GERD, related conditions up risk of nontuberculous mycobacterium infection

Gastroesophageal reflux disease (GERD) and its complications appear to increase the risk of nontuberculous mycobacterium (NTM) infection, suggests a study.

A team of investigators used the TriNetX database, which involved more than 130 million patients from 16 countries, to compare a test cohort of patients with GERD after esophagogastroduodenoscopy (EGD) with controls without a GERD diagnosis who underwent screening colonoscopy.

Five additional test cohorts were created, namely GERD without esophagitis (NERD), GERD with esophagitis (ERD), esophageal stricture, Barrett’s without dysplasia (BWOD), and Barrett’s with dysplasia (BWD). Sequential diagnoses were allowed in the test cohorts.

The investigators performed propensity score matching between the control group and each test group based on age, gender, ethnicity, BMI, comorbidities, use of oral contraceptives, NSAIDs, bisphosphonate, ferrous sulfate, or immunosuppressant agents. They used Kaplan-Meier and Cox proportional hazards models for time-to-event analysis in matched cohorts with the outcome of de novo NTM diagnosis.

After matching, the following populations were included: 982,194 for GERD; 772,557 for NERD; 287,803 for ERD; 72,545 for esophageal stricture; 79,520 for BWOD; and 14,401 for BWD.

The analysis revealed an increased risk of NTM diagnosis in most cohorts. No significant differences in such risk were observed across groups: GERD (hazard ratio [HR], 2.024), NERD (HR, 2.06), ERD (HR, 1.758), esophageal stricture (HR, 1.875), BWOD (HR, 1.28), and BWD (HR, 2.781).

“Our findings suggest a significant association between GERD and its complications with NTM,” the investigators said. “There was an increased risk of NTM in GERD patients compared with control and no relationship between severity of GERD and likelihood of contracting NTM.”