2010-2019年美国囊性纤维化患者肺部NTM感染风险和水质成分。

IF 3.3 Q2 ENVIRONMENTAL SCIENCES
Environmental Epidemiology Pub Date : 2023-08-25 eCollection Date: 2023-10-01 DOI:10.1097/EE9.0000000000000266
Ettie M Lipner, Joshua P French, Rachel A Mercaldo, Stephen Nelson, Adrian M Zelazny, Julia E Marshall, Michael Strong, Joseph O Falkinham, D Rebecca Prevots
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引用次数: 0

摘要

理由:非结核分枝杆菌(NTM)肺部疾病的患病率在美国的地理位置各不相同。先前的研究表明,水源水中某些水质成分的存在会增加NTM感染的风险。目的:确定影响美国囊性纤维化患者NTM肺部感染风险的水质成分。方法:我们使用2010-2019年间从囊性纤维化基金会患者登记处收集的NTM发病率数据进行了一项基于人群的病例对照研究。我们使用从水质门户网站提取的地表水数据,将患者的邮政编码与所在县和相关的患者居住县联系起来。我们使用逻辑回归模型来估计NTM感染的几率作为水质成分的函数。我们模拟了两种结果:由鸟分枝杆菌复合体(MAC)引起的肺部感染和脓肿分枝杆菌物种。结果:我们确定了484例MAC病例、222例脓肿分枝杆菌病例和2816例NTM阴性囊性纤维化对照,居住在11个州。在多变量模型中,我们发现,与囊性纤维化NTM阴性对照组相比,县级地表水中硫酸盐和钒的对数浓度每增加1个标准化单位,患有MAC的囊性纤维化患者的感染几率分别增加39%和21%。当将脓肿分枝杆菌建模为因变量时,钼的对数浓度每增加1个标准化单位,感染的几率就会增加36%。结论:这些发现表明,自然存在和人为存在的水质成分可能会影响城市供水系统水源中NTM的丰度,从而增加MAC和脓肿分枝杆菌感染的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The risk of pulmonary NTM infections and water-quality constituents among persons with cystic fibrosis in the United States, 2010-2019.

Rationale: The prevalence of nontuberculous mycobacterial (NTM) pulmonary disease varies geographically in the United States. Previous studies indicate that the presence of certain water-quality constituents in source water increases NTM infection risk.

Objective: To identify water-quality constituents that influence the risk of NTM pulmonary infection in persons with cystic fibrosis in the United States.

Methods: We conducted a population-based case-control study using NTM incidence data collected from the Cystic Fibrosis Foundation Patient Registry during 2010-2019. We linked patient zip code to the county and associated patient county of residence with surface water data extracted from the Water Quality Portal. We used logistic regression models to estimate the odds of NTM infection as a function of water-quality constituents. We modeled two outcomes: pulmonary infection due to Mycobacterium avium complex (MAC) and Mycobacterium abscessus species.

Results: We identified 484 MAC cases, 222 M. abscessus cases and 2816 NTM-negative cystic fibrosis controls resident in 11 states. In multivariable models, we found that for every 1-standardized unit increase in the log concentration of sulfate and vanadium in surface water at the county level, the odds of infection increased by 39% and 21%, respectively, among persons with cystic fibrosis with MAC compared with cystic fibrosis-NTM-negative controls. When modeling M. abscessus as the dependent variable, every 1-standardized unit increase in the log concentration of molybdenum increased the odds of infection by 36%.

Conclusions: These findings suggest that naturally occurring and anthropogenic water-quality constituents may influence the NTM abundance in water sources that supply municipal water systems, thereby increasing MAC and M. abscessus infection risk.

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来源期刊
Environmental Epidemiology
Environmental Epidemiology Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.70
自引率
2.80%
发文量
71
审稿时长
25 weeks
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