Review of the international clinical practice guidelines for the treatment of lung infections caused by nontuberculous mycobacteria

Nontuberculous mycobacteria are important respiratory pathogens in patients with cystic fibrosis (CF). For diagnosis, international guidelines recommend culture of sputum that has been decontaminated via chemical treatment. Fifty-six sputum samples from 32 patients known to be previously colonized or infected with NTM were subdivided, and the aliquots were subjected to six different decontamination strategies, followed by quantitative culture for NTM. Thirty sputum samples contained Mycobacterium abscessus complex (MABSC) and 11 contained Mycobacterium avium complex (MAC). Decontamination strategies included treatment with N-acetyl L-cysteine with 2% sodium hydroxide (NALC-NaOH), 4% NaOH, 1% chlorhexidine, 0.5 N sulfuric acid, 5% oxalic acid, double decontamination with NALC-NaOH, followed by 5% oxalic acid, and saline (0.85%) as a control. The samples were also cultured directly with no treatment. Treatment with NALC-NaOH resulted in an average reduction in colony count of 87% for MABSC when compared with direct culture. NaOH at 4% caused a 98.3% average reduction in colony count. All treatments that included NaOH resulted in colony counts that were statistically lower than those obtained from direct culture or the saline-treated control (p < 0.05). Standard treatments using sulfuric or oxalic acids were less deleterious, but still resulted in an average reduction in colony count of at least 30%. The viability of MAC was much less affected by most decontamination treatments. In conclusion, the viability of MABSC was severely compromised by standard decontamination regimens. This supports recent evidence showing that optimal recovery of MABSC is achieved by culture on an appropriate selective agar without decontamination of sputum samples.

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Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1125 ◽

2020 ◽

Vol 71 (4) ◽

pp. 905-913 ◽

Cited By ~ 7

Author(s):

Charles L Daley ◽

Jonathan M Iaccarino ◽

Christoph Lange ◽

Emmanuelle Cambau ◽

Richard J Wallace ◽

...

Keyword(s):

Infectious Diseases ◽

Pulmonary Disease ◽

Healthcare Professionals ◽

Mycobacterium Abscessus ◽

Clinical Microbiology Laboratory ◽

Pulmonary Medicine ◽

Assessment Development ◽

Evaluation Approach ◽

Mycobacterium Xenopi ◽

Immunodeficiency Virus

Abstract 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.

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Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline

Clinical Infectious Diseases ◽

10.1093/cid/ciaa241 ◽

2020 ◽

Vol 71 (4) ◽

pp. e1-e36 ◽

Cited By ~ 13

Author(s):

Charles L Daley ◽

Jonathan M Iaccarino ◽

Christoph Lange ◽

Emmanuelle Cambau ◽

Richard J Wallace ◽

...

Keyword(s):

Infectious Diseases ◽

Pulmonary Disease ◽

Healthcare Professionals ◽

Mycobacterium Abscessus ◽

Clinical Microbiology Laboratory ◽

Pulmonary Medicine ◽

Assessment Development ◽

Evaluation Approach ◽

Mycobacterium Xenopi ◽

Immunodeficiency Virus

Abstract 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.

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Recent advances in nontuberculous mycobacterial lung infections

F1000Research ◽

10.12688/f1000research.20096.1 ◽

2019 ◽

Vol 8 ◽

pp. 1710 ◽

Cited By ~ 2

Author(s):

David Horne ◽

Shawn Skerrett

Keyword(s):

Mycobacterium Tuberculosis ◽

Natural History ◽

Lung Disease ◽

Chronic Lung Disease ◽

Nontuberculous Mycobacteria ◽

Mycobacterium Leprae ◽

Mycobacterium Abscessus ◽

Recent Developments ◽

Lung Infections ◽

Ntm Lung Disease

Nontuberculous mycobacteria (NTM) are members of the Mycobacterium genus other than Mycobacterium tuberculosis complex and Mycobacterium leprae. NTM are widely distributed in the environment and are increasingly recognized as causes of chronic lung disease that can be challenging to treat. In this brief review, we consider recent developments in the ecology, epidemiology, natural history, and treatment of NTM lung disease with a focus on Mycobacterium avium complex (MAC) and Mycobacterium abscessus complex.

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Management of infections due to nontuberculous mycobacteria in solid organ transplant recipients—Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

Clinical Transplantation ◽

10.1111/ctr.13588 ◽

2019 ◽

Vol 33 (9) ◽

Cited By ~ 9

Author(s):

Sarah A. Longworth ◽

Jennifer S. Daly ◽

Keyword(s):

Infectious Diseases ◽

Community Of Practice ◽

Nontuberculous Mycobacteria ◽

Organ Transplant ◽

Solid Organ Transplant ◽

Solid Organ ◽

Transplant Recipients ◽

Organ Transplant Recipients ◽

Solid Organ Transplant Recipients ◽

American Society

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Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline

European Respiratory Journal ◽

10.1183/13993003.00535-2020 ◽

2020 ◽

Vol 56 (1) ◽

pp. 2000535 ◽

Cited By ~ 10

Author(s):

Charles L. Daley ◽

Jonathan M. Iaccarino ◽

Christoph Lange ◽

Emmanuelle Cambau ◽

Richard J. Wallace ◽

...

Keyword(s):

Infectious Diseases ◽

Pulmonary Disease ◽

Healthcare Professionals ◽

Mycobacterium Abscessus ◽

Clinical Microbiology Laboratory ◽

Pulmonary Medicine ◽

Assessment Development ◽

Evaluation Approach ◽

Mycobacterium Xenopi ◽

Immunodeficiency Virus

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.

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