• Razi Even-Dar, Idit Raz, Maya Brodsky, Nili Stein, Yochai Adir, Walid Saliba, Shifra Ken-Dror, Ronza Najjar- Debbiny, Raya Cohen, and Michal Shteinberg.
• Haifa and Western Galilee district, Clalit Health Services, Haifa, Israel.
• Chest. 2024 Dec 2.

BackgroundThe prevalence of non-Tuberculous Mycobacteria pulmonary disease (NTM-pd) is rising globally. Previously, we described a high prevalence of M. simiae isolation in Israel.Research QuestionsWhat is the prevalence of NTM-pd and M. simiae-pd in Northern Israel? Which factors are associated with mortality among people with NTM?Study Design And MethodsWe retrospectively recorded all samples from Clalit Health Services- Haifa district reference mycobacteria laboratory for growth of NTM, between January 2010 and March 2021. We manually reviewed a random sample of corresponding patients' electronic medical files and extracted demographic, clinical, and radiological data, as well as data on the course of the disease. Univariate and multivariate analyses were performed to assess factors associated with features of NTM-pd and mortality.Results2968 clinical isolates from 1501 people yielded NTM species. The relative abundance of M. simiae, MAC and other species increased over the study period. Among the 550 patients' files reviewed, clinical presentation, fulfilment of established criteria for NTM-pulmonary disease, and mortality rates were not significantly different between patients with M. simiae, MAC and M. kansassi/szulgai species, with 27.7, 35.3, and 27.8% of people fulfilling criteria for NTM-pd. Factors associated with mortality included age, male sex, and immunosuppression. Compared to MAC isolation, M. simiae was associated with elevated mortality: HR 1.84 (95% CI 1.05-3.23). The extrapolated national annual incidence rate of NTM- pd was 1.7-2.0:100,000 population.InterpretationInfection with M.simiae is prevalent in Israel, and although considered minimally pathogenic, demonstrated similar clinical and radiologic features to MAC-pd.Copyright © 2024. Published by Elsevier Inc.

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