Author(s)
Taylor Loth, BA
Brianne Roby, MD, FACS
Affiliation(s)
University of MN Medical School; Children's Minnesota;
Abstract:
Introduction:
Though rare, the incidence of nontuberculous mycobacterial (NTM) infections is increasing. The most common route of exposure being through soil and water. Amongst children, head and neck lymphadenitis is the most common presentation. However, analysis of NTM incidence between patients of different socioeconomic status (SES) has not been elucidated.
Objectives:
To compare the incidence of NTM infections in children from varying SES with the distribution of SES within the population of the respective state. To analyze likelihood of NTM exposure amongst socioeconomic groups.
Study Design:
Retrospective Review
Methods:
Medical records of 67 children diagnosed with NTM lymphadenitis at a tertiary pediatric hospital were reviewed. SES was determined using zip code as a proxy. The median income for each zip code was determined using data from the 2010 US Census Bureau. The distribution of income among patients was compared to that of the state in the year 2021.
Results:
There is a significant difference between the incidence of NTM infections among different SES and the statewide distribution of SES across all income levels. The results show a bell-curve trend with lowest and highest SES having the lowest incidence of NTM. Twenty percent of the state’s population had a median income less than $35,000 yet comprised only 4.8 % of NTM cases. On the opposite end of SES spectrum, those with median income of $100,000 represented 38% of the state population and only 12 percent of NTM cases. Those with a median income of $50,000 - $74,999 made up 42% of NTM cases, but only 17% of the state population.
Conclusion:
There is a significant difference between the distribution of NTM infection amongst socioeconomic groups and the distribution of SES across the state population that follows a bell curve pattern. Fewer children from the lowest and highest socioeconomic groups were diagnosed with NTM infection, while majority of cases were from children from middle socioeconomic groups. The underlying cause for this pattern could be related to environmental exposures (beaches, parks) that vary by SES. Knowledge of this interplay between NTM exposure and SES will better inform clinicians as they encounter this condition.