Table 2:
Studies of Rates of Pulmonary NTM Isolation and Disease by Region
| North America | |||||||
|---|---|---|---|---|---|---|---|
| Location (dates) | Case Definition | Data Source/Cohort | Annual Prevalence (per 100,000 population) | Period Prevalence | Incidence (per 100,000 population) | ||
| Isolation (dates) | Disease (dates) | Period Duration (years) | Prevalence (per 100,000 population) | ||||
| Canada | |||||||
| Ontario, Canada (1998–2010)131 | Isolation: ≥ 1 isolate Disease: ATS microbiologic criteria |
Public Health Ontario Laboratory Database | 11.4–22.2 (1998–2010) (APC: 6.3%); Annual Change (MAC: 0.291, M. xenopi: 0.059, M. abscessus: 0.019) | 4.65 – 9.08 (1998–2010) (APC: 8.0%)+** | - | - | - |
| United States | |||||||
| U.S. (2008–2015)45 | ICD-9/ICD-10 | Optum Clinformatics Data Mart Care Claims database | - | 6.78–11.70 (APC: 7.5%) (2008–2015) | 8 | - | 3.13–4.73 (2008–2015) (APC: 5.2%) (D) |
| Florida (2012–2018)55 | ICD-9-CM/ICD-10 | OneFlorida Clinical Research Consortium database | - | 14.3–22.6 (2012–2018) | 7 | - | 6.5–5.4 (2012–2018) (D) |
| Hawaii (2005–2013)52 | Isolation: ≥ 1 isolate Disease: ATS microbiologic criteria |
Kaiser Permanente Hawaii databases | 20–44 (2005–2013) (APC: 6%)** | 9–19 (2005–2013)+** | 9 | Range by Ethnic group: 50–300 (I)** | - |
| Hawaii (2005–2019)53 | ≥ 1 isolate | Kaiser Permanente Hawaii EHR databases | - | - | 15 | - | Overall Annualized: 44.8 (I)**, Range by Ethnic group: 17–63 (I)**, Cumulative: 247 (I)** |
| Maryland, Mississippi, Missouri, Ohio, Wisconsin (2008–2013)51 | ≥ 1 isolate | Surveillance data from Maryland, Mississippi, Missouri, Ohio, Wisconsin | Overall: 8.7–13.9 (2008–2013)§# (APC: 9.9%)§#, Maryland: 9.5–9.29 (2008–2013)§# Mississippi:10.2–13.69 (2008–2013)§#, Missouri: 5.5–13.39 (2008–2013)§#, Ohio: 5.8–11.39 (2008–2013)§#, Wisconsin: 15.4–24.69 (2008–2013)§# | - | - | - | - |
| North Carolina (2006–2010)58 | ≥ 1 isolate | All labs that test for NTM in 3 counties (hospital, commercial, public health) | Overall: 9.4** | - | - | - | - |
| North Carolina (2006–2010)38 | ≥ 1 isolate | All labs that test for NTM in 3 counties (hospital, commercial, publica health | - | - | 5 | - | Cumulative: 8.8 (I) |
| Oregon (2007–2012)10 | ATS microbiologic criteria | All laboratories that test for NTM in Oregon | - | 5.9 (2011–2012)+ | 6 | - | 5.0 (APC: 2.2%) (D)+; 3.8 (D)§+ |
| U.S.–Affiliated Pacific Island Jurisdictions (2007–2011)54 | ≥ 1 isolate | Diagnostic Laboratory Services data | 2–48 (2007–2011) (adjusted rate ratio 1.65) | - | 4 | Overall: 106 (I); American Samoa (22) (I), Federated States of Micronesia (164) (I) | - |
| Central and South America | |||||||
| Location (dates) | Case Definition | Data Source/Cohort | Annual Prevalence (per 100,000 population) | Period Prevalence | Incidence (per 100,000 population) | ||
| Isolation (dates) | Disease (dates) | Period Duration (years) | Prevalence (per 100,000 population) | ||||
| French Guiana (2008–2018)61 | Isolation: ≥ 1 isolate Disease: Full ATS criteria |
Three general hospitals EHR data | - | - | 11 | - | 6.17 (I); 1.07 (D) |
| Mexico City, Mexico (2001–2017)62 | Full ATS criteria | Tertiary care referral medical center EHR data | - | - | 17 | - | SGM: 0.6/1000 admissions (2001–2011)–1.9 (2012–2017) (D)#; RGM: 0.3/1000 (2001–2011)−1.1/1000 (2012–2017) (D)# |
| Uruguay (2006–2018)67 | ≥ 1 isolate | National tuberculosis reference laboratory EHR data | 0.33 – 1.57 (2006–2018) (4.79-fold increase)# | - | - | - | - |
| Europe | |||||||
| Location (dates) | Case Definition | Data Source/Cohort | Annual Prevalence (per 100,000 population) | Period Prevalence | Incidence (per 100,000 population) | ||
| Isolation (dates) | Disease (dates) | Period Duration (years) | Prevalence (per 100,000 population) | ||||
