2265. The epidemiology of non-tuberculous mycobacteria (NTM) from non-pulmonary sites over 4 years in Nebraska
Session: Poster Abstract Session: Non-Tuberculous Mycobacteria - Epidemiology and Management
Saturday, October 7, 2017
Room: Poster Hall CD
Posters
  • NTM IDSA 2017 Poster MT Final.pdf (123.1 kB)
  • Background: The recent outbreak of M.chimaera has focused attention on NTM species as the potential source of other clusters of infection. Since 2010 NTMs have been reportable in Nebraska.

    Methods: The NEDSS data base for Nebraska was searched for all NTM infections reported from 5/1/2013 through 4/ 30/2017. These entries were reviewed for species or group type and source of material. All pulmonary isolates were excluded.

    Results: Over 4 years, 421 lab reports of NTMs from non-pulmonary sites were received by the DPH. The most common group isolated was M. avium intracellulare group consisting of 246 specimens. Next was M. chelonae with 57 specimens, followed by M. fortuitum with 32, and M. abscessus and M. gordonae with 17 each. Three or fewer isolates of M. kansasii, M. marinum, M. mucogenicum or M. arupense were reported. Eight isolates were not speciated. The sources of those isolates were included in the report 46% of the time.

    Source

    MAI

    M.chelonae

    M. fortuitum

    M. abscessus

    M. gordonae

    Source Reported

    40%

    63%

    50%

    71%

    94%

    % of those cases reported by site

    Abscess, wound

    26%

    14%

    25%

    33.3% (1 ear)

    19%

    Tissue, mass, skin, or lesion

    22

    11 (1 sinus)

    0

    0

    12.5

    Neck or LN

    12

    11

    0

    0

    0

    Bone or Joint

    11

    14

    19

    0

    25

    Blood

    3

    22

    25

    25

    0

    Fluid Non Specified

    24

    5.5

    12.5

    16.7

    12.5

    Abdomen

    0

    11

    6

    0

    12.5

    Peritoneal fluid

    0

    3

    0

    8.3

    0

    Stool

    0

    14

    6

    8.3

    CSF

    2

    0

    0

    0

    0

    Other

    Urine-3

    Eye-5.5

    Cervix-8.3

    Urine 12.5


    Conclusion: The majority of NTM reported in Nebraska over 4 years came from an abscess, wound, mass, bone, joint or skin source. Interesting results included: the number of cases detected by blood culture (between 15-20%) in non-MAI NTMS, the number of abdominal sources or stool (5-10% each) in non-MAI NTM, and the unusual sites discovered such as the CSF (MAI only), peritoneal fluid, ear, eye, and cervix. These results suggest that looking for NTM in the blood or stool could be an effective way of making the diagnosis, that it is important to consider NTM in abdominal infections and infections of peritoneal dialysis fluid of unclear etiology. Lastly, NTM may play a role in infections in unusual sites such as the eye, the ear or cervix.

    Maureen Tierney, MD, MSc, Public Health, Nebraska Department of Health and Human Services, Lincoln, NE, Caitlin Pedati, MD, MPH, Epidemiology Unit, Nebraska Department of Health and Human Services, Lincoln, NE, Alison Keyser, MPH, Nebraska Department of Health and Human Services, Lincoln, NE and Tom Safranek, MD, Nebraska Health and Human Services System, Lincoln, NE

    Disclosures:

    M. Tierney, None

    C. Pedati, None

    A. Keyser, None

    T. Safranek, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.