TY - JOUR
T1 - Spatial Epidemiologic Analysis and Risk Factors for Nontuberculous Mycobacteria Infections, Missouri, USA, 2008–2019
AU - Mejia-Chew, Carlos
AU - Chavez, Miguel A.
AU - Lian, Min
AU - McKee, Angela
AU - Garrett, Leighton
AU - Bailey, Thomas C.
AU - Spec, Andrej
AU - Agarwal, Mansi
AU - Turabelidze, George
N1 - Publisher Copyright:
© 2023 Centers for Disease Control and Prevention (CDC). All rights reserved.
PY - 2023/8
Y1 - 2023/8
N2 - Nontuberculous mycobacteria (NTM) infections are caused by environmental exposure. We describe spatial distribution of NTM infections and associations with sociodemographic factors and flooding in Missouri, USA. Our retrospective analysis of mycobacterial cultures reported to the Missouri Department of Health and Social Services surveillance system during January 1, 2008–December 31, 2019, detected geographic clusters of infection. Multilevel Poisson regression quantified small-area geographic variations and identified characteristics associated with risk for infection. Median county-level NTM infection rate was 66.33 (interquartile range 51–91)/100,000 persons. Risk of clustering was significantly higher in rural areas (rate ratio 2.82, 95% CI 1.90–4.19) and in counties with >5 floodings per year versus no flooding (rate ratio 1.38, 95% CI 1.26–1.52). Higher risk for NTM infection was associated with older age, rurality, and more flooding. Clinicians and public health professionals should be aware of increased risk for NTM infections, especially in similar environments.
AB - Nontuberculous mycobacteria (NTM) infections are caused by environmental exposure. We describe spatial distribution of NTM infections and associations with sociodemographic factors and flooding in Missouri, USA. Our retrospective analysis of mycobacterial cultures reported to the Missouri Department of Health and Social Services surveillance system during January 1, 2008–December 31, 2019, detected geographic clusters of infection. Multilevel Poisson regression quantified small-area geographic variations and identified characteristics associated with risk for infection. Median county-level NTM infection rate was 66.33 (interquartile range 51–91)/100,000 persons. Risk of clustering was significantly higher in rural areas (rate ratio 2.82, 95% CI 1.90–4.19) and in counties with >5 floodings per year versus no flooding (rate ratio 1.38, 95% CI 1.26–1.52). Higher risk for NTM infection was associated with older age, rurality, and more flooding. Clinicians and public health professionals should be aware of increased risk for NTM infections, especially in similar environments.
UR - http://www.scopus.com/inward/record.url?scp=85165594529&partnerID=8YFLogxK
U2 - 10.3201/eid2908.230378
DO - 10.3201/eid2908.230378
M3 - Article
C2 - 37486160
AN - SCOPUS:85165594529
SN - 1080-6040
VL - 29
SP - 1540
EP - 1546
JO - Emerging Infectious Diseases
JF - Emerging Infectious Diseases
IS - 8
ER -