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Volume 23, Number 3—March 2017
Research

Pulmonary Nontuberculous Mycobacteria–Associated Deaths, Ontario, Canada, 2001–2013

Theodore K. MarrasComments to Author , Michael A. Campitelli, Hong Lu, Hannah Chung, Sarah K. Brode, Alex Marchand-Austin, Kevin L. Winthrop, Andrea S. Gershon, Jeffrey C. Kwong1, and Frances B. Jamieson1
Author affiliations: Mount Sinai Hospital, Toronto, Ontario, Canada (T.K. Marras, S.K. Brode); University of Toronto, Toronto (T.K. Marras, S.K. Brode, A.S. Gershon, J.C. Kwong, F.B. Jamieson); University Health Network, Toronto (T.K. Marras, S.K. Brode, J.C. Kwong); Institute for Clinical Evaluative Sciences, Toronto (M.A. Campitelli, H. Lu, H. Chung, A.S. Gershon, J.C. Kwong); West Park Healthcare Centre, Toronto (S.K. Brode); Public Health Ontario, Toronto (A. Marchand-Austin, J.C. Kwong, F.B. Jamieson); Oregon Health and Science University, Portland, Oregon, USA (K.L. Winthrop); Sunnybrook Health Sciences Centre, Toronto (A.S. Gershon)

Main Article

Table 2

Characteristics of patients with NTM pulmonary isolation and matched persons without NTM for MAC, Mycobacterium xenopi, and M. abscessus, Ontario, Canada, 2001–2013*

Characteristic
MAC
M. xenopi
M. abscessus
Isolation, 
n = 5,242
Control, 
n = 5,242
SDM
Isolation, 
n = 2,693
Control, 
n = 2,693
SDM
Isolation, 
n = 162
Control, 
n = 162
SDM
Female sex, % 51 51 0 48 47 0 49 49 0
Median age, y (IQR)
65 (49–76)
65 (49–76)
0

65 (48–76)
65 (48–76)
0

60 (43–74)
60 (43–74)
0
Underlying condition, %
Asthma 29 25 0.09 31 26 0.1 25 20 0.12
COPD 36 41 0.1 38 42 0.09 25 26 0.01
Diabetes 18 23 0.12 19 21 0.06 15 16 0.03
Rheumatoid arthritis 3 2 0.06 3 3 0.01 <4† 5 0.09
Chronic kidney disease 6 7 0.05 7 8 0.03 5 6 0.05
GERD 14 17 0.08 15 17 0.05 14 13 0.02
Bronchiectasis 7 4 0.13 6 4 0.09 6 5 0.03
Interstitial lung disease 3 2 0.06 3 3 0.03 <4† 4 0.11
Lung cancer 2 2 0.02 2 2 0.04 <4† <4† 0.18
HIV infection‡ 1 0.2 0.13 2 <0.2† 0.19 0 0
Solid organ transplant‡ 0.3 0.3 0 0.5 <0.2† 0.07 0 <4† 0.11
BMT‡ 0.1 0.1 0 <0.2† <0.2%† 0.04 0 0
Cystic fibrosis‡ 0.4 0.1 0.05 0.2 0 0.07 5 <4† 0.27
Prior tuberculosis‡
3
<0.1†
0.23

3
<0.2%†
0.25

<4†
0
0.19
Hospitalizations§
0.31 ± 0.77
0.30 ± 0.76
0.01

0.33 ± 0.78
0.31 ± 0.78
0.02

0.19 ± 0.53
0.23 ± 0.60
0.09
ED visits§
0.83 ± 1.22
0.79 ± 1.79
0.02

0.81 ± 1.21
0.77 ± 1.59
0.03

0.49 ± 0.88
0.46 ± 1.08
0.03
ACG diagnoses 9.0 ± 4.1 8.7 ± 4.1 0.06 9.1 ± 4.2 8.8 ± 4.2 0.08 7.3 ± 4.3 7.4 ± 4.4 0.01

*Matched according to age (years), sex, index date (± 90 d), and propensity score (estimating the patient-level likelihood of species-specific NTM pulmonary isolation) value within 0.2 × SD of the exposed patient. NTM pulmonary isolation was defined as the presence of 1 positive sputum specimen. Controls were persons without NTM matched by age, sex, index date, and propensity score. ACG, adjusted clinical group diagnoses using the ACG case mix system (16); BMT, hematopoietic stem cell transplant; COPD, chronic obstructive pulmonary disease; ED, emergency department; GERD, gastresophageal reflux disease; IQR, interquartile range; MAC, Mycobacterium avium complex; NTM, nontuberculous mycobacteria; SDM, standardized difference of the mean (value <0.1 generally considered not significant) (17). Blank cells indicate value undefined.
†Range reported because of small cell size (direct or by inference), which according to privacy regulations cannot be reported.
‡Baseline characteristics not included in the propensity score because of their effect to substantially reduce successful matching of exposed cases with unexposed controls. Inclusion of these variables as covariates was explored, but none significantly altered the hazard ratio point estimates.
§Number of events in year before index date.

Main Article

1These authors contributed equally to this article.

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Page updated: February 17, 2017
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