| Czech Republic (2012–2018)81 | Full ATS criteria | Public Health Institute Ostrava database for Moravian and Silesian Regions | - | - | 7 | - | 1.1 (D)# |
| Denmark (1991–2015)68 | Isolation: ≥ 1 isolate Disease: Modified ATS microbiologic criteria |
International Reference Laboratory data | - | - | 25 | - | 2.14 (I); Definite and Possible NTM-PD: 1.10 (D)+# |
| England, Wales and Northern Ireland (January 2007–July 2012)77 | ≥ 1 isolate | Public Health England database | - | - | 6 | - | 3.4–5.0 (2007–2012) (I)** |
| France (2010–2017)69 | ICD-10 or suggestive medication | National Health System database | - | - | 8 | 5.92 (D) | 1.025–1.096 (2010–2017) (D) |
| Germany (2009–2014)72 | ICD-10 | Health Risk Institute health services research database | - | 2.3–3.3 (2009–2014)§ | - | - | - |
| Germany (2010–2011)26 | ICD-10 | German statutory health insurances claims database | - | - | 2 | - | 1.12–1.48 (2010–2011) (D); Cumulative: 2.6 (D) |
| Germany (2011–2016)71 | ICD-10 (German modification) | InGef research database of statutory health insurances claims | - | ICD-10 coded: 3.79§; Predicted: 19.05§ | 5 | - | ICD-10 coded: 1.56 (D)§; Predicted: 15.33 (D)§ |
| Greece (January 2007 - May 2013)84 | Isolation: ≥ 1 isolate Disease: Full (12 pts) ATS criteria and ATS microbiologic criteria (56 pts) |
Sismanoglio-A. Fleming General Hospital of Attiki EHR data | - | - | 7 | - | Cumulative:18.9 (I); Cumulative: 8.8 (D)++ |
| Portugal (2002–2012)73 | Treatment for NTM-PD | National Tuberculosis Surveillance System database | - | - | 11 | - | 0.54 (D)# |
| Scotland (2000–2010)86 | ATS microbiologic criteria | Scottish Mycobacteria Reference Laboratory data | - | - | 11 | - | 2.43 (D)+**# |
| Serbia (2010–2015)74 | Isolation: 1 isolate Disease: ATS microbiologic criteria |
The National Reference Laboratory of Serbia database | - | 0.31 (2011–2012)–0.47 (2014–2015)+** | 6 | - | 1.3 (I); 0.29 (D)+** |
| Spain (1994 –2014)75 | Isolation: ≥ 1 isolate Disease: ≥2 positive cultures or antimicrobial chemotherapy |
Referral Hospital (Bellvitge University Hospital) Laboratory data | - | - | 21 | 113.2 (I)**; 42.8 (D)+++ ** | - |
| Spain (1994–2015)76 | Isolation: ≥ 1 isolate Disease: Full ATS criteria (only RGM) |
Referral Hospital (Bellvitge University Hospital) Laboratory data | - | - | 22 | - | 0.34–1.73 (2003–2015) (APC: 8.3%) (I)# |
| Spain (1997–2016)78 | Full ATS criteria | Microbiology Laboratory of Cruces University Hospital data | - | - | 20 | - | 10.6–1.8 (2016) (APC: 3.3% (MAC), −6.5% (M. kansasii)) (D) |
| The United Kingdom (2006–2016)79 | ‘Strict Cohort’, highly likely to have NTM-PD; ‘Expanded Cohort’ possible NTM-PD++++ | Clinical Practice Research Datalink | - | Strict Cohort: 7.68–4.70 (2006–2016)# | 10 | Strict Cohort: 6.38 (D)# | Strict Cohort: 3.85–1.28 (2006–2016) (D)#; Expanded Cohort: 22.9–40.9 (2006–2016) (D)# |
| The Netherlands (2012–2019)70 | Drug combination in drug dispensing database, ICD-10 | IQVIA’s Real-World Data Longitudinal Prescription database, Outpatient Pharmacy Database of the PHARMO Database Network, IQVIA’s health insurance claims database, Hospitalization Database of the PHARMO Database Network | - | 2.3–5.9 (databases); 6.2–9.9 (pulmonologist survey) | - | - | - |
| East Asia | |||||||
| Location (dates) | Case Definition | Data Source/Cohort | Annual Prevalence (per 100,000 population) | Period Prevalence | Incidence (per 100,000 population) | ||
| Isolation (dates) | Disease (dates) | Period Duration (years) | Prevalence (per 100,000 population) | ||||
| Japan (2001–2009)132 | Full ATS criteria | Microbiological database of 11 hospitals in Nagasaki prefecture | - | - | 9 | - | 4.6–10.1 (2001–2009) (D) |
| Japan (2004–2006)23 | ICD-8–10, estimated from Death Statistics | Vital Statistics of Japan database | - | 33–65 (2005)§ | - | - | - |
