Human infections due to nontuberculous mycobacteria: the infectious diseases and clinical microbiology specialists' point of view.
Nontuberculous mycobacteria (>150 species such as Mycobacterium avium, Mycobacterium kansasii, Mycobacterium chelonae and Mycobacterium abscessus) are opportunistic pathogens causing lung and extrarespiratory infections, beside M. ulcerans and M. marinum that are pathogens causing specific skin and soft tissue infections. Disseminated infections occur only in severe immunosuppressed conditions such as AIDS. The diagnosis is based on repeated isolations of the same mycobacterium associated with clinical and radiological signs, and the absence of tuberculosis. Precise species identification is obtained by molecular biology. Therapeutic antibiotic regimens differ with regard to the mycobacterial species that are involved. Prevention of iatrogenic infections relies on using sterile water in all injections, healthcare and cosmetic occupations. Future perspectives are to set effective antibiotic regimens tested in randomized therapeutic trials.
AP-HP, Hôpital Lariboisière-Fernand Widal, Service de Bactériologie, F-75010 Paris, France.|Centre National de Référence des Mycobactéries et Résistance des Mycobactéries aux Antituberculeux (CNR-MyRMA), F-75010 Paris, France.|Service de Maladies Infectieuses, Hôpital de Verona, Italie.
Lorenzo
L
Guglielmetti
AP-HP, Hôpital Lariboisière-Fernand Widal, Service de Bactériologie, F-75010 Paris, France.|Centre National de Référence des Mycobactéries et Résistance des Mycobactéries aux Antituberculeux (CNR-MyRMA), F-75010 Paris, France.|IAME, UMR 1137, INSERM, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France.
Faiza
F
Mougari
AP-HP, Hôpital Lariboisière-Fernand Widal, Service de Médecine interne 1, F-75475 Paris, France.
Amanda
A
Lopes
AP-HP, Hôpital Lariboisière-Fernand Widal, Service de Bactériologie, F-75010 Paris, France.|Centre National de Référence des Mycobactéries et Résistance des Mycobactéries aux Antituberculeux (CNR-MyRMA), F-75010 Paris, France.
Laurent
L
Raskine
AP-HP, Hôpital Lariboisière-Fernand Widal, Service de Bactériologie, F-75010 Paris, France.|Centre National de Référence des Mycobactéries et Résistance des Mycobactéries aux Antituberculeux (CNR-MyRMA), F-75010 Paris, France.|IAME, UMR 1137, INSERM, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France.
Emmanuelle
E
Cambau
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003550:Cystic Fibrosis / Q000150:complications; D024881:Drug Resistance, Bacterial; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D016867:Immunocompromised Host; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control; D009162:Mycobacterium avium / Q000472:pathogenicity; D019909:Mycobacterium kansasii / Q000472:pathogenicity; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity; D017192:Skin Diseases, Bacterial / Q000382:microbiology
D000900:Anti-Bacterial Agents
AIDS; M. avium; NTM; clarithromycin; cystic fibrosis; iatrogenic infections; lung infection; mycobacteria; nontuberculous mycobacteria; tuberculosis