The prevalence of non-tuberculous mycobacterium pulmonary infection in a tertiary hospital in Singapore

Non-tuberculous mycobacterial pulmonary infection (NTM-PI) is an increasing problem worldwide. Little is known on its prevalence and the profile of NTM-PI, and its trend in Singapore. This study investigated the epidemiology of NTM-PI, and the clinical profiles of a Singapore population over a 5 year period. <b>Objective:</b> To investigate the prevalence of NTM-PI, the NTM profile, and clinical characteristics of all adult patients hospitalised at a tertiary referral centre between 2011 and 2015. <b>Method:</b> Demographic and clinical profiles of patients hospitalised with NTM-PI were prospectively analyzed. NTM-PI was diagnosed based on the American Thoracic Society and Infectious Disease Society of America (ATS/IDSA) criteria. <b>Results:</b> A total of 457 patients fulfilled the ATS/IDSA criteria for NTM-PI during the study period. The median age of the study population was 72 years. 300 (65.8%) were male and 96 (21.1%) were current smokers. A total of thirteen species of NTM were identified. The most common NTM was M. abscessus (31.7%), followed by M. avium complex (21.7%), and M. Kansasii (18.8%). There was a reducing trend on the prevalence of M.abscessus-PI from 42.9% in 2011 to 10% in 2015. However, the prevalence of M.avium complex-PI increased from 11.1% in 2011 to 28.3% in 2015. Bronchiectasis (36.5%) is the commonest pulmonary comorbidity, while hypertension (37.5%) is the commonest non-pulmonary one. The prevalence of NTM-PI was 283/100,000 population. <b>Conclusion:</b> This study demonstrates a high prevalence and a unique profile of NTM-PI in Singapore. There is an urgent need to identify modifiable risk factors in the development of NTM-PI, and novel therapy for better treatment outcome.