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The European Respiratory Journal Jul 2020Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and...
Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as complex, , and among the slowly growing NTM and among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.
Topics: Adult; Humans; Mycobacterium Infections, Nontuberculous; Mycobacterium abscessus; Mycobacterium avium Complex; Mycobacterium kansasii; Nontuberculous Mycobacteria
PubMed: 32636299
DOI: 10.1183/13993003.00535-2020 -
Radiologic Clinics of North America May 2022Mycobacterial species other than Mycobacterium tuberculosis and Mycobacterium leprae constitute nontuberculous mycobacteria (NTM). NTM infections are on the rise,... (Review)
Review
Mycobacterial species other than Mycobacterium tuberculosis and Mycobacterium leprae constitute nontuberculous mycobacteria (NTM). NTM infections are on the rise, particularly in the Western world. They cause a wide range of pulmonary and systemic manifestations. The 2 most common types are as follows: classical cavitary type, seen with preexisting lung disease, and the nonclassical bronchiectatic type, seen in elderly women without preexisting lung disease. Disseminated infections by the hematogenous route are common in immunocompromised patients including those with HIV. Imaging plays a key role in the diagnosis and monitoring of NTM infection.
Topics: Aged; Bronchiectasis; Female; Humans; Lung Diseases; Mycobacterium Infections, Nontuberculous; Mycobacterium avium Complex; Nontuberculous Mycobacteria
PubMed: 35534127
DOI: 10.1016/j.rcl.2022.01.012 -
Clinical Infectious Diseases : An... Aug 2020Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and...
Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.
Topics: Adult; Humans; Mycobacterium Infections, Nontuberculous; Mycobacterium abscessus; Mycobacterium avium Complex; Mycobacterium kansasii; Nontuberculous Mycobacteria
PubMed: 32628747
DOI: 10.1093/cid/ciaa241 -
Microbiology Spectrum Jan 2017Rapidly growing mycobacteria (RGM) compose approximately one-half of the currently validated mycobacterial species and are divided into six major groups, including the... (Review)
Review
Rapidly growing mycobacteria (RGM) compose approximately one-half of the currently validated mycobacterial species and are divided into six major groups, including the Mycobacterium fortuitum group, M. chelonae/M. abscessus complex, M. smegmatis group, M. mucogenicum group, M. mageritense/M. wolinskyi, and the pigmented RGM. This review discusses each group and highlights the major types of infections associated with each group. Additionally, phenotypic and molecular laboratory identification methods, including gene sequencing, mass spectrometry, and the newly emerging whole-genome sequencing, are detailed, along with a discussion of the current antimicrobial susceptibility methods and patterns of the most common pathogenic species.
Topics: Bacteriological Techniques; Diagnostic Tests, Routine; Humans; Molecular Diagnostic Techniques; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria
PubMed: 28084211
DOI: 10.1128/microbiolspec.TNMI7-0027-2016 -
Clinics in Chest Medicine Mar 2015Diseases and therapies that reduce cell-mediated immunity increase the risk of nontuberculous mycobacterial (NTM) disease. Extrapulmonary NTM disease, including... (Review)
Review
Diseases and therapies that reduce cell-mediated immunity increase the risk of nontuberculous mycobacterial (NTM) disease. Extrapulmonary NTM disease, including disseminated, skin, and catheter-related disease, is more common in immunosuppressed than immunocompetent patients. Mycobacterium avium complex remains the most common cause of NTM infection, but rapid growers including Mycobacterium abscessus, Mycobacterium chelonae, and Mycobacterium fortuitum play an important role in skin and catheter-related infections. With the exception of antibiotic prophylaxis for AIDS patients, the prevention of NTM remains difficult. Management is complicated, involving restoration of immune function and removal of catheters in addition to treatment with species-specific antibiotics per current guidelines.
Topics: Anti-Bacterial Agents; Drug Administration Schedule; Humans; Immunocompromised Host; Immunosuppressive Agents; Lung Diseases; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria
PubMed: 25676522
DOI: 10.1016/j.ccm.2014.11.002 -
Dermatologic Clinics Jul 2015Skin and soft tissue infections caused by nontuberculous mycobacteria are increasing in incidence. The nontuberculous mycobacteria are environmental, acid-fast bacilli... (Review)
Review
Skin and soft tissue infections caused by nontuberculous mycobacteria are increasing in incidence. The nontuberculous mycobacteria are environmental, acid-fast bacilli that cause cutaneous infections primarily after trauma, surgery and cosmetic procedures. Skin findings include abscesses, sporotrichoid nodules or ulcers, but also less distinctive signs. Important species include Mycobacterium marinum and the rapidly growing mycobacterium: M. fortuitum, M. abscessus and M. chelonae. Obtaining tissue for mycobacterial culture and histopathology aids diagnosis. Optimal therapy is not well-established, but is species-dependent and generally dictated by susceptibility studies. Management often includes use of multiple antibiotics for several months and potential use of adjunctive surgery.
