Environmental predictors of pulmonary nontuberculous mycobacteria (NTM) sputum positivity among persons with cystic fibrosis in the state of Florida

Sydney L Foote; Ettie M Lipner; D Rebecca Prevots; Emily E Ricotta

doi:10.1371/journal.pone.0259964

Environmental predictors of pulmonary nontuberculous mycobacteria (NTM) sputum positivity among persons with cystic fibrosis in the state of Florida

PLoS One. 2021 Dec 9;16(12):e0259964. doi: 10.1371/journal.pone.0259964. eCollection 2021.

Authors

Sydney L Foote¹, Ettie M Lipner^{2

3}, D Rebecca Prevots⁴, Emily E Ricotta⁴

Affiliations

¹ Office of Data Science and Emerging Technologies, Office of Science Management and Operations, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, MD, United States of America.
² Center for Genes, Environment, and Health, National Jewish Health, Denver, CO, United States of America.
³ Department of Epidemiology, Colorado School of Public Health, Aurora, CO, United States of America.
⁴ Division of Intramural Research, Epidemiology and Population Studies Unit, NIAID, NIH, Rockville, MD, United States of America.

Abstract

Nontuberculous mycobacteria (NTM) are opportunistic human pathogens that are commonly found in soil and water, and exposure to these organisms may cause pulmonary nontuberculous mycobacterial disease. Persons with cystic fibrosis (CF) are at high risk for developing pulmonary NTM infections, and studies have shown that prolonged exposure to certain environments can increase the risk of pulmonary NTM. It is therefore important to determine the risk associated with different geographic areas. Using annualized registry data obtained from the Cystic Fibrosis Foundation Patient Registry for 2010 through 2017, we conducted a geospatial analysis of NTM infections among persons with CF in Florida. A Bernoulli model in SaTScan was used to identify clustering of ZIP codes with higher than expected numbers of NTM culture positive individuals. Generalized linear mixed models with a binomial distribution were used to test the association of environmental variables and NTM culture positivity. We identified a significant cluster of M. abscessus and predictors of NTM sputum positivity, including annual precipitation and soil mineral levels.

Publication types

Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adolescent
Adult
Case-Control Studies
Cluster Analysis
Cystic Fibrosis / epidemiology
Cystic Fibrosis / microbiology*
Female
Florida / epidemiology
Humans
Male
Middle Aged
Mycobacterium Infections, Nontuberculous / epidemiology*
Phylogeography
Registries
Risk Factors
Soil / chemistry*
Soil Microbiology
Sputum / microbiology
Young Adult

Substances

Soil

Grants and funding

SLF was supported in part by an appointment to the National Institute of Allergy and Infectious Diseases (NIAID) Emerging Leaders in Data Science Research Participation Program. This program is administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy (DOE) and NIAID. ORISE is managed by ORAU under DOE contract number DE-SC0014664. EML was supported by the Cystic Fibrosis Foundation, Clinical Pilot and Feasibility Award. EER and DRP were supported by the Division of Intramural Research, NIAID, National Institutes of Health. All opinions expressed in this paper are the author's and do not necessarily reflect the policies and views of NIAID, DOE, or ORAU/ORISE.