Pulmonary infections with nontuberculous mycobacteria on the rise globally

A recent review published in the International Journal of Infectious Diseases, most of the studies revealed overall increase in pulmonary nontuberculus mycobacteria (NTM) globally for both infection and disease.

To describe in detail the global trends of pulmonary nontuberculus mycobacteria infection and disease Victor Naestholt Dahl carried forward this extensive review. Culture-based NTM data and other studies reporting on pulmonary NTM infection and/or disease over time was included in this systematic review.

According to the use of guideline-based criteria for disease which was collected, infection was defined as the absence of symptoms and radiological findings that is compatible with NTM pulmonary disease. Using linear regressions and corresponding pooled estimates the trends of change for incidence/prevalence of NTM were calculated.

The highlights of this review article were:

• Most of the studies included in the review reported increasing pulmonary NTM infection (82.1%) and disease (66.7%) in the recent past.
• The annual rate of change per 1,00,000 persons/year for NTM infection was 4·0% while for NTM disease was and 4·1%.
• The overall annual change for absolute NTM infection and disease numbers was 2·0 and 0·5, respectively.
• In Mycobacterium avium, an increasing trend was also seen for complex infection (n=15/19, 78·9%) and disease (n= 10/12, 83·9%).
• An increasing trend for Mycobacterium abscessus complex (n=15/23, 65·2%) infection (n=11/17, 64·7%) but less so for disease (n=2/8, 25·0%).

In conclusion, the findings of this review has increasingly recognized that NTM as important opportunistic pathogens. Most of the studies report an increasing trend of pulmonary NTM infection and disease but the data on the NTM trends are mostly limited to its geographical representation. Further evidence via research is required to explain this global increase trend.

Reference:

Dahl, V. N., Mølhave, M., Fløe, A., van Ingen, P. J., Schön, P. T., Lillebaek, P. T., Andersen, P. A. B., & Wejse, P. C. (2022). Global trends of pulmonary infections with nontuberculous mycobacteria: a systematic review. In International Journal of Infectious Diseases. Elsevier BV. https://doi.org/10.1016/j.ijid.2022.10.013