Nontuberculous Mycobacteria

2021 ◽  
Vol 42 (04) ◽  
pp. 567-586
Author(s):  
Shera Tan ◽  
Shannon Kasperbauer
Keyword(s):  
Risk Factor ◽  
Pulmonary Disease ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Nontuberculous Mycobacteria ◽  
Mycobacterium Abscessus ◽  
Pulmonary Infections ◽  
Human Pathogens ◽  
Common Manifestation

AbstractNontuberculous mycobacteria (NTM) are ubiquitous in the environment and 193 species of NTM have been discovered thus far. NTM species vary in virulence from benign environmental organisms to difficult-to-treat human pathogens. Pulmonary infections remain the most common manifestation of NTM disease in humans and bronchiectasis continues to be a major risk factor for NTM pulmonary disease (NTM PD). This article will provide a useful introduction and framework for clinicians involved in the management of bronchiectasis and NTM. It includes an overview of the epidemiology, pathogenesis, diagnosis, and management of NTM PD. We will address the challenges faced in the diagnosis of NTM PD and the importance of subspeciation in guiding treatment and follow-up, especially in Mycobacterium abscessus infections. The treatment of both Mycobacterium avium complex and M. abscessus, the two most common NTM species known to cause disease, will be discussed in detail. Elements of the recent ATS/ERS/ESCMID/IDSA NTM guidelines published in 2020 will also be reviewed.

scholarly journals General Overview of Nontuberculous Mycobacteria Opportunistic Pathogens: Mycobacterium avium and Mycobacterium abscessus

2020 ◽  
Vol 9 (8) ◽  
pp. 2541 ◽  
Author(s):  
Kimberly To ◽  
Ruoqiong Cao ◽  
Aram Yegiazaryan ◽  
James Owens ◽  
Vishwanath Venketaraman
Keyword(s):  
Pulmonary Disease ◽  
Mycobacterium Avium ◽  
Nontuberculous Mycobacteria ◽  
Clinical Manifestations ◽  
Developed Countries ◽  
Incidence Rates ◽  
Mycobacterium Abscessus ◽  
Human Pathogens ◽  
General Overview ◽  
Wide Range

Nontuberculous mycobacteria (NTM) are emerging human pathogens, causing a wide range of clinical diseases affecting individuals who are immunocompromised and who have underlying health conditions. NTM are ubiquitous in the environment, with certain species causing opportunistic infection in humans, including Mycobacterium avium and Mycobacterium abscessus. The incidence and prevalence of NTM infections are rising globally, especially in developed countries with declining incidence rates of M. tuberculosis infection. Mycobacterium avium, a slow-growing mycobacterium, is associated with Mycobacterium avium complex (MAC) infections that can cause chronic pulmonary disease, disseminated disease, as well as lymphadenitis. M. abscessus infections are considered one of the most antibiotic-resistant mycobacteria and are associated with pulmonary disease, especially cystic fibrosis, as well as contaminated traumatic skin wounds, postsurgical soft tissue infections, and healthcare-associated infections (HAI). Clinical manifestations of diseases depend on the interaction of the host’s immune response and the specific mycobacterial species. This review will give a general overview of the general characteristics, vulnerable populations most at risk, pathogenesis, treatment, and prevention for infections caused by Mycobacterium avium, in the context of MAC, and M. abscessus.

scholarly journals 1274. Evaluating the Activity of SPR719, a Novel Aminobenzimidazole, against Nontuberculous Mycobacteria

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S653-S654
Author(s):  
Beverly Murray ◽  
Danielle Hall ◽  
Nicole S Cotroneo ◽  
Ian Critchley ◽  
Michael Pucci ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Mycobacterium Avium Complex ◽  
Nontuberculous Mycobacteria ◽  
Treatment Options ◽  
Pulmonary Infections ◽  
Disease Treatment ◽  
Summary Table ◽  
New Agents ◽  
Mortality And Morbidity ◽  
Slow Growing

