Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study

Abstract Background The objective of the study was to describe the epidemiology, management and cost of non-tuberculous mycobacteria pulmonary disease (NTM-PD) in France. Methods A retrospective analysis was performed using the SNDS (“Système national des données de santé”) database over 2010–2017....

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Nicolas Veziris, Claire Andréjak, Stéphane Bouée, Corinne Emery, Marko Obradovic, Raphaël Chiron
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Non-tuberculous mycobacteria Lung infection Antibiotics Mortality Real world evidence Claim database Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/0fcddbe93c6c44f2bdadec0512bc41cc
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:0fcddbe93c6c44f2bdadec0512bc41cc
record_format	dspace
spelling	oai:doaj.org-article:0fcddbe93c6c44f2bdadec0512bc41cc2021-11-21T12:42:44ZNon-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study10.1186/s12879-021-06825-x1471-2334https://doaj.org/article/0fcddbe93c6c44f2bdadec0512bc41cc2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06825-xhttps://doaj.org/toc/1471-2334Abstract Background The objective of the study was to describe the epidemiology, management and cost of non-tuberculous mycobacteria pulmonary disease (NTM-PD) in France. Methods A retrospective analysis was performed using the SNDS (“Système national des données de santé”) database over 2010–2017. Patients with NTM-PD were identified based on the ICD10 codes during hospitalizations and/or specific antibiotics treatment regimens. The study population was matched (age, sex and region) to a control group (1:3) without NTM-PD. Results 5628 patients with NTM-PD (men: 52.9%, mean age = 60.9 years) were identified over the study period and 1433 (25.5%) were treated with antibiotics. The proportion of patients still receiving treatment at 6 and 12 months was 40% and 22%, respectively. The prevalence of NTM-PD was estimated at 5.92 per 100,000 inhabitants and the incidence rate of NTM-PD remained stable over time between 1.025/100,000 in 2010 and 1.096/100,000 in 2017. Patients with NTM-PD had more co-morbidities compared to controls: corticoids (57.3% vs. 33.8%), chronic lower respiratory disease (34.4% vs. 2.7%), other infectious pneumonia (24.4% vs. 1.4%), malnutrition (based on hospitalization with the ICD-10 code reported during a hospital stay as a main or secondary diagnosis) (22.0% vs. 2.0%), history of tuberculosis (14.1% vs. 0.1%), HIV (8.7% vs. 0.2%), lung cancer and lung graft (5.7% vs. 0.4%), cystic fibrosis (3.2% vs. 0.0%), gastro-esophageal reflux disease (2.9% vs. 0.9%) and bone marrow transplant (1.3% vs. 0.0%) (p < 0.0001). The mean Charlson comorbidity index score was 1.6 (vs. 0.2 for controls; p < 0.0001). NTM-PD was independently associated with an increased mortality rate with a hazard ratio of 2.8 (95% CI: 2.53; 3.11). Mortality was lower for patients treated with antibiotics compared to untreated patients (HR = 0.772 (95% CI [0.628; 0.949]). Annual total expenses the year following the infection in a societal perspective were € 24,083 (SD: 29,358) in NTM-PD subjects vs. € 3402 (SD: 8575) in controls (p < 0.0001). Main driver of the total expense for NTM-PD patients was hospital expense (> 50% of the total expense). Conclusion Patients with NTM-PD in France were shown to have many comorbidities, their mortality risk is high and mainly driven by NTM-PD, and their management costly. Only a minority of patients got treated with antibiotics and of those patients treated, many stopped their therapy prematurely. These results underline the high burden associated with NTM-PD and the need for improvement of NTM-PD management in France.Nicolas VezirisClaire AndréjakStéphane BouéeCorinne EmeryMarko ObradovicRaphaël ChironBMCarticleNon-tuberculous mycobacteriaLung infectionAntibioticsMortalityReal world evidenceClaim databaseInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Non-tuberculous mycobacteria Lung infection Antibiotics Mortality Real world evidence Claim database Infectious and parasitic diseases RC109-216
