Jerry A Nick1, D Rebecca Prevots2, Ettie M Lipner3,4, James L Crooks5,6, Joshua French7, Michael Strong8. 1. Department of Medicine, National Jewish Health, Denver, CO, USA. 2. National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA. 3. Center for Genes, Environment and Health, National Jewish Health, Denver, CO, USA. LipnerE@NJHealth.org. 4. Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA. LipnerE@NJHealth.org. 5. Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA. 6. Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, CO, USA. 7. Department of Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO, USA. 8. Center for Genes, Environment and Health, National Jewish Health, Denver, CO, USA.
Abstract
RATIONALE: Nontuberculous mycobacteria (NTM) are ubiquitous environmental bacteria that may cause chronic lung disease and are one of the most difficult-to-treat infections among persons with cystic fibrosis (pwCF). Environmental factors likely contribute to increased NTM densities, with higher potential for exposure and infection. OBJECTIVE: To identify water-quality constituents that influence odds of NTM infection among pwCF in Colorado. METHODS: We conducted a population-based nested case-control study using patient data from the Colorado CF Center NTM database. We associated data from pwCF and water-quality data extracted from the Water Quality Portal to estimate odds of NTM infection. Using Bayesian generalized linear models with binomial-distributed discrete responses, we modeled three separate outcomes; any NTM infection, infections due to Mycobacterium avium complex species, and infections due to M. abscessus group species. RESULTS: We observed a consistent association with molybdenum in the source water and M. abscessus group species infection among pwCF in all models. For every 1-unit increase in the log concentration of molybdenum in surface water, the odds of infection for those with M. abscessus group species compared to those who were NTM culture-negative increased by 79%. The odds of M. abscessus group infection varied by county; the counties with the highest probability of infection are located along the major rivers. CONCLUSIONS: We have identified molybdenum in the source water as the most predictive factor of M. abscessus group infection among pwCF in Colorado. This finding will help inform patients at risk for NTM of their relative risks in residing within specific regions.
RATIONALE: Nontuberculous mycobacteria (NTM) are ubiquitous environmental bacteria that may cause chronic lung disease and are one of the most difficult-to-treat infections among persons with cystic fibrosis (pwCF). Environmental factors likely contribute to increased NTM densities, with higher potential for exposure and infection. OBJECTIVE: To identify water-quality constituents that influence odds of NTM infection among pwCF in Colorado. METHODS: We conducted a population-based nested case-control study using patient data from the Colorado CF Center NTM database. We associated data from pwCF and water-quality data extracted from the Water Quality Portal to estimate odds of NTM infection. Using Bayesian generalized linear models with binomial-distributed discrete responses, we modeled three separate outcomes; any NTM infection, infections due to Mycobacterium avium complex species, and infections due to M. abscessus group species. RESULTS: We observed a consistent association with molybdenum in the source water and M. abscessus group species infection among pwCF in all models. For every 1-unit increase in the log concentration of molybdenum in surface water, the odds of infection for those with M. abscessus group species compared to those who were NTM culture-negative increased by 79%. The odds of M. abscessus group infection varied by county; the counties with the highest probability of infection are located along the major rivers. CONCLUSIONS: We have identified molybdenum in the source water as the most predictive factor of M. abscessus group infection among pwCF in Colorado. This finding will help inform patients at risk for NTM of their relative risks in residing within specific regions.
Authors: Carrie Reed; C Fordham von Reyn; Sandra Chamblee; Tedd V Ellerbrock; Johnny W Johnson; Bryan J Marsh; Linda S Johnson; Robert J Trenschel; C Robert Horsburgh Journal: Am J Epidemiol Date: 2006-05-04 Impact factor: 4.897
Authors: Ettie M Lipner; Joshua French; Carleton R Bern; Katherine Walton-Day; David Knox; Michael Strong; D Rebecca Prevots; James L Crooks Journal: Int J Environ Res Public Health Date: 2020-05-29 Impact factor: 3.390
Authors: Ettie M Lipner; Joshua P French; Stephen Nelson; Joseph O Falkinham Iii; Rachel A Mercaldo; Rebekah A Blakney; Yihe G Daida; Timothy B Frankland; Kyle P Messier; Jennifer R Honda; Stacey Honda; D Rebecca Prevots Journal: Environ Epidemiol Date: 2022-09-02
Authors: Ettie M Lipner; Joshua P French; Joseph O Falkinham; James L Crooks; Rachel A Mercaldo; Emily Henkle; D Rebecca Prevots Journal: Ann Am Thorac Soc Date: 2022-04