Epidemiology of mycobacterial disease

Drug-sensitive (halo) and drug-resistant (no halo) forms of the environmental pathogen Mycobacterium avium

Drug-sensitive (halo) and drug-resistant (no halo) forms of the environmental pathogen Mycobacterium avium

 

Mycobacterium tuberculosis, a globally important microbial pathogen, and related environmental mycobacteria (non-tuberculous mycobacteria, or NTM), are useful models for understanding how infectious respiratory diseases emerge and spread. 

We pioneered the application of real-time molecular epidemiology in direct support of tuberculosis outbreak control efforts. More recently, we published extensively cited findings on 1) person-to-person spread of M. abscessus among cystic fibrosis patients; and 2) community-based case-control analyses of risk factors for pulmonary M. avium complex (MAC) disease in HIV-negative adults.

Association studies conducted by our laboratory implicate shower aerosols as uniquely significant sources of non-tuberculous mycobacteria (NTM) infection in Washington and Oregon (see Tzou et al, 2020).

 
N (positive)1
Unadjusted analysis
Age-adjusted analysis2
Fully adjusted analysis3
Household site
Cases
Controls
Odds ratio
95% CI
Odds ratio
95% CI
Odds ratio
95% CI
Bathroom faucet
40 (23)
48 (20)
1.7
0.8-4.0
1.8
0.7-4.3
2.1
0.8-5.5
Kitchen faucet
40 (23)
48 (22)
1.6
0.7-4.0
1.4
0.6-3.5
1.6
0.6-4.2
Shower aerosols
39 (18)
46 (10)
3.2
1.1-8.9
3.8
1.2-11.7
4.0
1.2-13.4
Indoor soil
30 (17)
38 (13)
2.0
0.7-5.4
1.6
0.6-4.6
1.4
0.5-4.4
Outdoor soil
39 (10)
46 (9)
1.2
0.4-3.4
1.1
0.4-3.2
1.2
0.4-3.4

 

1Some case-control pairs had more than one control. Positives were samples with at least NTM isolate.

2Adjusted for age over 80 years

3Adjusted for age, race, and education level

 

Recent publications:

Association between Mycobacterium avium Complex Pulmonary Disease and Mycobacteria in Home Water and Soil

Tzou CL, Dirac MA, Becker AL, Beck NK, Weigel KM, Meschke JS, and Cangelosi GA (2020). Association between Mycobacterium avium complex pulmonary disease and mycobacteria in home water and soil: A case-control study. Ann Am Thorac Soc. 17:57-62. PMID: 31644315.

Environment or host?: A case-control study of risk factors for Mycobacterium avium complex lung disease

Dirac MA, Horan KL, Doody DR, Meschke JS, Park DR, Jackson LA, Weiss NS, Winthrop KL, Cangelosi GA (2012). Environment or host?:  A case-control study of risk factors for Mycobacterium avium complex lung disease. Am J Respir Crit Care Med. Oct 1;186(7):684-91. PMID: 22859521

Respiratory outbreak of Mycobacterium abscessus subspecies massiliense in a lung transplant and cystic fibrosis center

Aitken ML, Limaye A, Pottinger P, Whimbey E, Goss CH, Tonelli MR, Cangelosi GA, Ashworth-Dirac M, Olivier KN, Brown-Elliot BA, McNulty S, and Wallace RJ (2012). Respiratory Outbreak of Mycobacterium abscessus Subspecies massiliense in a Lung Transplant and Cystic Fibrosis Center. Am. J. Respir. Crit. Care Med. 185: 231-232. PMID: 22246710

Use of PCR-based Mycobacterium tuberculosis genotyping to prioritize tuberculosis outbreak control activities

Ashworth M, Horan KL, Freeman R, Oren E, Narita M, and Cangelosi GA (2008). Use of PCR-based Mycobacterium tuberculosis genotyping to prioritize tuberculosis outbreak control activities. J Clin Microbiol 46(3):856-62. PMID: 18174293

 

Hero
Drug-sensitive (halo) and drug-resistant (no halo) forms of the environmental pathogen Mycobacterium avium