ATYPICAL MYCOBACTERIA IN WESTERN AUSTRALIA

Nontuberculous mycobacteria-associated lung disease in hospitalized persons, United States, 1998-2005

This bacterium is an underappreciated cause of lung disease and infection rates appear to be increasing.

The prevalence and trends of pulmonary nontuberculous mycobacteria (NTM)–associated hospitalizations in the United States were estimated using national hospital discharge data. Records were extracted for all persons with a pulmonary NTM International Classification of Diseases code (031.0) hospitalized in the 11 states with continuous data available from 1998 through 2005. Prevalence was calculated using US census data. Pulmonary NTM hospitalizations (031.0) increased significantly with age among both sexes: relative prevalence for persons 70–79 years of age compared with those 40–49 years of age was 15/100,000 for women (9.4 vs. 0.6) and 9/100,000 for men (7.6 vs. 0.83). Annual prevalence increased significantly among men and women in Florida (3.2%/year and 6.5%/year, respectively) and among women in New York (4.6%/year) with no significant changes in California. The prevalence of pulmonary NTM–associated hospitalizations is increasing in selected geographic areas of the United States.

Treatment of pulmonary disease caused by opportunist mycobacteria

Opportunist mycobacterial infections localised to the chest may be treated with combinations of standard antimycobacterial drugs. The combination of rifampicin and ethambutol seems to be particularly effective, both in vivo and in vitro. In vitro sensitivity testing with single drugs may have a role in the future when the levels of in vitro resistance compatible with the clinical response to treatment are eventually established. Sensitivity testing against drugs in combination may prove useful for modifying treatment regimens in those patients who either fail to respond to initial chemotherapy or relapse. Further evidence on this will, it is hoped, emerge from the prospective studies currently in progress.

Mycobacterium Battey infection resembling tuberculosis

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