Chen HH, Lin CH, Chao WC. Mortality association of nontuberculous mycobacterial infection requiring treatment in Taiwan: a population-based study.
Ther Adv Respir Dis 2022;
16:17534666221103213. [PMID:
35748569 PMCID:
PMC9234830 DOI:
10.1177/17534666221103213]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background:
Infection due to nontuberculous mycobacteria (NTM) is an emerging issue
worldwide, and we aimed to address the epidemiology and mortality
association of NTM infection requiring treatment in Taiwan.
Methods:
We used the 2003–2018 data of 2 million representative individuals in
Taiwan’s National Health Insurance Research Database. We identified patients
with newly diagnosed NTM infection and received treatment as NTM cases. Age-
and sex-matched (1:40) as well as propensity score-matched (PSM) (1:2)
non-NTM individuals were selected as non-NTM controls. We used a Cox
proportional hazard model to determine hazard ratios (HRs) with 95%
confidence intervals (CIs).
Results:
We identified 558 patients with NTM infection requiring treatment. The mean
age was 62.5 ± 15.4 years, and 57.5% of them were male. The incidence
increased from 0.54 per 100,000 person-year in 2003 to 3.35 per 100,000
person-year in 2018. The overall mortality was 35.2%, with a mean follow-up
duration of 4.1 ± 3.6 years. We found that NTM infection was independently
associated with a greater risk of mortality (HR: 1.71; 95% CI: 1.47–1.98)
compared with age- and sex-matched controls, and the association remained
consistent (HR: 1.44; 95% CI: 1.19–1.75) compared with propensity-matched
controls. We also found that old age, male, high Charlson comorbidity index,
and the use of steroids or anti-neoplastic agents/immunosuppressants were
associated with mortality risk.
Conclusion:
In conclusion, we found a steady increase in patients with NTM infection
requiring treatment in Taiwan and further demonstrated that NTM infection
was associated with greater risk of mortality using two comparable non-NTM
control subjects.
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