From Dr Falkinhams paper: “Reducing Exposure to Nontuberculous Mycobacteria (NTM)”
Joseph O. Falkinham, III Ph.D. Updated: 3 May 2021

🔴Geographic Distribution of Mycobacterium Disease and Species in the United States.

The prevalence of NTM disease across the United States is not uniform, but exhibits “hot spots” and “low spots”. Florida, Louisiana, Santa Barbara, Philadelphia (Lande et al., 2019), and New York City are hot spots, while upstate New York and the southwest are low spots (Adjemian et al., 2012). High soil moisture content and humidity are strong predictors of NTM presence. High NTM numbers are also associated with recirculating hot water systems in hospitals and high-rise condominiums and apartments.
Distinct NTM species also have unique distributions. On the eastern coast of the United States there exists a “Fall Line” that separates the geology of the rocky Appalachian Mountains (Piedmont) from the sandy coastal Tidewater region. Cities on the “Fall Line” include: Philadelphia (PA), Georgetown and Richmond (VA), Fayetteville (NC), Columbia (SC), and August (GA). Florida is entirely to the east of the “Fall Line”. To the east of the “Fall Line” patients are more likely to be infected with Mycobacterium abscessus, while to the west of the “Fall Line” patients are more often infected with members of the Mycobacterium avium complex (MAC). One of the current objectives of the Falkinham Lab is to find out why.