Mycobacterial infections in a large Virginia hospital, 2001-2009

We queried the University of Virginia Clinical Data Repository for all mycobacterial infections from 2001-2009.Of 494 mycobacterial infections in 467 patients there were 22 species. Patients with pulmonary Tb were more likely to be reported as immigrants (p < 0.001) and less likely to have a predisposing risk factor for NTM (pre-existing lung disease or host predisposition; p = 0.002). Review of chest CT scans revealed that TB infection was more likely to exhibit cavities and pleural effusion than NTM infection (p < 0.05). Among NTM infections M. kansasii, M. xenopi, and M. fortuitum were more likely than MAC to have cavities. There were at least 83 patients that met criteria for NTM lung disease and these were caused by 9 species. M. abscessus infection was associated with cystic fibrosis and M. xenopi infection was associated with male gender.In our center mycobacterial infections were common and of diverse species. Immigrant status, cavities, and effusion were associated with TB vs. NTM.A better understanding of the epidemiology of mycobacterial infections leads the research agenda issued by national NTM guidelines [1]. NTM infections are usually not reported to public health departments, thus data on incidence and species distribution are sparse. However there have been suggestions that NTM disease is increasing in some areas [2,3], making the demography and species distribution of these infections important to understand. The mid-Atlantic and southeastern United States are known to be high incidence regions for mycobacteria, likely related to a high prevalence of NTM in local soils [4]. The University of Virginia hospital is a tertiary referral center that receives patients from across the region. Thirty years have passed since the last systematic report of mycobacterial infections at our institution [5]. Thus we sought to describe the epidemiology, clinical characteristics, and radiology of all mycobacterial infections seen at our hospital from 2001-2009. To o