BACKGROUND The prevalence of non-Tuberculous Mycobacteria pulmonary disease (NTM-pd) is rising globally. Previously, we described a high prevalence of M. simiae isolation in Israel. RESEARCH QUESTIONS What is the prevalence of NTM-pd and M. simiae-pd in Northern Israel? Which factors are associated with mortality among people with NTM? STUDY DESIGN AND METHODS We retrospectively recorded all samples from Clalit Health Services- Haifa district reference mycobacteria laboratory for growth of NTM, between January 2010 and March 2021. We manually reviewed a random sample of corresponding patients' electronic medical files and extracted demographic, clinical, and radiological data, as well as data on the course of the disease. Univariate and multivariate analyses were performed to assess factors associated with features of NTM-pd and mortality. RESULTS 2968 clinical isolates from 1501 people yielded NTM species. The relative abundance of M. simiae, MAC and other species increased over the study period. Among the 550 patients' files reviewed, clinical presentation, fulfilment of established criteria for NTM-pulmonary disease, and mortality rates were not significantly different between patients with M. simiae, MAC and M. kansassi/szulgai species, with 27.7, 35.3, and 27.8% of people fulfilling criteria for NTM-pd. Factors associated with mortality included age, male sex, and immunosuppression. Compared to MAC isolation, M. simiae was associated with elevated mortality: HR 1.84 (95% CI 1.05-3.23). The extrapolated national annual incidence rate of NTM- pd was 1.7-2.0:100,000 population. INTERPRETATION Infection with M.simiae is prevalent in Israel, and although considered minimally pathogenic, demonstrated similar clinical and radiologic features to MAC-pd.

中文翻译：

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以色列北部的非结核分枝杆菌感染和肺部疾病：以 M. simiae 为重点。


背景 非结核分枝杆菌肺病 （NTM-pd） 的患病率在全球范围内正在上升。之前，我们描述了以色列 M. simiae 分离的高患病率。研究问题 NTM-pd 和 M. simiae-pd 在以色列北部的患病率是多少？哪些因素与 NTM 患者的死亡率相关？研究设计和方法 我们回顾性记录了 2010 年 1 月至 2021 年 3 月期间来自 Clalit Health Services-Haifa 区参考分枝杆菌实验室的 NTM 生长的所有样本。我们手动审查了相应患者电子病历档案的随机样本，并提取了人口统计学、临床和放射学数据，以及病程数据。进行单变量和多变量分析以评估与 NTM-pd 特征和死亡率相关的因素。结果 来自 1501 例患者的 2968 例临床分离株产生了 NTM 种属。M. simiae、MAC 和其他物种的相对丰度在研究期间有所增加。在回顾的 550 例患者档案中，临床表现、满足 NTM 肺病既定标准和死亡率在 M. simiae、MAC 和 M. kansassi/szulgai 物种患者之间没有显著差异，符合 NTM-pd 标准的人为 27.7% 、 35.3% 和 27.8%。与死亡率相关的因素包括年龄、男性和免疫抑制。与 MAC 分离相比，M. simiae 与死亡率升高相关： HR 1.84 （95% CI 1.05-3.23）。推断的全国 NTM-pd 年发病率为 1.7-2.0：100,000 人口。解释 M.simiae 感染在以色列很普遍，虽然被认为致病性最小，但表现出与 MAC-pd 相似的临床和放射学特征。