[Nontuberculous mycobacteria in cystic fibrosis].
Patients with cystic fibrosis are particularly at risk of infection with non-tuberculous mycobacteria (NTM). Prevalence of these infections increases with age to around 15 %. The main species involved are M. abscessus and M. avium, the latter not found in children under 15. Diagnosis relies on clinical, radiological and above all bacteriological criteria defined by the ATS. Identification of the causal species of NTM is essential and requires genetic techniques, some of which are currently evaluated. Treatment depends on the mycobacterial species. For M. avium, combined therapy with rifampicin, clarithromycin and ethambutol must be extended 12 months after negativation. M. abscessus infection is particularly resistant to therapy. Usual treatment is a one month course of intravenous imipenem or cefoxitin plus amikacin followed by oral clarithromycin plus ethambutol for at least 12 months after negativation. In case of local lesions, surgery is an option.
Le Bourgeois
M
M
Service de pneumologie pédiatrique, hôpital Necker-Enfants-malades, Assistance-publique-Hôpitaux-de Paris, 75015 Paris, France. muriel.lebourgeois@nck.aphp.fr
Sermet-Gaudelus
I
I
Catherinot
E
E
Gaillard
J L
JL
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D017291:Clarithromycin / Q000627:therapeutic use; D003550:Cystic Fibrosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification; D012293:Rifampin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D004977:Ethambutol; D017291:Clarithromycin; D012293:Rifampin