scholarly journals The Changing Pattern of Nontuberculous Mycobacterial Disease

2003 ◽  
Vol 14 (5) ◽  
pp. 281-286 ◽  
Author(s):  
Joseph O Falkinham
Keyword(s):  
Pulmonary Disease ◽  
Nontuberculous Mycobacteria ◽  
Mycobacterial Infection ◽  
Mycobacterium Abscessus ◽  
Mycobacterium Fortuitum ◽  
Older Individuals ◽  
Mycobacterial Disease ◽  
Cervical Lymphadenitis ◽  
Source Of Infection ◽  
Increased Risk

Nontuberculous mycobacteria are human opportunistic pathogens whose source of infection is the environment. These include both slow-growing (eg,Mycobacterium kansasii and Mycobacterium avium) and rapid-growing (eg,Mycobacterium abscessusandMycobacterium fortuitum) species. Transmission is through ingestion or inhalation of water, particulate matter or aerosols, or through trauma. The historic presentation of pulmonary disease in older individuals with predisposing lung conditions and in children has been changing. Pulmonary disease in elderly individuals who lack the classic predisposing lung conditions is increasing. Pulmonary disease and hypersensitivity pneumonitis have been linked with occupational or home exposures to nontuberculous mycobacteria. There has been a shift fromMycobacterium scrofulaceumtoM aviumin children with cervical lymphadenitis. Further, individuals who are immunosuppressed due to therapy or HIV-infection are at a greatly increased risk for nontuberculous mycobacterial infection. The changing pattern of nontuberculous mycobacterial disease is due in part to the ability of these pathogens to survive and proliferate in habitats that they share with humans, such as drinking water. The advent of an aging population and an increase in the proportion of immunosuppressed individuals suggest that the prevalence of nontuberculous mycobacterial disease will increase.

scholarly journals Surgery in nontuberculous mycobacteria pulmonary disease

Breathe ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 288-301 ◽  
Author(s):  
Mimi Lu ◽  
Dominic Fitzgerald ◽  
Jonathan Karpelowsky ◽  
Hiran Selvadurai ◽  
Chetan Pandit ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Lung Disease ◽  
Pulmonary Disease ◽  
Nontuberculous Mycobacteria ◽  
Mycobacterium Abscessus ◽  
Surgical Approaches ◽  
List Type ◽  
Persistent Symptoms ◽  
Increased Risk ◽  
Study Results

Medical treatment of pulmonary nontuberculous mycobacteria (NTM) disease has highly variable outcomes. Despite the use of multiple antibiotics, sputum clearance is often difficult to achieve, especially in cases with macrolide resistant NTM infection. Immunocompromised patients and those with structural lung disease are at increased risk, although occurrence in immunocompetent patients without structural lung disease is well recognised. Most pulmonary NTM disease involvesMycobacterium aviumcomplex (MAC), but with enhanced identification multiple species have now been recognised as opportunistic pathogens. The observed increase in NTM disease, especially infection with multidrug-resistantMycobacterium abscessuscomplex, is probably multifactorial. Surgery has been used as adjuvant treatment in patients with 1) focal disease that can be removed or 2) bothersome symptoms despite medical treatment that can be ameliorated. Early post-surgical mortality is low, but long-term morbidity and mortality are highly dependent on the degree of lung involvement and the residual lung function, the potency of medical treatment and the type of surgical intervention. In conjunction with antibiotic therapy, reported post-surgical sputum clearance was excellent, although publication bias should be considered. Bronchopleural fistulae were problematic, especially in pneumonectomy cases. Study results support the use of minimal resection surgery, in a carefully selected subgroup of patients with focal disease or persistent symptoms.Educational aimsTo critically review the literature describing the use of surgery in the treatment of pulmonary disease caused by nontuberculous mycobacteria (NTM).To assess the outcomes and complications observed with different surgical approaches used in the treatment of pulmonary NTM disease.

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.

Mycobacterium abscessus Pulmonary Disease: Important Pathogen as Microbial Substitution During the Treatment of Non- abscessus Mycobacterial Disease

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 143A
Author(s):  
Yoshiya Tsunoda ◽  
Yuki Sumazaki ◽  
Akimasa Sekine ◽  
Toru Tanaka ◽  
Hiroyuki Takoi ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Mycobacterium Abscessus ◽  
Mycobacterial Disease

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.

