Nontuberculous mycobacteria are a diverse group of organisms related to M. tuberculosis and cause a wide range of human disease. Unlike tuberculosis, nontuberculous mycobacterial disease is not reportable to public health authorities in the United States (US), and the total burden of disease is uncertain.
To estimate the mortality burden of nontuberculous mycobacterial disease in the US over a 15-year period, and to identify temporal trends.
The US Multiple Cause of Death Files were searched from 1999 through 2014 for a listing of nontuberculous mycobacterial disease by ICD10 code as either the underlying or contributing cause of death. Characteristics of individuals with nontuberculous mycobacteria-related deaths in the US were summarized. Age-adjusted mortality rates and rate ratios were calculated with 95% confidence intervals using bridged-race population estimates, and time trends were evaluated with negative binomial regression.
MEASUREMENTS AND MAIN RESULTS
There was a significant increase in nontuberculous mycobacteria-related deaths among individuals without a diagnosis of HIV infection (p=0.004), and mortality rates increased with advancing age. Age-adjusted mortality rate ratios were lower in men (risk ratio 0.84, 95% confidence interval 0.80, 0.87) compared with women, and lower in Hispanic individuals (risk ratio 0.53, 95% confidence interval 0.49, 0.56) and black, non-Hispanic individuals (risk ratio 0.83, 95% confidence interval 0.77, 0.88) compared with white, non-Hispanic individuals.
The mortality of nontuberculous mycobacterial disease among HIV-uninfected individuals has increased during the past 15 years in the US, and these deaths disproportionately occurred in older white women.