Pneumologie 2016; 70 - A21
DOI: 10.1055/s-0036-1592245

Prevalence of Nontuberculous Mycobacterial Pulmonary Disease, Germany, 2009 – 2014

FC Ringshausen 1, D Wagner 2, A de Roux 3, R Diel 4, D Hohmann 5, L Hickstein 6, T Welte 1, J Rademacher 7
  • 1Hannover Medical School, German Center for Lung Research
  • 2University Hospital Freiburg
  • 3Pneumologische Praxis am Schloss Charlottenburg, Berlin
  • 4University Medical Center Schleswig-Holstein, Kiel, German Center for Lung Research
  • 5HGC GesundheitsConsult, Düsseldorf
  • 6Health Risk Institute, Berlin
  • 7Hannover Medical School

The authors recently demonstrated that the burden of nontuberculous mycobacterial pulmonary disease (NTM-PD) is steadily increasing in Germany, as in many other countries [1]. However, population-based data on the epidemiology of NTM-PD are still scarce.

They analyzed representative samples of German routine statutory health insurance (SHI) claim data regarding the annual prevalence rates of NTM-PD (ICD-10 diagnosis code A31.0) over a six-year period and the distribution of age and sex, the site of health care provision as well as concomitant conditions.

Overall, from 2009 to 2014 we identified between 85 and 126 subjects with NTM-PD per year, with a balanced sex distribution. Mean age was not significantly different between males and females, except in 2013. The majority of subjects were managed in outpatient care (76 – 87%). Notably, the most frequent concomitant diagnosis was COPD/emphysema (ICD-10 codes J43-J44) in 62 – 79% of subjects. Between 6.6 and 18.3% of subjects had bronchiectasis. Annual prevalence rates increased from 2.3 (95% CI 1.87 – 2.87) to 3.3 (95% CI 2.78 – 3.94) cases per 100,000 population between 2009 and 2014, while the corresponding projected total number of subjects with NTM-PD in Germany increased from 1,907 to 2697 (Figure 1A). Overall, annual rates did not differ significantly between males and females. The highest prevalence rates were observed among subjects aged ≥50 years, in particular among males and females aged ≥80 years in 2014 (9.4 (95% CI 4.35 – 17.78) and 9.6 (95% CI 5.44 – 15.65) per 100,000, respectively; Figure 1B).

In conclusion, the annual prevalence rate of NTM-PD in Germany increased between 2009 and 2014. NTM-PD showed a strong association with advanced age and chronic airway diseases. Further reliable data on the epidemiology of NTM-PD are urgently needed and could become available if NTM-PD became a notifiable disease or comprehensive disease-specific registries were established [2].

References:

[1] Ringshausen FC, Apel RM, Bange FC, de Roux A, Pletz MW, Rademacher J, et al. Burden and trends of hospitalisations associated with pulmonary non-tuberculous mycobacterial infections in Germany, 2005 – 2011. BMC Infect Dis. 2013;13:231

[2] Ringshausen FC, Wagner D, de Roux A, Diel R, Hohmann D, Hickstein L, et al. Prevalence of Nontuberculous Mycobacterial Pulmonary Disease, Germany, 2009 – 2014. Emerg Infect Dis. 2016, in press