Topics: Anti-Bacterial Agents; Humans; Mycobacterium Infections, Nontuberculous; Mycobacterium chelonae; Mycobacterium fortuitum; Mycobacterium marinum; Skin; Skin Diseases, Bacterial; Soft Tissue Infections
PubMed: 26143432
DOI: 10.1016/j.det.2015.03.017 -
Scientific Reports Mar 2017Mycobacterium tuberculosis and Mycobacterium leprae have remained, for many years, the primary species of the genus Mycobacterium of clinical and microbiological...
Mycobacterium tuberculosis and Mycobacterium leprae have remained, for many years, the primary species of the genus Mycobacterium of clinical and microbiological interest. The other members of the genus, referred to as nontuberculous mycobacteria (NTM), have long been underinvestigated. In the last decades, however, the number of reports linking various NTM species with human diseases has steadily increased and treatment difficulties have emerged. Despite the availability of whole genome sequencing technologies, limited effort has been devoted to the genetic characterization of NTM species. As a consequence, the taxonomic and phylogenetic structure of the genus remains unsettled and genomic information is lacking to support the identification of these organisms in a clinical setting. In this work, we widen the knowledge of NTMs by reconstructing and analyzing the genomes of 41 previously uncharacterized NTM species. We provide the first comprehensive characterization of the genomic diversity of NTMs and open new venues for the clinical identification of opportunistic pathogens from this genus.
Topics: Chromosome Mapping; Gene Transfer, Horizontal; Genetic Variation; Genome, Bacterial; Humans; Molecular Sequence Annotation; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Open Reading Frames; Phylogeny; Sequence Analysis, DNA
PubMed: 28345639
DOI: 10.1038/srep45258 -
Clinical Infectious Diseases : An... Aug 2020Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and...
Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.
Topics: Adult; Humans; Mycobacterium Infections, Nontuberculous; Mycobacterium abscessus; Mycobacterium avium Complex; Mycobacterium kansasii; Nontuberculous Mycobacteria
PubMed: 32797222
DOI: 10.1093/cid/ciaa1125 -
Clinical Microbiology and Infection :... Jun 2024Nontuberculous mycobacteria (NTM) are highly abundant in soil, dust, and water sources, making human-pathogen contact frequent and recurrent. NTM represents over 200... (Review)
Review
BACKGROUND
Nontuberculous mycobacteria (NTM) are highly abundant in soil, dust, and water sources, making human-pathogen contact frequent and recurrent. NTM represents over 200 species/subspecies; some are considered strict or opportunistic pathogens. Mycobacterium abscessus, often regarded as one of the most antibiotic-resistant mycobacteria, is the second most frequent NTM pulmonary disease pathogen.
OBJECTIVES
To describe the epidemiology of M. abscessus through a literature review focusing on clinical aspects.
SOURCES
We conducted searches on PubMed and Web of Knowledge for articles published from 2010 to the present using the keywords 'Mycobacterium abscessus', 'Nontuberculous mycobacteria', and 'epidemiology'. Our search prioritized original reports on the occurrence of NTM and M. abscessus infection/disease.
CONTENT
Advanced molecular and genetic diagnostic techniques have refined the M. abscessus complex (MABC) microbiological classification over the last few decades. MABC can adhere to surfaces and form a biofilm. This characteristic and its resistance to common disinfectants allow these microorganisms to persist in the water distribution systems, becoming a constant reservoir. The frequency and manifestation of NTM species vary geographically because of environmental conditions and population susceptibility differences. MABC lung disease, the most frequent site of NTM infection in humans, is often seen in patients with underlying lung diseases such as bronchiectasis, whereas MABC disseminated disease is related to immunosuppression. Skin and soft tissue infections are associated with surgical or injection procedures. Epidemiological evidence suggests an overall increase in MABC infection and disease in the last decade.
IMPLICATIONS
Establishing the burden of this disease is challenging because of varying measures of incidence and prevalence, referral bias, and differences in medical practices and reporting. Furthermore, environmental and structural determinants, infection routes, and MABC pulmonary disease mechanisms require additional investigation. This review contributes to a better understanding of the epidemiology of MABC, which could inform clinical practice and future research.
Topics: Humans; Mycobacterium abscessus; Mycobacterium Infections, Nontuberculous
PubMed: 37778416
DOI: 10.1016/j.cmi.2023.08.035 -
Frontiers in Cellular and Infection... 2021(MABC is one of the most clinically relevant species among nontuberculous mycobacteria. MABC's prevalence has increased over the last two decades. Although these... (Review)
Review
(MABC is one of the most clinically relevant species among nontuberculous mycobacteria. MABC's prevalence has increased over the last two decades. Although these changes can be explained by improvements in microbiological and molecular techniques for identifying species and subspecies, a higher prevalence of chronic lung diseases may contribute to higher rates of MABC. High rates of antimicrobial resistance are seen in MABC, and patients experience multiple relapses with low cure rates. This review aims to integrate existing knowledge about MABC epidemiology, microbiological identification and familiarize readers with molecular mechanisms of resistance and therapeutic options for pulmonary infections with MABC.
Topics: Anti-Bacterial Agents; Humans; Lung Diseases; Mycobacterium Infections, Nontuberculous; Mycobacterium abscessus; Nontuberculous Mycobacteria
PubMed: 33981630
DOI: 10.3389/fcimb.2021.659997