Temporal trends and recent disparities in nontuberculous mycobacterial mortality among older adults in the United States: A CDC WONDER analysis

Document Type

Article

Department

Medical College Pakistan; Medicine

Abstract

Introduction: Even though nontuberculous mycobacteria (NTM) are increasingly recognized as significant pathogens, particularly in older and immunocompromised individuals, nationwide data on NTM-associated mortality trends are limited.
Materials and methods: The present cross-sectional study used CDC WONDER data (1999-2023) to assess NTM-related (ICD-10: A31) mortality trends adults in the U.S. aged ≥ 45. Trends were stratified by gender, age, race, urbanization status, region, state, and place of death. Age-adjusted and crude mortality rates (AAMRs, CMRs) were calculated per million population. Trends were analyzed using Joinpoint regression to estimate annual and average annual percentage changes (APCs, AAPCs).
Results: NTM-related mortality increased significantly from 1999 to 2023, with AAMR rising from 5.1 to 7.0 per million (AAPC = 1.38%*, 95% CI: 0.77-1.99). Among the reported 15,626 deaths, females accounted for 51.7%. However, males had higher AAMRs throughout. CMRs markedly increased across age groups, with the ≥ 85 cohort displaying the highest burden and most pronounced rise in mortality (AAPC = 2.66%*, 95% CI: 2.03-3.49). White and Hispanic groups displayed significantly rising AAMRs over time, with Black adults being the only group evidencing the reverse trend (AAPC = -1.40%*, 95% CI: -2.44 to -0.14). All regions except for the West reported rising AAMRs, led consistently by the South, which increased from 6.2 to 8.6 (AAPC = 1.32%*, 95% CI: 0.69-1.85). Hawaii (12.2), South Carolina (9.8), and Vermont (9.0) recorded the highest AAMRs. Urban areas consistently exhibited higher AAMRs than rural areas.
Conclusion: NTM mortality is rising, with considerable demographic and geographic disparities, underscoring a need for targeted public health interventions.

Publication (Name of Journal)

Infectious Diseases Now

DOI

10.1016/j.idnow.2026.105284

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