March 2021

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 27, No. 3, March 2021

Important Note: Not all articles that EID publishes represent work done at CDC or by CDC staff. In your stories, please clarify whether a study was conducted by CDC (“a CDC study”) or by another institution (“a study published by CDC in the EID journal”). Opinions expressed by authors contributing to EID do not necessarily reflect the opinions of CDC or the institutions with which the authors are affiliated. EID requests that, when possible, you include a live link to the actual journal article in your stories. Once the embargo lifts, this month’s articles will be found in the Ahead of Print section of the EID website at

The articles of interest summarized below will appear in the March 2021 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature Emerging Viruses. The articles are embargoed until February 10, 2021, at 12 p.m. EDT.

1.     Extrapulmonary Nontuberculous Mycobacterial Infections in Hospitalized Patients, United States, 2009–2014, Emily E. Ricotta et al.

Nontuberculous mycobacteria (NTM) are mycobacteria other than those that cause tuberculosis and leprosy. NTM can be found in the environment (soil, dust, and natural or municipal water sources). NTM can form difficult-to-eliminate biofilms, which adhere to moist surfaces, such as the insides of plumbing or implanted medical devices. They most commonly infect people who are susceptible because of a compromised immune system or recent medical or cosmetic (e.g., tattoos, pedicures) procedure. NTM infections can affect tissue other than the lungs (extrapulmonary infections), such as skin, joints, and lymph nodes, or the infection can be disseminated in otherwise sterile body tissue, such as blood. To learn more about the extent of extrapulmonary NTM infections in the United States, researchers examined clinical, demographic, and laboratory data for hospitalized patients recorded in a large database during 2009–2014. They found that NTM infections varied by geographic region in terms of prevalence, infection type, and species of mycobacteria. Rapidly growing NTM are more prevalent in the South than in other regions. Infection with Mycobacterium avium complex is more common among patients with concurrent HIV and fungal infection, a relevant finding because treatment is more effective for infection with this species of NTM. Overall, extrapulmonary NTM infections are rare; incidence rates (new cases) of disseminated NTM infections remain relatively stable while skin and soft tissue NTM infections are increasing, possibly because of the increased number of patients taking immunosuppressive drugs or undergoing cosmetic procedures.

Contact: NIAID Office of Communications, email or phone: 301-402-1663.

2.    Foodborne Origin and Global Spread of Staphylococcus saprophyticus, Opeyemi U. Lawal et al.

Staphylococcus saprophyticus is the cause of urinary tract infection (UTI) in 10%–20% of the young women who have uncomplicated UTIs. The bacterium also lives in the gut of livestock, such as pigs and cattle, and is a contaminant of meat, fermented food products, and polluted aquatic environments. Because the basic features of S. saprophyticus epidemiology are largely unknown, researchers in Portugal analyzed 333 samples of S. saprophyticus bacteria collected from UTI patients worldwide during a 20-year period and 232 samples of S. saprophyticus bacteria recovered at pig-processing operations in Europe. They found that the meat-production chain is one of the sources of the S. saprophyticus causing UTIs in humans. The implicated S. saprophyticus strains belonged to two lineages that have distinctive genetic features and are widely spread both locally and globally. The researchers identified several characteristics, including antimicrobial resistance and an increased rate of genetic recombination, that make S. saprophyticus UTI infections potentially more difficult to treat. Those findings provide the groundwork for future studies on the population genetics of this bacterium and on the disease mechanisms that threaten human health.

Contact: Maria Miragaia, Laboratory of Bacterial Evolution and Molecular Epidemiology, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa (ITQB-NOVA), Oeiras, Portugal; Communication office contact: Renata Ramalho; email:; phone number: +351-965007727.

3.    Oral Human Papillomavirus Infection in Children during the First 6 Years of Life, Stina Syrjänen et al.

Note: There is no embargo on this article. The article is available online at

Mucosal HPV infections (those found in the oral and genital mucus membranes) have mostly been regarded as sexually transmitted diseases. However, certain mucosal HPVs have also been found in virgins, infants, and children, which indicates a nonsexual mode of transmission. To better understand the modes of transmission and outcomes of HPV infections in children, researchers in Finland evaluated oral swab samples from 331 children who participated in the Finnish Family HPV Study. The children were followed from the time of their birth through 9 follow-up visits, at which they were tested for 24 different strains (genotypes) of HPV. Oral HPV prevalence for children varied from 8.7% (at a 36-month visit) to 22.8% (at birth), and 18 HPV genotypes were identified. HPV16 was the most prevalent type to persist, followed by HPV18, HPV33, and HPV6. Persistent, oral, high-risk HPV infection for children was associated with the mother carrying oral HPV at the tim/e of birth and development of high-risk HPV in the mother during follow-up. Children acquire their first oral HPV infection at an early age, and the HPV status of the mother has a major impact on the persistence of oral HPV in her children.

Contact: Stina Syrjänen, Department of Oral Pathology and Oral Radiology, Institute of Dentistry, Faculty of Medicine, University of Turku, Turku, Finland; e-mail:; phone: +358 400375331.



Page last reviewed: February 9, 2021