Association of Healthcare and Aesthetic Procedures with Infections Caused by Nontuberculous Mycobacteria, France, 2012–2020

To the Editor: Daniau et al. (1) described extrapulmonary nontuberculous mycobacteria (NTM) infections associated with medical procedures in France, highlighting the need for timely case reporting and genomic analysis to identify outbreak causes and prevent infections. On the basis of our experience investigating NTM healthcare-associated infections (HAIs) and outbreaks, we believe that an enhanced approach toward NTM that recognizes early signals of potential outbreaks and promptly uses the skills and investigative expertise of public health professionals is integral to mitigating disease spread. NTM pose substantial costs and burdens for patients, contributing to more hospitalizations and deaths than other waterborne pathogens (2). Among Centers for Disease Control and Prevention consultations for waterborne HAI outbreaks, 30% were caused by NTM, accounting for 40% of cases and further substantiating need to prevent transmission in healthcare facilities (3). Extrapulmonary NTM infections can be challenging to detect because of their long incubation period and nonspecific signs and symptoms, which raises concern that many healthcare-associated cases are unidentified (4).