Key points
- The Nontuberculous Mycobacteria (NTM) Surveillance Program collects data for describing incidence and trends of these infections.
- Public health professionals and healthcare providers can use these data to further public health research and improve health outcomes.
Overview
Aims
As part of CDC's Emerging Infections Program (EIP) Healthcare-Associated Infections – Community Interface Activity (HAIC), the Nontuberculous Mycobacteria (NTM) Surveillance Program identifies and describes:
- 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.
Process
To collect this information, trained professionals conduct active population- and laboratory-based surveillance in five EIP sites. CDC and EIP staff clean, analyze, and disseminate the data through annual reports and peer-reviewed publications.
Purpose
Public health and healthcare professionals can use these data to inform policy and prevention strategies that reduce NTM infections
Highlights
Trends in age and race
Extrapulmonary NTM (ENTM)
- There were 1.3 ENTM incident 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
Pulmonary NTM (PNTM)
- There were 6.2 prevalent and 3.8 incident confirmed PNTM cases per 100,000 persons in EIP sites in 2021.
- Confirmed PNTM incidence was higher in females than males.
- Most confirmed PNTM cases had underlying chronic lung disease.2
Explore the data
Annual reports
Publications using NTM Surveillance Program data
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
Masters TL, Charles Tony N, Ewing TO, et al. Genomic Epidemiology of Extrapulmonary Nontuberculous Mycobacteria Isolates at Emerging Infections Program Sites—United States, 2019–2010. J Infect Dis. 2025 Apr 15;231(4):902-912. doi: 10.1093/infdis/jiae488.
About the data
| EIP Site | Area under surveillance for ENTM |
|---|---|
| Colorado* | Adams, Arapahoe, Denver, Douglas, Jefferson |
| Georgia* | Cobb, Clayton, DeKalb, Douglas, Fulton, Gwinnett, Newton, Rockdale |
| Minnesota* | Statewide |
| New York | Monroe |
| Oregon | Statewide* |
| EIP Site | Area under surveillance for PNTM |
|---|---|
| Colorado* | Adams, Arapahoe, Denver, Douglas, Jefferson |
| Georgia* | Fulton |
| Minnesota* | Hennepin, Ramsey |
| New York | Monroe |
| Oregon | Clackamas, Multnomah, Washington |
*NTM reportable in the surveillance area(s)
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).
Surveillance staff regularly query local clinical laboratories serving EIP site surveillance areas for pulmonary or extrapulmonary NTM specimens among residents.
- Centers for Disease Control and Prevention. 2023. Emerging Infections Program, Healthcare-Associated Infections – Community Interface Surveillance Report, Extrapulmonary Nontuberculous Mycobacteria (ENTM), 2021. Available at: https://www.cdc.gov/healthcare-associated-infections/media/pdfs/2021-ENTM-Report-508.pdf
- Centers for Disease Control and Prevention. 2024. Emerging Infections Program, Healthcare-Associated Infections – Community Interface Surveillance Report, Pulmonary Nontuberculous Mycobacteria (PNTM), 2021. Available at: https://www.cdc.gov/healthcare-associated-infections/media/pdfs/2021-PULM-Report-508.pdf
- Centers for Disease Control and Prevention. 2025. Emerging Infections Program, Healthcare-Associated Infections – Community Interface Surveillance Report, Extrapulmonary Nontuberculous Mycobacteria (ENTM), 2022. Available at: https://www.cdc.gov/healthcare-associated-infections/media/pdfs/2022- ENTM-Report-508.pdf