Pulmonary disease caused by non-tuberculous mycobacteria

2017 ◽  
Author(s):  
Janet Stowell ◽  
Ronan Breen
Keyword(s):  
Pulmonary Disease ◽  
Mycobacterial Infection ◽  
Chronic Obstructive ◽  
Mycobacterial Disease ◽  
Immune Restoration ◽  
Obstructive Pulmonary Disease ◽  
Radiological Changes ◽  
Inflammatory Syndrome ◽  
Mycobacterium Malmoense

This chapter describes a case of Mycobacterium malmoense in a male ex-smoker with chronic obstructive pulmonary disease. The approaches to a diagnosis of pulmonary non-tuberculous mycobacterial disease are discussed, including key laboratory features and associated radiological changes. The factors influencing the decision to treat and treatment regimen selected are reviewed, along with evidence from landmark trials regarding drug combinations and the role of surgery in managing non-tuberculous mycobacterial disease. This case was complicated by a secondary diagnosis of invasive aspergillosis, and the challenges of treating non-tuberculous mycobacteria and Aspergillus concurrently are highlighted. Non-tuberculous mycobacterial infection in HIV-positive patients can behave differently to non-tuberculous mycobacterial disease in immunocompetent individuals. Restoring immunocompetence is key to the success of non-tuberculous mycobacterial treatment in these individuals, but beware Mycobacterium avium complex-related immune restoration inflammatory syndrome.

scholarly journals Profile of Nontuberculous Mycobacteria in Patients Suspected of Tuberculosis and Drug-Resistant Tuberculosis

2020 ◽  
Vol 12 (03) ◽  
pp. 203-211
Author(s):  
Megha Sharma ◽  
Bharti Malhotra ◽  
Jitendra Tiwari ◽  
Shipra Bhargava
Keyword(s):  
Nontuberculous Mycobacteria ◽  
Multidrug Resistant ◽  
Mycobacterium Abscessus ◽  
Mycobacterium Fortuitum ◽  
Drug Resistant ◽  
Culture Methods ◽  
Mycobacterium Chelonae ◽  
Drug Resistant Tuberculosis ◽  
Indicator Tube ◽  
Resistant Tuberculosis

Abstract Objective Infections due to nontuberculous mycobacteria (NTM) is increasing globally and may present as drug-resistant tuberculosis (DRTB). In India, data on NTM prevalence and species diversity is limited. Present study was conducted to detect the prevalence and profile of NTM among patients suspected of DRTB using paraffin slide culture (PSC)and mycobacteria growth indicator tube (MGIT) culture methods for isolation of NTM. Material and Method A total of 2,938 samples suspected of TB/DRTB were cultured on PSC and MGIT960. Species identification of mycobacterial isolate was done by sequencing of 16s ribosomal RNA gene. Result Among 2938 samples, 35 (1.19%) were found positive for NTM by PSC and 9 (0.30%) were found positive by MGIT. The diversity of NTM species was high (13 species). Out of 35 NTM isolates by PSC, maximum 34.29% (12) isolates were found to be Mycobacterium fortuitum, followed by 11.43% (4) Mycobacterium abscessus and Mycobacterium chelonae, and 42.85% (15) were other species viz. 8.57% (3) were Mycobacterium intracellulare and Mycobacterium kansasii, 5.71% (2) were Mycobacterium peregrinum, and 2.85% (1) were Mycobacterium flavescens, Mycobacterium farcinogenes, Mycobacterium moriokanese, Mycobacterium wolinskyi, Mycobacterium simiae, Mycobacterium goodii, and Mycobacterium terrae each. Coinfection of Mycobacterium tuberculosis(MTB) and NTM was found in 60% (21) samples. Conclusion Prevalence of NTM was low among multidrug resistant tuberculosis/TB suspected patients, similar to other studies done in India. PSC was found better than MGIT for the isolation of NTM, though poor separation of NTM and MTB on subculture may have led to false negativity in cases of coinfection. About 13 species were isolated; M. fortuitum was the most common of all. Since coinfection of NTM and TB can also occur, samples of patients suspected of NTM should be cultured on PSC even if positive for MTB.

scholarly journals Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020

2021 ◽  
Vol 12 ◽  
Author(s):  
Qiong Ma ◽  
Rende Chen ◽  
Enhui Yang ◽  
Youhua Yuan ◽  
Yongfu Tian ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Median Duration ◽  
Musculoskeletal System ◽  
Granulomatous Inflammation ◽  
Mycobacterial Infection ◽  
Mycobacterium Abscessus ◽  
Diagnostic Methods ◽  
Mycobacterium Fortuitum ◽  
Specific Symptoms

Non-tuberculous mycobacterial (NTM) infection of the musculoskeletal system is rare but poses a grave threat to public health. These infections yield non-specific symptoms that remain undetected until the development of the later stages of the disease. In this study, we performed a retrospective review of 25 cases of musculoskeletal NTM infection at two tertiary medical centres over a 5-year period to determine the clinical features and improve the current clinical diagnosis and treatment. The most common mycobacterial species detected were Mycobacterium fortuitum in eleven patients, Mycobacterium abscessus in eight patients, Mycobacterium houstonense in three patients, Mycobacterium avium in two patients, and Mycobacterium smegmatis in one patient. The sites of infection included the limbs and joints, most commonly the knee (ten patients) and foot (six patients). The median duration from the onset of symptoms to diagnosis was 2.5 months (0.8–13.5 months). Deep sinus tracts extending to the surgical site were observed in 60% of the patients (15/25), and granulomatous inflammation and granulomatous inflammation with necrosis occurred in 60% of the patients (15/25). All patients underwent surgical treatment for infection control, and all patients, except one, received antimycobacterial therapy based on drug sensitivity assays. The median duration of the antimicrobial chemotherapy was 5 months (range: 3–20 months). At the final follow-up, 24 patients presented with absence of recurrence and one patient succumbed owing to heart failure after debridement. Our findings highlight the importance of vigilance and improvements in the diagnostic methods for musculoskeletal NTM infection. Aggressive surgical treatment and antimycobacterial drug treatment can help achieve satisfactory results.

