Pulmonary disease caused by nontuberculous mycobacteria

Curtis H. Weiss, Jeffrey Glassroth*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

60 Scopus citations

Abstract

The propensity of various nontuberculous mycobacteria to cause lung disease varies widely and is conditioned by host factors; infection is believed to occur from environmental sources. Nontuberculous mycobacteria pulmonary disease (PNTM) is increasing worldwide and Mycobacterium avium complex is the most common cause. PNTM usually occurs in one of three prototypical forms: hypersensitivity pneumonitis, cavitary tuberculosis-like disease or nodular bronchiectasis. PNTM has been linked in some patients to genetic variants of the cystic fibrosis transmembrane conductance regulator gene and a distinct patient phenotype. Interactions between PNTM and other comorbidities are also increasingly appreciated. Guidelines for diagnosis, emphasizing chest imaging and microbiology, have been published; speciation using molecular techniques is critical for accuracy and for treatment decisions. Clinical trials are lacking to inform treatment for many species and experience with M. avium complex and several others species serves as a guide instead. Use of multiple drugs for a period of at least 12 months following sputum conversion is the norm for most species. In vitro drug susceptibility results for many drugs may not correlate with clinical outcomes and such testing should be done on a selective basis.

Original languageEnglish (US)
Pages (from-to)597-613
Number of pages17
JournalExpert Review of Respiratory Medicine
Volume6
Issue number6
DOIs
StatePublished - Dec 2012

Keywords

  • Mycobacterium abscessus
  • Mycobacterium avium complex
  • diagnosis
  • epidemiology
  • hypersensitivity pneumonitis
  • macrolide
  • mycobacteria
  • nodular bronchiectasis
  • nontuberculous mycobacteria
  • treatment

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health

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