Abstract
Abstract
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 May 1, 2013 through April 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 and 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.
Disclosures
All authors: No reported disclosures.