spellingShingle	Non-tuberculous mycobacteria Lung infection Antibiotics Mortality Real world evidence Claim database Infectious and parasitic diseases RC109-216 Nicolas Veziris Claire Andréjak Stéphane Bouée Corinne Emery Marko Obradovic Raphaël Chiron Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study
description	Abstract Background The objective of the study was to describe the epidemiology, management and cost of non-tuberculous mycobacteria pulmonary disease (NTM-PD) in France. Methods A retrospective analysis was performed using the SNDS (“Système national des données de santé”) database over 2010–2017. Patients with NTM-PD were identified based on the ICD10 codes during hospitalizations and/or specific antibiotics treatment regimens. The study population was matched (age, sex and region) to a control group (1:3) without NTM-PD. Results 5628 patients with NTM-PD (men: 52.9%, mean age = 60.9 years) were identified over the study period and 1433 (25.5%) were treated with antibiotics. The proportion of patients still receiving treatment at 6 and 12 months was 40% and 22%, respectively. The prevalence of NTM-PD was estimated at 5.92 per 100,000 inhabitants and the incidence rate of NTM-PD remained stable over time between 1.025/100,000 in 2010 and 1.096/100,000 in 2017. Patients with NTM-PD had more co-morbidities compared to controls: corticoids (57.3% vs. 33.8%), chronic lower respiratory disease (34.4% vs. 2.7%), other infectious pneumonia (24.4% vs. 1.4%), malnutrition (based on hospitalization with the ICD-10 code reported during a hospital stay as a main or secondary diagnosis) (22.0% vs. 2.0%), history of tuberculosis (14.1% vs. 0.1%), HIV (8.7% vs. 0.2%), lung cancer and lung graft (5.7% vs. 0.4%), cystic fibrosis (3.2% vs. 0.0%), gastro-esophageal reflux disease (2.9% vs. 0.9%) and bone marrow transplant (1.3% vs. 0.0%) (p < 0.0001). The mean Charlson comorbidity index score was 1.6 (vs. 0.2 for controls; p < 0.0001). NTM-PD was independently associated with an increased mortality rate with a hazard ratio of 2.8 (95% CI: 2.53; 3.11). Mortality was lower for patients treated with antibiotics compared to untreated patients (HR = 0.772 (95% CI [0.628; 0.949]). Annual total expenses the year following the infection in a societal perspective were € 24,083 (SD: 29,358) in NTM-PD subjects vs. € 3402 (SD: 8575) in controls (p < 0.0001). Main driver of the total expense for NTM-PD patients was hospital expense (> 50% of the total expense). Conclusion Patients with NTM-PD in France were shown to have many comorbidities, their mortality risk is high and mainly driven by NTM-PD, and their management costly. Only a minority of patients got treated with antibiotics and of those patients treated, many stopped their therapy prematurely. These results underline the high burden associated with NTM-PD and the need for improvement of NTM-PD management in France.
format	article
author	Nicolas Veziris Claire Andréjak Stéphane Bouée Corinne Emery Marko Obradovic Raphaël Chiron
author_facet	Nicolas Veziris Claire Andréjak Stéphane Bouée Corinne Emery Marko Obradovic Raphaël Chiron
author_sort	Nicolas Veziris
title	Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study
title_short	Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study
title_full	Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study
title_fullStr	Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study
title_full_unstemmed	Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study
title_sort	non-tuberculous mycobacterial pulmonary diseases in france: an 8 years nationwide study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/0fcddbe93c6c44f2bdadec0512bc41cc
work_keys_str_mv	AT nicolasveziris nontuberculousmycobacterialpulmonarydiseasesinfrancean8yearsnationwidestudy AT claireandrejak nontuberculousmycobacterialpulmonarydiseasesinfrancean8yearsnationwidestudy AT stephanebouee nontuberculousmycobacterialpulmonarydiseasesinfrancean8yearsnationwidestudy AT corinneemery nontuberculousmycobacterialpulmonarydiseasesinfrancean8yearsnationwidestudy AT markoobradovic nontuberculousmycobacterialpulmonarydiseasesinfrancean8yearsnationwidestudy AT raphaelchiron nontuberculousmycobacterialpulmonarydiseasesinfrancean8yearsnationwidestudy
_version_	1718418806948233216

Non-tuberculous mycobacterial pulmonary diseases in France: an 8 years nationwide study

Ejemplares similares