Epidemiological trends in nontuberculous mycobacterial infection among people with cystic fibrosis in Germany.

People with cystic fibrosis (pwCF) are at risk for infection with nontuberculous mycobacteria (NTM). The epidemiology and screening practice of NTM among pwCF in Germany are largely unknown and require investigation. We analyzed the data of the German Cystic Fibrosis Registry from 2016 to 2020 for NTM. The annual prevalence and incidence of any NTM, Mycobacterium abscessus complex (MABC), Mycobacterium avium complex (MAC), Mycobacterium gordonae, and other mycobacteria were determined and correlated to patient characteristics. Patients with incident MABC and MAC infection were compared. The annual NTM prevalence and incidence remained stable between 7.53% and 8.76%, as well as 3.31% and 4.95%, respectively, among the approximately 6000 registry participants. MABC was the most common NTM, whereas only the prevalence of MAC increased slightly. In each year, only about one-third of all patients were screened for NTM. An association between NTM infections and Aspergillus fumigatus infection and/or allergic bronchopulmonary aspergillosis was observed. On average, patients with incident MAC infection were older than patients with MABC infection. The NTM burden in pwCF in Germany remained unchanged between 2016 and 2020. MABC was the dominant species detected, whereas only MAC infections increased with time and patient age. The previously observed association of Aspergillus fumigatus and NTM was reaffirmed. Awareness of NTM needs to be improved.

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Déclaration de conflit d'intérêts

Declaration of competing interest MS reports grants from Mukoviszidose e.V.; personal honoraria for lectures and sponsored seminars from Vertex; fees for clinical trial participation for his institution from Vertex, Gilead, and Corbus. FS reports fees for clinical trial participation from Vertex, Gilead, and Corbus; personal honoraria for lectures from Vertex, Biogen, and Novartis; personal payments for participation on advisory boards from Vertex and Gilead. LN reports grants or contracts from German Center for Lung Research, Vertex Pharmaceuticals, and Boehringer Ingelheim for clinical trial participating; participation on a trial steering committee for CF STORM, medical lead of the German CF Registry, pharmacovigilance study manager of the ECFSPR; receipt of medical writing from Articulate Science. FCR reports grants from the German Center for Lung Research (DZL), the German Center for Infection Research (DZIF), the Innovative Medicines Initiative (IMI; EU/EFPIA), and the iABC Consortium (including Alaxia, Basilea, Novartis, and Polyphor), Mukoviszidose Institute, Novartis, Insmed Germany, Grifols, Bayer Healthcare, and InfectoPharm paid to his institution; fees for clinical trial participation from Abbvie, AstraZeneca, Boehringer Ingelheim, Celtaxsys, Corbus, Insmed, Novartis, Parion, University of Dundee, Vertex, and Zambon paid to his institution; personal consulting fees from Parion Sciences, Grifols, Zambon, Insmed, and Helmholtz Center for Infection Research; personal honoraria for lectures from!DE Werbeagentur GmbH, Interkongress GmbH, AstraZeneca, Insmed, Grifols, University Hospital Frankfurt; payment for expert testimony from the Social Court Cologne; financial support for attending meetings from the German Kartagener Syndrome and Primary Ciliary Dyskinesia Patient Advisory Group, as well as the German Cystic Fibrosis Patient Advisory Group (Mukoviszidose e.V.); personal payments for participation on an advisory board from Insmed, Grifols, and Shionogi; as well as honorary (unpaid) commitment as coordinator of the ERNLUNG Bronchiectasis Core Network, co-chair of the German Bronchiectasis Registry PROGNOSIS, member of the steering committee of the European Bronchiectasis Registry EMBARC, member of the steering committee of the European NTM Registry EMBARC-NTM, co-speaker of the Medical Advisory Board of the German Kartagener Syndrome and Primary Ciliary Dyskinesia Patient Advisory Group, speaker of the Respiratory Infections and TB group of the German Respiratory Society (DGP), speaker of the Cystic Fibrosis group of German Respiratory Society (DGP), principal investigator of the German Center for Lung Research (DZL), member of the Protocol Review Committee of the PCD Clinical Trial Network, and member of Physician Association of the German Cystic Fibrosis Patient Advisory Group (Mukoviszidose e.V.). The other authors have no competing interests to declare.