Epidemiology of Human Pulmonary Infection with Non-Tuberculous Mycobacteria: A Review

Population-based data have documented a continued increase in NTM prevalence since 2000. Annual prevalence in North American and Australia ranges from 3.2–9.8 per 100,000, and is generally higher than in Europe. Studies of NTM PD from South Korea, Japan, and Taiwan, also suggest increasing prevalence. In Africa and the Middle East, prevalence of NTM ranges from 4% –15% among suspected TB cases and 18%–20% among suspected multi-drug resistant TB (MDR TB) cases. M. avium complex (MAC) is predominant in North America and East Asia, whereas M. kansasii, M. xenopi, and M. malmoense are more common in Europe. Host factors important to the current epidemiology of NTM PD include thoracic skeletal abnormalities, rheumatoid arthritis, and use of immunomodulatory drugs. Clustering of disease within families suggests a heritable genetic predisposition to disease susceptibility. Warm, humid environments with high atmospheric vapor pressure contribute to population risk.