Surveillance of Extrapulmonary Nontuberculous Mycobacteria Infections

Oregon, USA, 2007-2012

Emily Henkle; Katrina Hedberg; Sean D. Schafer; Kevin L. Winthrop

Emerging Infectious Diseases. 2017;23(10):1627-1630.

Case Definition

We defined an extrapulmonary NTM infection case as having >1 isolates from skin/soft tissue (wound, abscess, tissue, or exit catheter); disseminated sites (blood, bone marrow, cerebrospinal fluid, pericardial fluid, or peritoneal fluid); lymph node (lymph node or neck abscess); joint (synovial or joint fluid); or other (urine, eye, sinus, or nasopharyngeal). We excluded isolates from an unknown source or from feces, saliva, or gastric sites. M. gordonae was reported but is considered nonpathogenic, so we excluded it from estimates of disease incidence. Rapid-growing mycobacteria (RGM) species include M. chelonae/abscessus complex, M. fortuitum, and M. chelonae;^[4] we included these in the analysis.

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Table. Characteristics of 334 nontuberculous mycobacterium infections, Oregon, USA, 2007–2012*
Category	Infection site†					Total, N = 334
Category	Skin/soft tissue, n = 197	Disseminated, n = 57	Lymph node, n = 28	Joint, n = 14	Other, n = 38	Total, N = 334
Annual incidence/100,000 population	0.9	0.2	0.1	0.1	0.2	1.5
Patient demographics
Sex
F	115 (58)	19 (33)	15 (54)	7 (50)	20 (52)	176 (53)
M	82 (42)	38 (67)	13 (46)	7 (50)	18 (48)	158 (47)
Median age, y (range)	51 (0.8–92)	41 (1–82)	44 (0.8–76)	70 (39–88)	61 (21–88)	51 (0.8–92)
HIV positive	8 (4)	34 (60)	5 (18)	0 (0)	3 (8)	50 (15)
Mycobacterium species
Rapid-growing species	85 (43.1)	5 (8.8)	2 (7.1)	3 (21.4)	13 (34.2)	108 (32.3)
M. chelonae/abscessus complex	40 (20.3)	2 (3.5)	1 (3.6)	1 (7.1)	8 (21.1)	52 (15.6)
M. fortuitum complex	28 (14.2)	1 (1.8)	1 (3.6)	1 (7.1)	1 (2.6)	32 (9.6)
M. chelonae	17 (8.6)	2 (3.5)	0 (0)	1 (7.1)	4 (10.5)	24 (7.2)
Slow-growing species
M. avium/intracellulare complex	70 (35.5)	45 (78.9)	23 (82.1)	9 (64.3)	20 (52.6)	167 (50)
M. marinum	20 (10.2)	0 (0)	0 (0)	0 (0)	1 (2.6)	21 (6.3)
M. goodii	5 (2.5)	0 (0)	1 (3.6)	0 (0)	0 (0)	6 (1.8)
M. aubagnense	1 (0.5)	1 (1.8)	0 (0)	0 (0)	1 (2.6)	3 (0.9)
M. xenopi	1 (0.5)	0 (0)	1 (3.6)	0 (0)	1 (2.6)	3 (0.9)
M. alvei	2 (1)	0 (0)	0 (0)	0 (0)	0 (0)	2 (0.6)
M. neoaurum	0 (0)	2 (3.5)	0 (0)	0 (0)	0 (0)	2 (0.6)
Other species‡	13 (6.6)	4 (7)	1 (3.6)	2 (14.3)	2 (5.3)	22 (6.6)

*Values are no. (%) patients except as indicated. Total excludes 13 M. gordonae isolates: 6 skin/soft tissue, 1 disseminated, 1 lymph node, 5 other.†Skin/soft tissue: wound, abscess, tissue, or exit catheter; disseminated: blood, bone marrow, cerebrospinal fluid, pericardial fluid, or peritoneal fluid; lymph node: lymph node or neck abscess; joint: synovial or joint fluid; other: urine, eye, sinus, or nasopharyngeal.‡Other species were 8 unspeciated and 1 each of M. asiaticum, M. branderi, M. brisbanense, M. heckeshornense, M. immunogenum, M. interjectum, M. kansasii, M. lentiflavum, M. llaterense, M. mucogenicum/phocaicum, M. obuense, M. simiae, M. thermoresistible, and M. vaccae.

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Surveillance of Extrapulmonary Nontuberculous Mycobacteria Infections

Oregon, USA, 2007-2012

Case Definition

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