Nontuberculous Mycobacterial Infection and Pulmonary Disease in Northern Israel a summary of the article from the June 2025 Chest Journal
7/7/20251 min read
Summary: Prevalence and Impact of NTM and Mycobacterium simiae Pulmonary Disease in Northern Israel
Study Question
This study aimed to assess the prevalence of nontuberculous mycobacteria (NTM) pulmonary disease, especially from Mycobacterium simiae, in Northern Israel, and to identify factors associated with mortality in affected patients.
Key Findings
Between 2010 and 2021, NTM isolation rates increased significantly, especially for MAC and M. simiae.
The annual incidence of confirmed NTM pulmonary disease in Israel was estimated at 1.7 to 2.0 per 100,000 people, lower than in North America, but similar to rates in Germany and the UK.
M. simiae caused pulmonary disease at rates comparable to MAC, with similar radiologic and clinical presentation, but was associated with higher mortality in multivariable analysis.
Only 31 of 550 patients received treatment, suggesting possible under-treatment, especially for M. simiae.
Factors linked to mortality included older age, COPD, and immunosuppression.
Rural residence was associated with M. simiae isolation, possibly due to soil or water exposure.
Interpretation
This study challenges the traditional view of M. simiae as a non-pathogenic colonizer. Despite its growing presence and its similarity to MAC in disease presentation, M. simiae was often not treated, potentially due to outdated perceptions and lack of treatment guidelines. The higher associated mortality signals the need for greater clinical awareness and updated guidelines for managing less common NTM species.
The results underscore the importance of re-evaluating the clinical relevance of M. simiae, conducting prospective studies, and considering environmental factors in NTM epidemiology.
For the complete abstract click here.