Nontuberculous mycobacteria and the lung: from suspicion to treatment.
Nontuberculous mycobacteria (NTM) are resilient bacteria that grow in virtually any environment, especially those where competing microorganisms are destroyed, such as in chlorinated water. They have been discovered in soil, dust, food, water, and domestic and wild animals. Nontuberculous mycobacteria tend to infect individuals with local (e.g., damaged skin or lung) or systemic (e.g., HIV, drugs, malignancy) defects in host defence, and their incidence and prevalence have consistently increased in the last decade. Difficulty may arise in determining whether an isolated NTM from a microbiological sample is in fact a contaminant or a pathogenic organism. In this review, we discuss the important mycobacteria involved in lung disease, factors that predispose individuals to infection, and their diagnosis and treatment according to updated guidelines. English language publications in MEDLINE and references from relevant articles from January 1, 1990 to June 28, 2009 were reviewed. Keywords searched were "nontuberculous,""mycobacteria," "diagnosis," and "treatment."
McGrath
Emmet E
EE
Department of Respiratory Medicine, Northern General Hospital, Sheffield S5 7AU, UK. e.mcgrath@sheffield.ac.uk
Blades
Zoe
Z
McCabe
Josie
J
Jarry
Hannah
H
Anderson
Paul B
PB
D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D018942:Macrolides / Q000627:therapeutic use; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy*; D009170:Nontuberculous Mycobacteria / Q000187:drug effects*; D012294:Rifamycins / Q000627:therapeutic use
D018942:Macrolides; D012294:Rifamycins; D004977:Ethambutol