title: [Diagnosis and treatment of atypical mycobacterial infections of the respiratory tract].
abstract: BACKGROUND
  Non tuberculous mycobacteria (NTM), unlike tuberculous mycobacteria, are not strictly human pathogens. The diagnosis of infection and the choice of treatment remain difficult.
  
  
  BACKGROUND
  Evidence of a NTM in a pulmonary sample is not synonymous with infection. The diagnosis depends on the association of clinical, radiological and microbiological factors. If a NTM is isolated from a respiratory sample, the probability of infection depends on the species. The main NTMs responsible for pulmonary infection in France are Mycobacterium avium intracellulare, Mycobacterium xenopi, Mycobacterium kansasi and Mycobacterium abscessus. Their management is difficult and poorly understood. Treatment is well established for M. avium intracellulare and M. kansasii, with combinations of clarithromycin-rifampicin-ethambutol and isoniazid-rifampicin-ethambutol respectively. For M. xenopi, the optimal treatment is not known and a combination of clarithromycin-rifampicin-ethambutol, with moxifloxacin as an alternative, is currently recommended. In general, treatment is prolonged and often associated with problems of tolerance.
  
  
  CONCLUSIONS
  The management of NTM infection, taking into account of the increase in patients "at risk", is an important issue. Further studies are needed to improve the criteria for infection and to find the optimal therapeutic combinations.
authors.affiliation: Service de pneumologie et réanimation respiratoire, CHU d'Amiens, avenue Laënnec, Amiens cedex 1, France. Andrejak.claire@chu-amiens.fr
authors.forename: C
authors.initials: C
authors.lastname: Andréjak
authors.forename: F-X
authors.initials: FX
authors.lastname: Lescure
authors.forename: J-L
authors.initials: JL
authors.lastname: Schmit
authors.forename: V
authors.initials: V
authors.lastname: Jounieaux
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis / Q000188:drug therapy; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D012307:Risk Factors; D013045:Species Specificity; D013048:Specimen Handling / Q000379:methods; D013183:Sputum / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents