Non-tuberculous mycobacteria in chronic obstructive pulmonary disease

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Presentation transcript:

Non-tuberculous mycobacteria in chronic obstructive pulmonary disease Michael D. Schweitzer1,2, Valeria Bagley1,2, Kira Balestrini1,2, Andrea M. Guerrero1,2, Arash Sharifi3, Andrew Quartin1,2, Michael Campos1,2, Mehdi Mirsaeidi1,2. 1Division of Pulmonary and Critical Care, University of Miami; FL, USA. 2Section of Pulmonary, Miami VA Medical Center; FL, USA. 3Rosenstiel School of Marine and Atmospheric, University of Miami; FL, USA. Background Maps Pulmonary infection from non- tuberculous mycobacteria (NTM) is principally acquired from environmental exposure and its distribution appears to depend on the geographical location. NTM related deaths have shown a significant rise. Congenital and acquired conditions, such as Chronic Obstructive Pulmonary Disease (COPD), increase the susceptibility to develop NTM disease. Map 1. NTM-COPD geographic diversity per cases. Map 2. NTM Period Prevalence in COPD per 100,000. Objectives To determine the period prevalence and geographic distribution of NTM infected subjects among the COPD population in the United States. Methods Retrospective cross sectional study performed in VA Hospitals/Centers utilizing the Veterans Affairs Informatics and Computer Infrastructure (VINCI) between the years 2000 and 2016. International Classification of Diseases ninth and tenth revision (ICD9 and 10) was used to define COPD (ICD9: 491; ICD10: J.44.0, J44.1, J44.9) and pulmonary NTM (ICD9: 031; ICD10: A31.9). Statistical analysis and map generation: Period prevalence for NTM/COPD was calculated for each state. Data grid heat map was generated using the Kriging method. Results Conclusions Patient characteristics and demographics: VINCI identified 2,050,055 COPD subjects, out of which 5,600 also had a NTM diagnoses. 4,724 subjects were included, as the remaining 875 were excluded due to NTM being diagnosed prior to COPD. Geographical distribution: NTM/COPD geographical distribution was higher in the following five states: Florida (732, 15.5%), California (424, 9%), Texas (374, 7.9%), New York (205, 4.3%) and Louisiana (164, 3.5%). Between the years 2000 to 2016, the total period prevalence of NTM in 100,000 COPD subjects was 230. The five states with the highest period prevalence of NTM in COPD were Puerto Rico (370), Florida (351), District of Columbia (309), Wisconsin (308) and Louisiana (303). NTM infections are common in COPD patients, particularly those aged between 55 to 75 years. We strongly suggest routine screening for NTM in the COPD population. By identifying the distribution of NTM cases in the different States, we may be able to later understand the geographical and environmental implications surrounding this disease.