Table 2.
Clinical Characteristics and Community and Healthcare Exposures of Persons With Extrapulmonary or Pulmonary Nontuberculous Mycobacteria Infection
| Characteristic | Extrapulmonary N = 68 |
Pulmonary N = 231 |
|---|---|---|
| Days from index specimen collection to culture result date, median (interquartile range) | 30 (20.5–41) | 47 (31–68) |
| Location of index specimen collection, n (%) | ||
| Inpatient | 35 (51.5) | 74 (32.0) |
| Outpatient | 33 (48.5) | 154 (66.7) |
| Unknown | 0 | 3 (1.3) |
| Signs and symptoms in the 14 d before the DISC,a n (%) | ||
| Any | 62 (91.2) | 201 (87.0)b |
| Chest pain | – | 31 (13.4) |
| Cough | – | 159 (68.8) |
| Dyspnea | – | 63 (27.3) |
| Fatigue or malaise | 14 (20.6) | 50 (21.6) |
| Fever | 16 (23.5) | 29 (12.6) |
| Hemoptysis | – | 32 (13.9) |
| Night sweats | 3 (4.4) | 17 (7.4) |
| Pain at infection site | 26 (38.2) | – |
| Positive imaging | 4 (5.9) | – |
| Pus, drainage, abscess | 22 (32.4) | – |
| Redness or swelling | 23 (33.8) | – |
| Weight loss | 10 (14.7) | 37 (16.0) |
| Other | 14 (20.6) | 35 (15.2) |
| None | 2 (2.9) | 18 (7.8) |
| Unknown | 3 (4.4) | 10 (4.3) |
| Chest imaging in the 90 d before or after the DISC, n (%) | ||
| Chest CT only | – | 115 (49.8) |
| Bronchiectasis only | 16/115 (13.9) | |
| Nodules only | … | 41/115 (35.7) |
| Cavity or cavitation only | … | 7/115 (6.1) |
| Bronchiectasis plus nodules | … | 31/115 (27.0) |
| Nodules or cavities | … | 87/115 (75.7) |
| None of the above | … | 12/115 (10.4) |
| Unknown | … | 0 |
| Chest radiograph only | – | 40 (17.3) |
| Bronchiectasis only | … | 6/40 (15.0) |
| Nodules only | … | 7/40 (17.5) |
| Cavity or cavitation only | … | 5/40 (12.5) |
| Bronchiectasis plus nodules | … | 7/40 (17.5) |
| Nodules or cavities | … | 20/40 (50.0) |
| None of the above | … | 14/40 (35.0) |
| Unknown | … | 0 |
| Chest CT and chest radiograph | – | 47 (20.3) |
| Bronchiectasis only | … | 3/47 (6.4) |
| Nodules only | … | 14/47 (29.8) |
| Cavity or cavitation only | … | 2/47 (4.3) |
| Bronchiectasis plus nodules | … | 15/47 (31.9) |
| Nodules or cavities | … | 39/47 (83.0) |
| None of the above | … | 5/47 (10.6) |
| Unknown | … | 0 |
| None | – | 27 (11.7) |
| Unknown | – | 2 (0.9) |
| Clinician-diagnosed NTM disease,c n (%) | 52 (76.5) | 181 (78.4) |
| Diagnostic criteria for pulmonary NTM disease [26], n (%) | ||
| Both clinical and radiologic criteria were met | – | 76 (32.9) |
| Clinical criterion only was met | – | 101 (43.7) |
| Radiologic criterion only was met | – | 8 (3.5) |
| Neither clinical nor radiologic criteria were metd | – | 12 (5.2) |
| Unknown or data not available | – | 34 (14.7) |
| Referral to specialist, n (%)e | 59 (86.8) | 219 (94.8) |
| Infectious diseases specialist | 47/59 (79.7) | 144/219 (65.8) |
| Pulmonary specialist | 2/59 (3.4) | 151/219 (68.9) |
| Infectious diseases and pulmonary specialists | 0/59 | 79/219 (36.1) |
| Surgeon | 27/59 (45.8) | 5/219 (2.3) |
| Otherf | 6/59 (10.2) | 1/219 (0.5) |
| NTM-related hospitalization in the year before or on the DISC,g n (%) | 33 (48.5) | 41 (17.7) |
| Hospitalized on the DISC,h n (%) | 31 (45.6) | 72 (31.2) |
| Documented exposures in the year before or on the DISC,i n (%) | … | … |
| Community | 21 (31.8) | 60 (26.0) |
| Acupuncture | 1 (1.5) | – |
| Bird contact | 1 (1.5) | 2 (0.9) |
| Construction | 0 | 4 (1.7) |
| Fish tank | 1 (1.5) | 1 (0.4) |
| Gardening or landscaping | 1 (1.5) | 9 (3.9) |
| Homelessness | 3 (4.5) | 10 (4.3) |
| Hot tub | 1 (1.5) | 6 (2.6) |
| Humidifier use | 0 | 2 (0.9) |
| Incarceration | 2 (3.0) | 6 (2.6) |
| Livestock | 0 | 2 (0.9) |
| Nail salon | 1 (1.5) | 0 |
| Neti pot | 3 (4.5) | 0 |
| Nebulizer | – | 6 (2.6) |
| Swimming pool | 0 | 4 (1.7) |
| Tattoo | 1 (1.5) | – |
| Trauma | 7 (10.6) | – |
| Other | 8 (12.1) | 25 (10.8) |
| Healthcare | 28 (42.4) | 74 (32.0) |
| Bronchoscopy | – | 46 (19.9) |
| Cystic fibrosis clinic | – | 14 (6.1) |
| Dental procedure | 2 (3.0) | 1 (0.4) |
| Injection or infusion | 10 (15.2) | 10 (4.3) |
| Medical device | 1 (1.5) | 2 (0.9) |
| Nursing home residence | 2 (3.0) | 7 (3.0) |
| Surgical procedure | 19 (28.8) | 5 (2.2) |
| Other | 0 | 3 (1.3) |
| None | 21 (31.8) | 90 (39.0) |
| Unknown | 3 (4.5) | 20 (8.7) |
– indicates variable not collected.
Date of index specimen collection.
Includes patients with ≥1 specified pulmonary or systemic symptom: chest pain, cough, dyspnea, fatigue or malaise, fever, hemoptysis, or night sweats.
Defined as a diagnosis of NTM disease recorded in the medical record; unknown for 4 extrapulmonary and 3 pulmonary NTM cases.
Two pulmonary NTM cases did not meet the imaging criterion, and clinical criterion data were unknown; 1 pulmonary NTM case did not meet the clinical criterion and imaging was not performed.
Referral to specialist was unknown for 1 extrapulmonary and 3 pulmonary NTM cases.
Examples of other specialists include dermatologist, neurologist, hematologist/oncologist, otolaryngologist, hepatologist, chiropractor.
Five extrapulmonary and 6 pulmonary NTM cases had unknown overall hospitalization status in the year before the DISC, and 1 extrapulmonary and 1 pulmonary NTM case had unknown NTM-related hospitalization status.
Five extrapulmonary and 6 pulmonary NTM cases had unknown overall hospitalization status in the year before the DISC, and 1 extrapulmonary and 1 pulmonary NTM case had unknown admission and/or discharge dates.
Among 66 extrapulmonary NTM cases not known to be associated with an outbreak (2 outbreak-associated extrapulmonary NTM cases were excluded). Multiple exposures could be reported for a case.
Abbreviations: CT, computed tomography; DISC, date of index specimen collection; NTM, nontuberculous mycobacteria.