Abstract Background Pulmonary infections caused by Nontuberculous Mycobacteria (NTM) are increasing in prevalence and are associated with high mortality and morbidity. Members of the Mycobacterium avium complex (MAC; primarily M. avium and M. intracellulare) and M. abscessus are most commonly associated with NTM pulmonary disease. Treatment options are limited and new agents with potent activity are needed. In this study, the activity of SPR719, a novel aminobenzimidazole, against NTM is reported. MIC range and MIC50/90 summary table Methods The susceptibility of 58 non-consecutive, non-duplicate clinical NTM isolates was determined in accordance with the Clinical and Laboratory Standards Institute (CLSI) standard M24. Isolates included 20 rapidly-growing mycobacteria (10 M. abscessus/chelonae Group, 6 M. fortuitum Group, and 4 M. mucogenicum Group) and 38 slow-growing mycobacteria (28 MAC and 10 M. kansasii). SPR719 and comparators clarithromycin (CLA), amikacin (AMK), moxifloxacin (MXF), rifabutin (RFB), minocycline (MIN), and imipenem (IPM) were evaluated. Minimum bactericidal concentrations (MBC) for SPR719, CLA, and AMK were determined in accordance with CLSI M26. Results The activity of SPR719 and comparators by MIC range and MIC50/90 (µg/mL) is summarized in the accompanying table. SPR719 activity was not affected by resistance to CLA, AMK, or MXF. MBC:MIC ratios for SPR719 and CLA were typically >8 which indicates a bacteriostatic mode of action; AMK MBC:MIC ratios were typically ≤ 4 indicative of bactericidal activity. Conclusion SPR719 had potent activity by both MIC50/90 and MIC range across the evaluated NTM species. The SPR719 activity against clinically relevant MAC and M. abcessus/chelonae Group isolates was comparable or superior to the evaluated comparators, and SPR719 was active against isolates resistant to currently utilized agents. These results highlight the potential of SPR719 in the treatment of NTM pulmonary disease. Disclosures Nicole S. Cotroneo, BS, Spero Therapeutics (Employee, Shareholder) Ian Critchley, PhD, Spero Therapeutics (Employee, Shareholder) Michael Pucci, PhD, Spero Therapeutics (Employee, Shareholder) Suzanne Stokes, PhD, Spero Therapeutics (Employee, Shareholder)

scholarly journals ­­­­­­­­­Surgical Resection Compared to Medical Management in localized Mycobacteria Avium Complex­­­ Pulmonary Infection­­­­s-A Case Control Study

2020 ◽  
Author(s):  
Gabriel Fregoso ◽  
Rakesh Dhiman ◽  
Michael Lanuti ◽  
John Wain ◽  
Rocio Hurtado ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Surgical Resection ◽  
Mycobacterium Avium ◽  
Medical Management ◽  
Odds Ratio ◽  
Mycobacterium Avium Complex ◽  
Lung Resection ◽  
Case Series ◽  
Case Control ◽  
Pulmonary Infections

Abstract Background Pulmonary infections associated with Mycobacterium avium complex can be challenging to treat medically and the role of surgical lung resection is not well established. We aim to assess safety and microbiologic response in patient with localized Mycobacterium avium complex pulmonary infections managed with surgical lung resection compared to medical management alone. Methods We present a multi-institutional case series of 16 patients with localized Mycobacterium avium complex pulmonary infections managed with surgical lung resection. We highlight the case of a 30 to 40-year-old patient with localized pulmonary disease amenable to surgical resection for illustrative purposes and report on outcomes compared with medically treated patients at the same institution in case-control design. Results Of 745 patients meeting microbiologic diagnostic criteria for Mycobacterium avium complex pulmonary infections, 98 had localized pulmonary disease and of these 16 underwent surgical resection. Univariate and multivariate analysis results indicated no difference in surgical resection group compared with medical treatment: microbiologic response rate (odds ratio 0.49, 0.1–2.41), 2-year all-cause mortality (odds ratio 0.87, 0.18–4.32), and composite outcome of 2-year mortality and lack of microbiological response (multivariate logistic regression OR = 0.45, 0.09–1.57). Conclusions This case series describes patients with localized pulmonary Mycobacterium avium complex for whom surgical resection was pursued and shows examples of patients that may benefit from surgery. Though surgery for pulmonary Mycobacterium avium complex disease is rarely performed, it appears as safe and at least as effective as medical-therapy alone.

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