullt ◽  
Åsa Lindberg ◽  
Peter Lanbeck ◽  
Bertil Christensson ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Antibiotic Therapy ◽  
Organ Dysfunction ◽  
Antibiotic Treatment ◽  
Retrospective Chart Review ◽  
Population Based ◽  
Clinical Findings ◽  
Intravenous Antibiotic ◽  
Major Health Problem ◽  
Intravenous Antibiotic Therapy

Abstract Background Although sepsis is a major health problem, data on sepsis epidemiology are scarce. The aim of this study was to assess the incidence of sepsis, based on clinical findings in all adult patients treated with intravenous antibiotic in all parts of all hospitals in an entire population. Methods This is a retrospective chart review of patients ≥18 years, living in 2 regions in Sweden, who were started on an intravenous antibiotic therapy on 4 dates, evenly distributed over the year of 2015. The main outcome was the incidence of sepsis with organ dysfunction. The mean population ≥18 years at 2015 in the regions was 1275753. Five hundred sixty-three patients living in the regions were started on intravenous antibiotic treatment on the dates of the survey. Patients who had ongoing intravenous antibiotic therapy preceding the inclusion dates were excluded, if sepsis was already present. Results Four hundred eighty-two patients were included in the study; 339 had a diagnosed infection, of those, 96 had severe sepsis according to the 1991/2001 sepsis definitions, and 109 had sepsis according to the sepsis-3. This is equivalent to an annual incidence of traditional severe sepsis of 687/100000 persons (95% confidence interval [CI], 549–824) or according to the sepsis-3 definition of 780/100000 persons (95% CI, 633–926). Seventy-four patients had sepsis according to both definitions. Conclusions The incidence of sepsis with organ dysfunction is higher than most previous estimates independent of definition. The inclusion of all inpatients started on intravenous antibiotic treatment of sepsis in a population makes an accurate assessment of sepsis incidence possible.

scholarly journals 784. The Changing Epidemiology of Disseminated Mycobacterium avium complex in the United States

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S280-S281
Author(s):  
Khalid M Dousa ◽  
Rafael Ponce-Terashima ◽  
Daniel Van Aartsen ◽  
Alejandro De La Hoz ◽  
John L Johnson
Keyword(s):  
United States ◽  
Risk Factors ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
The United States ◽  
Healthcare Systems ◽  
Electronic Health Record Data ◽  
Integrated Healthcare ◽  
Record Data ◽  
Necrosis Factor

Abstract Background The epidemiology of disseminated Mycobacterium avium complex (DMAC) infection in the United States is changing. Previously most DMAC occurred in adults with advanced AIDS. Since the development of effective antiretroviral therapy, the incidence of DMAC in AIDS has fallen more than 10-fold. Malignancy, immunosuppression, and tumor necrosis factor inhibitors are known risk factors for DMAC. We sought to describe the epidemiology of DMAC disease in HIV seronegative patients in the United States. Methods We performed a retrospective analysis of a commercial database (Explorys Inc., Cleveland, OH). This database contains an aggregate of Electronic Health Record data from 26 major integrated healthcare systems in the United States from 1999 to present. Explorys contains de-identified information from over 50 million patients, 360 hospitals, and over 317,000 providers. We identified a total of 571 persons diagnosed with DMAC, based on Systemized Nomenclature of Medicine-Clinical Terms. We excluded 80 HIV-infected and identified association of the infection with known risk factors. Results Of 570 patients, 491 HIV-uninfected patients with DMAC were studied. Underlying structural pulmonary diseases were COPD and bronchiectasis (51% and 47%, respectively). Two hundred ten patients had concomitant malignancy of which lung cancer was the most frequent (43%). Seventy-nine percent were receiving corticosteroids and 10 patients (2%) were on TNF inhibitors (2%). Conclusion In this study, majority of patients with DMAC are HIV-uninfected. Larger studies should focus on identifying the prevalence and risk factors of DMAC in the post-AIDS era. Disclosures All authors: No reported disclosures.

Outcomes and risk factors after adjuvant surgical treatments for Mycobacterium avium complex lung disease

2018 ◽  
Vol 67 (4) ◽  
pp. 363-369 ◽  
Author(s):  
Katsuo Yamada ◽  
Yukio Seki ◽  
Taku Nakagawa ◽  
Yuta Hayashi ◽  
Mitsuaki Yagi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Disease ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Surgical Treatments

scholarly journals Environmental Risk Factors for Infection with Mycobacterium avium Complex

2006 ◽  
Vol 164 (1) ◽  
pp. 32-40 ◽  
Author(s):  
Carrie Reed ◽  
C. Fordham von Reyn ◽  
Sandra Chamblee ◽  
Tedd V. Ellerbrock ◽  
Johnny W. Johnson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mycobacterium Avium ◽  
Environmental Risk ◽  
Mycobacterium Avium Complex ◽  
Environmental Risk Factors
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