Satoshi Hamada1, Yutaka Ito2, Toyohiro Hirai1, Kimihiko Murase1, Takahiro Tsuji1, Kohei Fujita3, Tadashi Mio3, Koichi Maekawa4, Takashi Fujii5, Shigeki Ono6, Takashi Nishimura7, Akihiko Hayashi8, Toshiaki Komori9, Naohisa Fujita10, Akio Niimi11, Satoshi Ichiyama12, Kazuo Chin13, Michiaki Mishima1. 1. Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 2. Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Nagoya, Japan. Electronic address: yutaka@med.nagoya-cu.ac.jp. 3. Department of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. 4. Department of Respiratory Medicine, Takeda General Hospital, Kyoto, Japan. 5. Department of Cardiovascular Medicine, Ako City Hospital, Ako, Japan. 6. Department of Gastroenterology and Hepatology, Ako City Hospital, Ako, Japan. 7. Department of Respiratory Medicine, Kyoto Katsura Hospital, Kyoto, Japan. 8. Department of Laboratory Medicine, Kyoto City Hospital, Kyoto, Japan. 9. Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan. 10. Department of Infection Control and Clinical Laboratory, Kyoto Prefectural University of Medicine, Kyoto, Japan. 11. Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Nagoya, Japan. 12. Clinical Laboratory of Medicine, Kyoto University, Kyoto, Japan. 13. Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Abstract
OBJECTIVE/ BACKGROUND: The prevalence of pulmonary nontuberculous mycobacterial (pNTM) disease, including Mycobacterium avium complex (MAC), varies widely according to geographic region. However, the factors that influence regional variations in pNTM disease prevalence remain unknown. This study was undertaken to examine whether environmental or occupational factors or host traits could influence regional variations in pNTM disease prevalence. METHODS: We collected laboratory data on pulmonary tuberculosis (pTB) and pNTM from two hospitals in the West Harima area of Japan and five hospitals in Kyoto City, Japan from 2012 to 2013. We estimated microbiological pNTM disease prevalence by multiplying all pTB cases in each area with the ratio of pNTM cases and pTB cases at the survey hospitals in each area. We administered a standardized questionnaire to 52 patients and 120 patients with pulmonary MAC (pMAC) disease at Ako City Hospital and Kyoto University Hospital, respectively. RESULTS: The estimated prevalence of microbiological pNTM disease in the West Harima area (85.4/100,000 population-years) was significantly higher than that observed in Kyoto City (23.6/100,000 population-years; p<.001). According to multiple logistic regression analysis, in Ako City Hospital, primary (activities directly related to natural resources) and secondary industries (construction, mining, and manufacturing primary industry produce; odds ratio [OR]=4.79; 95% confidence interval [CI]=1.49-14.0; p=.007) and soil exposure (OR=13.6; 95% CI=4.94-45.26; p<.001) were associated with pMAC disease. CONCLUSION: Environmental factors, both industrial structures associated with occupational dust and environmental soil exposure, could influence the regional variations in pNTM disease prevalence.
OBJECTIVE/ BACKGROUND: The prevalence of pulmonary nontuberculous mycobacterial (pNTM) disease, including Mycobacterium avium complex (MAC), varies widely according to geographic region. However, the factors that influence regional variations in pNTM disease prevalence remain unknown. This study was undertaken to examine whether environmental or occupational factors or host traits could influence regional variations in pNTM disease prevalence. METHODS: We collected laboratory data on pulmonary tuberculosis (pTB) and pNTM from two hospitals in the West Harima area of Japan and five hospitals in Kyoto City, Japan from 2012 to 2013. We estimated microbiological pNTM disease prevalence by multiplying all pTB cases in each area with the ratio of pNTM cases and pTB cases at the survey hospitals in each area. We administered a standardized questionnaire to 52 patients and 120 patients with pulmonary MAC (pMAC) disease at Ako City Hospital and Kyoto University Hospital, respectively. RESULTS: The estimated prevalence of microbiological pNTM disease in the West Harima area (85.4/100,000 population-years) was significantly higher than that observed in Kyoto City (23.6/100,000 population-years; p<.001). According to multiple logistic regression analysis, in Ako City Hospital, primary (activities directly related to natural resources) and secondary industries (construction, mining, and manufacturing primary industry produce; odds ratio [OR]=4.79; 95% confidence interval [CI]=1.49-14.0; p=.007) and soil exposure (OR=13.6; 95% CI=4.94-45.26; p<.001) were associated with pMAC disease. CONCLUSION: Environmental factors, both industrial structures associated with occupational dust and environmental soil exposure, could influence the regional variations in pNTM disease prevalence.
Authors: Arielle W Parsons; Stephanie N Dawrs; Krishna Pacifici; Jennifer R Honda; Stephen T Nelson; Grant J Norton; Ravleen Virdi; Nabeeh A Hasan; L Elaine Epperson; Brady Holst; Edward D Chan; Vianey Leos-Barajas; Brian J Reich; James L Crooks; Michael Strong Journal: Appl Environ Microbiol Date: 2022-04-18 Impact factor: 5.005