Non-Tuberculous Mycobacterial Infections Related to Peritoneal Dialysis

2017 ◽  
Vol 38 (2) ◽  
pp. 147-149 ◽  
Author(s):  
Hiroyuki Inoue ◽  
Naoki Washida ◽  
Kohkichi Morimoto ◽  
Keisuke Shinozuka ◽  
Takahiro Kasai ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Mycobacterial Infection ◽  
Mycobacterium Abscessus ◽  
Mycobacterium Fortuitum ◽  
Mycobacterium Chelonae ◽  
Exit Site Infection ◽  
Mycobacterial Infections ◽  
Tunnel Infection ◽  
Multi Agent ◽  
Catheter Replacement

Most infections related to peritoneal dialysis (PD) are caused by common bacteria, and non-tuberculous mycobacteria are rare. The clinical characteristics and prognosis of PD patients with non-tuberculous mycobacterial infections were investigated at our hospital. Non-tuberculous mycobacteria were detected in 11 patients (exit-site infection, tunnel infection, and peritonitis in 3, 5, and 3 patients, respectively). Mycobacterium fortuitum, Mycobacterium chelonae, and Mycobacterium abscessus were identified in 4, 2, and 2 patients, respectively. Most patients with peritonitis or tunnel infection required catheter removal. During the study period (2007 – 2017), peritonitis occurred in 44 patients, including 3 patients (6.8%) with non-tuberculous mycobacterial peritonitis. When non-tuberculous mycobacterial infection occurs, multi-agent antibiotic therapy, unroofing surgery, and/or catheter replacement should be performed to prevent peritonitis.

scholarly journals Species Typing of Nontuberculous Mycobacteria by Use of Deoxyribozyme Sensors

2019 ◽  
Vol 65 (2) ◽  
pp. 333-341 ◽  
Author(s):  
Hillary N Wood ◽  
Ashelyn E Sidders ◽  
Lauren E Brumsey ◽  
Evgeny S Morozkin ◽  
Yulia V Gerasimova ◽  
...  
Keyword(s):  
Nontuberculous Mycobacteria ◽  
Point Of Care ◽  
Pcr Amplification ◽  
Rapid Identification ◽  
Mycobacterium Abscessus ◽  
Mycobacterium Fortuitum ◽  
Target Sequence ◽  
Proof Of Concept ◽  
Catalytic Core ◽  
Point Of Care Diagnostics

Abstract BACKGROUND Nontuberculous mycobacteria (NTM) species are a rising threat, especially to patients living with pulmonary comorbidities. Current point-of-care diagnostics fail to adequately identify and differentiate NTM species from Mycobacterium tuberculosis (Mtb). Definitive culture- and molecular-based testing can take weeks to months and requires sending samples out to specialized diagnostic laboratories. METHODS In this proof-of-concept study, we developed an assay based on PCR amplification of 16S ribosomal RNA (rRNA) rrs genes by using universal mycobacterial primers and interrogation of the amplified fragments with a panel of binary deoxyribozyme (BiDz) sensors to enable species-level identification of NTM (BiDz-NTMST). Each BiDz sensor consists of 2 subunits of an RNA-cleaving deoxyribozyme, which form an active deoxyribozyme catalytic core only in the presence of the complimentary target sequence. The target-activated BiDz catalyzes cleavage of a reporter substrate, thus triggering either fluorescent or colorimetric (visually observed) signal depending on the substrate used. The panel included BiDz sensors for differentiation of 6 clinically relevant NTM species (Mycobacterium abscessus, Mycobacterium avium, Mycobacterium intracellulare, Mycobacterium fortuitum, Mycobacterium kansasii, and Mycobacterium gordonae) and Mtb. RESULTS Using the fluorescent BiDz-NTMST assay, we successfully identified the species of 38 clinical isolates. In addition, a subset of strains was tested with visual BiDz sensors, providing proof-of-concept for species typing of NTM by the naked eye. CONCLUSIONS The BiDz-NTMST assay is a novel platform for rapid identification of NTM species. This method is highly specific and significantly faster than current tools and is easily adaptable for onsite diagnostic laboratories in hospitals or clinical laboratories.

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