威斯康星州成年人的非结核分枝杆菌感染及其与种族和社会劣势的关系。

IF 6.8 2区 医学 Q1 RESPIRATORY SYSTEM Annals of the American Thoracic Society Pub Date : 2023-08-01 DOI:10.1513/AnnalsATS.202205-425OC
Bryan J Vonasek, Danièle Gusland, Kevin P Hash, Andrew L Wiese, Julie Tans-Kersten, Brad C Astor, Suzanne N Gibbons-Burgener, Elizabeth A Misch
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引用次数: 0

摘要

理由:基于人群的非结核分枝杆菌(NTM)感染流行病学数据非常有限,尤其是不同种族群体和社会经济阶层之间的 NTM 感染差异。威斯康星州是少数几个可以通报分枝杆菌疾病的州之一,因此可以对该州的非结核分枝杆菌感染流行病学进行大规模、基于人群的分析。研究目标估计威斯康星州成人非结核分枝杆菌感染的发病率,描述全州非结核分枝杆菌感染的地理分布情况,确定不同非结核分枝杆菌引起感染的频率和类型,并调查非结核分枝杆菌感染与人口统计学和社会经济状况之间的关联。研究方法我们利用 2011 年至 2018 年期间提交给威斯康星州电子疾病监测系统的威斯康星州居民所有 NTM 分离物的实验室报告开展了一项回顾性队列研究。在分析 NTM 频率时,如果来自同一人的多份报告不相同、收集自不同地点或收集时间相隔一年以上,则将其列为单独的分离物。结果:共分析了来自 6811 名成人的 8135 个 NTM 分离物。分枝杆菌复合体占呼吸道分离株的 76.4%。从皮肤和软组织中分离出的分枝杆菌中,最常见的是螯合分枝杆菌。在研究期间,NTM 感染的年发病率保持稳定(从每 10 万人 22.1 例到每 10 万人 22.4 例)。黑人(每 100,000 人中有 224 人)和亚裔(每 100,000 人中有 244 人)的 NTM 感染累计发病率明显高于白人(每 100,000 人中有 97 人)。NTM总感染率明显更高(P 结论:黑人和亚裔的NTM感染率明显高于白人:90%以上的非结核分枝杆菌感染来自呼吸道部位,其中绝大多数由复合鸟疫霉菌引起。快速生长的分枝杆菌主要是皮肤和软组织病原体,也是重要的呼吸道次要病原体。我们发现,2011 年至 2018 年期间,威斯康星州的 NTM 感染年发病率保持稳定。非白色人种群体和处于社会不利地位的人群中NTM感染的发生率更高,这表明NTM疾病在这些群体中的发生率也可能更高。
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Nontuberculous Mycobacterial Infection in Wisconsin Adults and Its Relationship to Race and Social Disadvantage.

Rationale: Population-based data on the epidemiology of nontuberculosis mycobacterial (NTM) infections are limited, particularly with respect to variation in NTM infection among racial groups and socioeconomic strata. Wisconsin is one of a handful of states where mycobacterial disease is notifiable, allowing large, population-based analyses of the epidemiology of NTM infection in this state. Objectives: To estimate the incidence of NTM infection in Wisconsin adults, describe the geographic distribution of NTM infection across the state, identify the frequency and type of infection caused by different NTM species, and investigate associations between NTM infection and demographics and socioeconomic status. Methods: We conducted a retrospective cohort study using laboratory reports of all NTM isolates from Wisconsin residents submitted to the Wisconsin Electronic Disease Surveillance System from 2011 to 2018. For the analyses of NTM frequency, multiple reports from the same individual were enumerated as separate isolates when nonidentical, collected from different sites or collected more than one year apart. Results: A total of 8,135 NTM isolates from 6,811 adults were analyzed. Mycobacterium avium complex accounted for 76.4% of respiratory isolates. The M. chelonae-abscessus group was the most common species isolated from skin and soft tissue. The annual incidence of NTM infection was stable over the study period (from 22.1 per 100,000 to 22.4 per 100,000). The cumulative incidence of NTM infection among Black (224 per 100,000) and Asian (244 per 100,000) individuals was significantly higher compared with that among their White counterparts (97 per 100,000). Total NTM infections were significantly more frequent (P < 0.001) in individuals from disadvantaged neighborhoods, and racial disparities in the incidence of NTM infection generally remained consistent when stratified by measures of neighborhood disadvantage. Conclusions: More than 90% of NTM infections were from respiratory sites, with the vast majority caused by M. avium complex. Rapidly growing mycobacteria predominated as skin and soft tissue pathogens and were important minor respiratory pathogens. We found a stable annual incidence of NTM infection in Wisconsin between 2011 and 2018. NTM infection occurred more frequently in non-White racial groups and in individuals experiencing social disadvantage, suggesting that NTM disease may be more frequent in these groups as well.

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来源期刊
Annals of the American Thoracic Society
Annals of the American Thoracic Society Medicine-Pulmonary and Respiratory Medicine
CiteScore
9.30
自引率
3.60%
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0
期刊介绍: The Annals of the American Thoracic Society (AnnalsATS) is the official international online journal of the American Thoracic Society. Formerly known as PATS, it provides comprehensive and authoritative coverage of a wide range of topics in adult and pediatric pulmonary medicine, respiratory sleep medicine, and adult medical critical care. As a leading journal in its field, AnnalsATS offers up-to-date and reliable information that is directly applicable to clinical practice. It serves as a valuable resource for clinical specialists, supporting their formative and continuing education. Additionally, the journal is committed to promoting public health by publishing research and articles that contribute to the advancement of knowledge in these fields.
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