| Japan (2009–2014) 107 | ICD-10 | The Japanese National Database of Health Insurance Claims | - | 29 (2011) | 6 | - | 8.6 (2011) (D) |
| Japan (2012–2013)105 | ATS microbiologic criteria | 3 major laboratories (SRL, Inc., LSI Medience Corporation, BML, Inc.) | - | 12 (2012–2013)+** | 2 | 24 (D)+** | - |
| South Korea (2001–2015)104 | Full ATS criteria | NTM Registry of Tertiary Referral Hospital (Samsung Medical Center) | - | - | 15 | - | 7.0–55.6 (2001–2015) (D) |
| South Korea (2003–2016)98 | ICD-10 | National Health Insurance Service database | - | 1.2–33.3§ | 14 | - | 1.0–17.9 (2003–2019) (D)§ |
| South Korea (2006–2016)100 | Full ATS criteria | Tertiary Referral Hospital (Severance Hospital) EHR data | - | - | 11 | - | 4.6–19.6 (2006–2016) (I); 1.2–4.8 (2006–2016) (APC: 14%) (D) |
| South Korea (2007–2018)99 | ICD-10 | Health Insurance Review and Assessment Service database | - | 5.3–41.7 | 12 | - | Diagnostic-based: 3.5–18.0 (2008–2018) (APC: 16.7%) (D); Clinically-refined: 2.9–12.3 (2008–2018) (APC: 13.2%) (D) |
| South Korea (2009–2015)133 | ICD-10 | Health Insurance Review and Assessment service database | - | - | 7 | - | 6.6–26.6 (2009–2015) (D) |
| South Korea (2009–2015)103 | Full ATS criteria | Tertiary care Hospitals (Pusan National University, Pusan National University Yangsan) EHR data | - | - | 7 | - | 6.8–12.9 (2009–2015) (D)# |
| Taiwan (2000–2012)115 | Full ATS criteria | Tertiary Medical Center (National Taiwan University) data | - | - | - | - | 3.4–13 (D) |
| Taiwan (2003–2018)113 | ICD-9-CM, treatment | National Health Insurance Research database | - | 0.68–7.17# (Treatment Case) | - | - | 0.54–3.35 (2003–2018) (D) (Treatment Case)# |
| Taiwan (2005–2013)112 | ICD-9-CM, ≥ 2 cultures, treatment | National Health Insurance Research database | - | - | - | - | 5.3–14.8 (2005–2013) (D)§# |
| Taiwan (2007–2010)114 | ≥ 1 isolate | National TB Registry of Taiwan CDC | - | - | - | - | 8.6 (I) |
| Taiwan (2010–2014)116 | Full ATS criteria | 6-Hospital EHR database | - | - | - | - | 46 (D) |
| West and Central Asia | |||||||
| Location (dates) | Case Definition | Data Source/Cohort | Annual Prevalence (per 100,000 population) | Period Prevalence | Incidence (per 100,000 population) | ||
| Isolation (dates) | Disease (dates) | Period Duration (years) | Prevalence (per 100,000 population) | ||||
| Iran (1990–2014)134 | - | - | - | - | 25 | 9.6–10.6 (D)# | - |
| Oceania | |||||||
| Location (dates) | Case Definition | Data Source/Cohort | Annual Prevalence (per 100,000 population) | Period Prevalence | Incidence (per 100,000 population) | ||
| Isolation (dates) | Disease (dates) | Period Duration (years) | Prevalence (per 100,000 population) | ||||
| Australia (2001–2016)41 | ≥ 1 isolate | Queensland Notifiable Conditions database | - | - | 16 | - | 11.1–25.88 (I)# |
| Australia (2012–2015)3 | ≥ 1 isolate | Queensland Notifiable Conditions database | - | - | 4 | - | 25.9 (I)# |
*
Rates expressed as annual rates per 100,000 population, averaged over study period unless otherwise specified
**
Studies which excluded M. gordonae
ICD-9 – International diagnostic classification of diseases – ninth revision
ICD-10 – International diagnostic classification of diseases – tenth revision
SGM – slow-growing mycobacteria
RGM – rapid-growing mycobacteria
EHR – electronic health records
APC – annual percent change
+
NTM-PD is defined using ATS microbiologic criteria
++
NTM-PD is defined using ATS microbiologic criteria and full ATS criteria
+++
NTM-PD is defined ≥2 positive cultures or antimicrobial chemotherapy
++++
‘Strict Cohort’ is defined using evidence of treatment and/or monitoring of NTM-PD and ‘expanded cohort’ is defined using NTM disease clinical terminology codes
#
Included patients with NTM isolated from extrapulmonary sites/specimens from extrapulmonary sites
§
Adjusted