Tables 2.
| a. Sensitivity and positive predictive value of various case-finding algorithms for nontuberculous mycobacteria (NTM)within Kaiser Permanente Northern California anti-TNF cohort(n=18 cases identified) + | |||
|---|---|---|---|
| Case-finding Algorithm (number of patients identified) |
Sensitivity* [# (%) of total cases identified] |
Sensitivity 95% CI |
PPV+ (95% CI) |
| 031 Diagnostic codes¥ | |||
| ≥ 1 (n=11) | 9 (50%) | 0.26-0.74 | 82% (0.48-0.98) |
|
Nontuberculous Mycobacteria isolated in Culture± (n=23) |
18 (100%) | 0.81-1.00 | 78% (0.56-0.93) |
|
ATS/IDSA microbiologic disease criteria € (n=18) |
18 (100%) | 0.81-1.00 | 100% (0.81-1.00) |
|
Nontuberculous Mycobacteria isolated in Culture± AND any 031 Diagnostic codes¥ (n=10) |
9 (50%) | 0.26-0.74 | 90% (0.56-1.00) |
| b: Sensitivity and positive predictive value of case-finding algorithms for nontuberculous mycobacteria (NTM) within Portland Veteran’s Affairs Medical Center’s general population, (n=71 cases identified) + | |||
|---|---|---|---|
| Case-finding Algorithm (number of patients identified) |
Sensitivity* [# (%) of total cases identified] |
Sensitivity 95% CI |
PPV+ (95% CI) |
| 031 Diagnostic codes¥ | |||
| ≥ 1 (n=62) | 46 (65%) | (0.53-0.76) | 74% (0.62-0.85) |
| Nontuberculous Mycobacteria isolated in Culture± (n=132) |
54 (76%) | (0.65-0.85) | 41% (0.32-0.50) |
| ATS/IDSA microbiologic disease criteria€ (n=58) |
45 (63%) | (0.51-0.75) | 77.6% (0.65-0.88) |
| Nontuberculous Mycobacteria isolated in Culture± AND any 031 Diagnostic codes¥ (n=39) |
30 (42%) | (0.31-0.55) | 77% (0.61-0.89) |
| Nontuberculous Mycobacteria isolated in Culture± OR any 031 Diagnostic codes¥ (n=171) |
70 (99%) | (0.92-1.00) | 41% (0.34-0.49) |
| 031 Diagnostic codes¥ AND ATS/IDSA microbiologic disease criteria€ (n=24) |
24 (34%) | (0.23-0.46) | 100% (0.86-1.00) |
|
031 Diagnostic codes¥ OR ATS/IDSA microbiologic disease criteria € (n=96)* |
67 (94%) | (0.86-0.98) | 70% (0.60-0.79) |
| 031 Diagnostic codes¥ AND Azithromycin or clarithromycin ≥30 Days∞ (n=24) |
24 (34%) | (0.23-0.46) | 100% (0.86-1.00) |
| ATS/IDSA microbiologic disease criteria€ AND Azithromycin/Clarithromycin ≥30 Days ∞ (n=23) |
21 (30%) | (0.19-0.42) | 91% (0.72-1.00) |
Preferred algorithms that maximize sensitivity and PPV are in bold
American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) criteria for nontuberculous mycobacteria pulmonary disease used to define pulmonary disease; extrapulmonary disease defined by nontuberculous mycobacteria isolation from a sterile site. Cases confirmed by chart review
Calculation of sensitivity using assumption that all potential cases were identified by searching Diagnostic codes and mycobacterial culture results (n=20)
NTM Diagnostic codes received ≥ 1 time during the study period
M. gordonae (non-pathogenic species) excluded from consideration
ATS/IDSA disease criteria for NTM pulmonary disease include microbiologic, radiologic, and symptomatic criteria. Microbiologic criteria include NTM isolated from one bronchoscopy specimen or at least 2 sputum specimens; extrapulmonary disease defined by nontuberculous mycobacteria isolation from a sterile site.
Preferred algorithms that maximize sensitivity and PPV are in bold
American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) criteria for nontuberculous mycobacteria pulmonary disease used to define pulmonary disease; extrapulmonary disease defined by nontuberculous mycobacteria isolation from a sterile site. Cases confirmed by chart review
Calculation of sensitivity using assumption that all potential cases were identified by searching Diagnostic codes and mycobacterial culture results (n=71)
Nontuberculous mycobacteria Diagnostic codes received ≥ 1 time during the study period
M. gordonae (non-pathogenic species) excluded from consideration
ATS/IDSA disease criteria for NTM pulmonary disease include microbiologic, radiologic, and symptomatic criteria. Microbiologic criteria include NTM isolated from one bronchoscopy specimen or at least 2 sputum specimens.
Long term macrolide use is cornerstone of NTM disease therapy