Abstract
BackgroundRepresentative population-based data on the epidemiology of pulmonary non-tuberculous mycobacterial (PNTM) infections in Europe are limited. However, these data are needed in order to optimise patient care and to facilitate the allocation of healthcare resources. The aim of the present study was to investigate the current burden and the trends of PNTM infection-associated hospitalisations in Germany.MethodsInternational Classification of Diseases, 10th revision (ICD-10) discharge diagnosis codes were extracted from the official nationwide diagnosis-related groups (DRG) hospital statistics in order to identify PNTM infection-associated hospitalisations (ICD-10 code A31.0) between 2005 and 2011. Poisson log-linear regression analysis was used to assess the significance of trends.ResultsOverall, 5,959 records with PNTM infection as any hospital discharge diagnosis were extracted from more than 125 million hospitalisations. The average annual age-adjusted rate was 0.91 hospitalisations per 100,000 population. Hospitalisation rates increased during the study period for both males and females, with the highest rate of 3.0 hospitalisations per 100,000 population among elderly men, but the most pronounced average increase of 6.4%/year among females, particularly those of young and middle age, and hospitalisations associated with cystic fibrosis. Overall, chronic obstructive pulmonary disease (COPD) was the most frequent PNTM infection-associated condition in 28.9% of hospitalisations and also showed a significant average annual increase of 4.8%.ConclusionsThe prevalence of PNTM infection-associated hospitalisations is steadily increasing in Germany. COPD is currently the most important associated condition. Our population-based study provides evidence of a changing epidemiology of PNTM infections and highlights emerging clinical implications.
Highlights
Representative population-based data on the epidemiology of pulmonary non-tuberculous mycobacterial (PNTM) infections in Europe are limited
Burden of PNTM infection as a hospital discharge diagnosis From 2005 to 2011, a total of 125.2 million hospitalisations were analysed over an observational period of 574.4 million person-years
The overall average annual age-adjusted hospitalisation rate was 0.91 per 100,000 population
Summary
Representative population-based data on the epidemiology of pulmonary non-tuberculous mycobacterial (PNTM) infections in Europe are limited. There is growing evidence that the epidemiology of PNTM infections is changing, with immunocompetent subjects suffering from pre-existing structural lung disease and adults aged ≥50 years with a substantial proportion of never-smoking females without previous lung disease being increasingly reported from outside Europe [5,7,13,14] Most of these studies were either solely laboratory-based or used the frequency of NTM isolates from clinical specimens in order to determine prevalence and to reason the significance of NTM infection in conjunction with clinical and radiological data according to the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) statement on the diagnosis of NTM disease [3,7,10,11,13,14,15]. Primarily used for the billing of health services, some important epidemiological evidence has originated from the analysis of International Classification of Diseases hospital discharge diagnosis codes and health insurance claims [9,16]
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