Abstract
Objectives
To determine the incidence and clinical characteristics of cutaneous nontuberculous
mycobacterial (NTM) infection during the past 30 years and whether the predominant
species have changed.
Patients and Methods
Using Rochester Epidemiology Project data, we identified Olmsted County, Minnesota,
residents with cutaneous NTM infections between January 1, 1980, and December 31,
2009, examining the incidence of infection, patient demographic and clinical features,
the mycobacterium species, and therapy.
Results
Forty patients (median age, 47 years; 58% female [23 of 40]) had positive NTM cultures
plus 1 or more clinical signs. The overall age- and sex-adjusted incidence of cutaneous
NTM infection was 1.3 per 100,000 person-years (95% CI, 0.9-1.7 per 100,000 person-years).
The incidence increased with age at diagnosis (P=.003) and was higher in 2000 to 2009 (2.0 per 100,000 person-years; 95% CI, 1.3-2.8
per 100,000 person-years) than in 1980 to 1999 (0.7 per 100,000 person-years; 95%
CI, 0.3-1.1 per 100,000 person-years) (P=.002). The distal extremities were the most common sites of infection (27 of 39 patients
[69%]). No patient had human immunodeficiency virus infection, but 23% (9 of 39) were
immunosuppressed. Of the identifiable causes, traumatic injuries were the most frequent
(22 of 29 patients [76%]). The most common species were Mycobacterium marinum (17 of 38 patients [45%]) and Mycobacterium chelonae/Mycobacterium abscessus (12 of 38 patients [32%]). In the past decade (2000-2009), 15 of 24 species (63%)
were rapidly growing mycobacteria compared with only 4 of 14 species (29%) earlier
(1980-1999) (P=.04).
Conclusion
The incidence of cutaneous NTM infection increased nearly 3-fold during the study
period. Rapidly growing mycobacteria were predominant during the past decade.
Abbreviations and Acronyms:
NTM (nontuberculous mycobacteria), REP (Rochester Epidemiology Project), RGM (rapidly growing mycobacteria), rRNA (ribosomal RNA), SGM (slowly growing mycobacteria), SSTI (skin and soft tissue infection)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: December 06, 2012
Footnotes
Grant Support: This study was made possible by the Rochester Epidemiology Project (Principal Investigators: Walter A. Rocca, MD, MPH, and Barbara P. Yawn, MD, MSc). Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Copyright
© 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
