Changing incidence and characteristics of non-tuberculous mycobacterial infections in Scotland and comparison with Mycobacterium tuberculosis complex incidence (2011 to 2019)

Anna Jarchow-macdonald, Michael Smith, Amie-louise Seagar, Clark D Russell, Pauline Claxton, Ian F Laurenson, Olga-lucia Moncayo-nieto

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background
An increase in infections with non-tuberculous mycobacteria (NTM) has been noted globally and their incidence has overtaken that of Mycobacterium tuberculosis complex (MTBc) in many countries. Using data from a national reference laboratory, we aimed to determine if this trend was observed in Scotland.

Methods
We undertook a retrospective review of all NTM isolates received by the Scottish Mycobacteria Reference Laboratory (SMRL) over 9 years from 2011 to 2019 inclusive. Clinical episodes were defined as per 2017 BTS and 2020 ATS/ERS/ESCMID/IDSA NTM guidelines. These rates were compared with Scottish tuberculosis rates over the same period.

Results
Of 8552 NTM isolates from 4586 patients in 2011 to 2019, 7739 (90.5%) were considered clinically relevant. These represented 2409 episodes of NTM infection, with M. avium, M. intracellulare and M. abscessus complex being most common. 1953 (81.1%) were pulmonary NTM infection episodes from 1470 patients and 456 extra-pulmonary episodes from 370 patients. We estimated a rise in incidence from 3.4 to 6.5 per 100,000 person-years (2011-2019 inclusive) with an increase in NTM incidence over MTBc incidence in Scotland by 2017.

Conclusion
The incidence of NTM infection in Scotland has overtaken MTBc incidence. NTM infection leads to a costly healthcare burden, possibly as much as UK £1.47 million (US$ and Euro 1.73 million) annually. We recommend standardisation of isolate referral with clinical surveillance and implementation of agreed standards of care delivered through multi-disciplinary teams. This would improve diagnosis and patient management as well as assessment of diagnostics and novel treatments through clinical trials.
Original languageEnglish
JournalOpen forum infectious diseases
DOIs
Publication statusPublished - 12 Dec 2022

Fingerprint

Dive into the research topics of 'Changing incidence and characteristics of non-tuberculous mycobacterial infections in Scotland and comparison with Mycobacterium tuberculosis complex incidence (2011 to 2019)'. Together they form a unique fingerprint.

Cite this