Nontuberculous Mycobacteria (NTM) Surveillance

Overview

As part of CDC's Emerging Infections Program (EIP) Healthcare-Associated Infections – Community Interface (HAIC) Activity, the Nontuberculous Mycobacteria (NTM) Surveillance Program conducts surveillance to identify and describe:

• The epidemiology of pulmonary and extrapulmonary NTM infections (PNTM and ENTM).
• Microbiologic characteristics of public health relevance.
• Antimicrobial susceptibility of organisms causing NTM infections.
• The molecular epidemiology of NTM.

To collect this information, trained professionals conduct active population- and laboratory-based surveillance in four EIP sites.

Public health professionals and healthcare administrators can use these data to inform policy and prevention strategies that reduce NTM infections.

Highlights

What the data shows

• There were 1.3 ENTM cases per 100,000 persons in EIP sites in 2021.
• Skin and soft tissue infections were the most commonly reported extrapulmonary infection type.
• The most common exposures at the infection site for ENTM infections were surgery, injection or infusion, a medical device and/or trauma.1

Explore the data

Annual reports

ENTM 2021

Publications

Grigg C, Jackson KA, Barter D, et al. Epidemiology of Pulmonary and Extrapulmonary Nontuberculous Mycobacteria Infections at 4 US Emerging Infections Program Sites: A 6-Month Pilot. Clin Infect Dis. 2023;77(4):629-637. doi:10.1093/cid/ciad214

About the data

Methods

EIP sites conducting surveillance

*NTM reportable in the surveillance area(s)

Case definitions

Excluded mycobacterial species: M. gordonae, M. paragordonae, M. tuberculosis complex, M. leprae, M. lepromatosis, and M. ulcerans.

Pulmonary cases

Definitions for confirmed pulmonary cases are consistent with published guidelines.

Possible case

• NTM identified from a single sputum, tracheal or endotracheal specimen during the calendar year; and no NTM identified from pulmonary specimens, and no lung biopsy specimens with histopathologic features (granulomatous inflammation or acid-fast bacilli) during the 12 months before or after the date of incident specimen collection (DISC).

Confirmed case

When the following microbiological criteria are met during the 12 months before or after the DISC:

• Identification of NTM via culture or culture-independent test methods from any of the following:
  • At least two separate sputum (expectorated or induced), tracheal or endotracheal specimens.
  • One bronchial wash or bronchoalveolar lavage or lung tissue specimen.
  • A lung biopsy specimen with histopathologic features (granulomatous inflammation or acid-fast bacilli) and identification of NTM via culture or culture-independent test methods from at least one pulmonary specimen.

Extrapulmonary cases

• Identification of NTM via culture or culture-independent test in any non-pulmonary body site, excluding stool or rectal swab specimens.

Prevalent case

During the 12 months before the DISC, the case-patient had one or more specimens positive for NTM from the same infection type (pulmonary or extrapulmonary) or there was medical record documentation indicating NTM infection of the same type.

Incident case

During the 12 months before the DISC, the case-patient had no specimens positive for NTM from the same infection type (pulmonary or extrapulmonary), and there was no medical record documentation of the same type of NTM infection (pulmonary or extrapulmonary).

Case ascertainment

Surveillance staff regularly query local clinical laboratories serving EIP site surveillance areas for pulmonary or extrapulmonary NTM specimens among residents.

Resources

Case report forms for EIP surveillance staff

• 2023 Extrapulmonary NTM
• 2023 Pulmonary NTM