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Nontuberculous Mycobacteria—Overview

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  • Author: Won-Jung Koh1
  • Editor: David Schlossberg2
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; 2: Philadelphia Health Department, Philadelphia, PA
  • Source: microbiolspec January 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0024-2016
  • Received 30 October 2016 Accepted 21 November 2016 Published 27 January 2017
  • Won-Jung Koh, wjkoh@skku.edu
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  • Abstract:

    Nontuberculous mycobacteria (NTM) are emerging pathogens that affect both immunocompromised and immunocompetent patients. The development of molecular methods has allowed the characterization of new species and the identification of NTM to the precise species and subspecies levels. The incidence and prevalence of NTM lung disease are increasing worldwide, and this syndrome accounts for the majority of clinical cases of NTM disease. Common causative organisms of pulmonary infection are the slowly growing mycobacteria complex and and the rapidly growing mycobacteria, including complex. NTM lung disease often affects elderly people with chronic lung disease and may be a manifestation of a complex genetic disorder determined by interactions among multiple genes, as well as environmental exposures. To be diagnosed with NTM lung disease, patients should meet all clinical and microbiologic criteria, but the decision to start treatment is complex, requiring careful individualized analysis of risks and benefits. Clinicians should be alert to the unique aspects of NTM lung disease, including the need for proper diagnosis, the availability of advanced molecular methods for species and subspecies identification, and the benefits and limitations of recommended treatments.

  • Citation: Koh W. 2017. Nontuberculous Mycobacteria—Overview. Microbiol Spectrum 5(1):TNMI7-0024-2016. doi:10.1128/microbiolspec.TNMI7-0024-2016.

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References

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2017-01-27
2017-11-20

Abstract:

Nontuberculous mycobacteria (NTM) are emerging pathogens that affect both immunocompromised and immunocompetent patients. The development of molecular methods has allowed the characterization of new species and the identification of NTM to the precise species and subspecies levels. The incidence and prevalence of NTM lung disease are increasing worldwide, and this syndrome accounts for the majority of clinical cases of NTM disease. Common causative organisms of pulmonary infection are the slowly growing mycobacteria complex and and the rapidly growing mycobacteria, including complex. NTM lung disease often affects elderly people with chronic lung disease and may be a manifestation of a complex genetic disorder determined by interactions among multiple genes, as well as environmental exposures. To be diagnosed with NTM lung disease, patients should meet all clinical and microbiologic criteria, but the decision to start treatment is complex, requiring careful individualized analysis of risks and benefits. Clinicians should be alert to the unique aspects of NTM lung disease, including the need for proper diagnosis, the availability of advanced molecular methods for species and subspecies identification, and the benefits and limitations of recommended treatments.

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Figures

Image of FIGURE 1
FIGURE 1

Fibrocavitary form of lung disease in a 62-year-old male patient. The patient underwent antituberculosis treatment and a right upper lobectomy at 30 years of age. Chest computed tomography shows a large cavity in the right upper lung field. Note the emphysema in both lungs.

Source: microbiolspec January 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0024-2016
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Image of FIGURE 2
FIGURE 2

Nodular bronchiectatic form of lung disease in a 63-year-old female patient. Chest computed tomography shows severe bronchiectasis in the right middle lobe and in the lingular segment of the left upper lobe. Note the multiple small nodules and tree-in-bud appearance suggesting bronchiolitis in both lungs.

Source: microbiolspec January 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0024-2016
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Tables

Generic image for table
TABLE 1

Classification of NTM commonly causing human disease

Source: microbiolspec January 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0024-2016
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TABLE 2

Pulmonary and extrapulmonary disease caused by NTM

Source: microbiolspec January 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0024-2016
Generic image for table
TABLE 3

Diagnostic criteria of NTM lung disease

Source: microbiolspec January 2017 vol. 5 no. 1 doi:10.1128/microbiolspec.TNMI7-0024-2016

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