Pulmonology Pulmonology
Pulmonol 2018;24:120-31 - Vol. 24 Num.2 DOI: 10.1016/j.pulmoe.2017.12.005
Review
Non-tuberculous mycobacterial pulmonary infections
J.D. Chalmersa,, , T. Aksamitb, A.C.C. Carvalhoc, A. Rendond, I. Francoe
a Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom
b Mayo Clinic College of Medicine, Rochester, MN, USA
c Laboratory of Innovation in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute IOC, Fiocruz, Rio de Janeiro, Brazil
d Hospital Universitario de Monterrey, Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias, Monterrey, Nuevo León UANL, Mexico
e Respiratory Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
Received 16 December 2017, Accepted 26 December 2017
Abstract

Non-tuberculous mycobacterial (NTM) infections are increasingly rapidly worldwide. The reason for this phenomenon is unclear, but may include the ageing population, the increasing use of immunosuppressive drugs, the increasing prevalence of diseases that confer susceptibility to NTM, such as COPD and bronchiectasis, and growing testing for NTM. Awareness of the NTM related diseases is rising but is still suboptimal. Guidelines from the American Thoracic Society and Infectious Diseases Society of America have provided a framework for evaluating disease and evaluating care. Compliance with these guidelines is, however, very poor globally.

NTM infections are amongst the most challenging cases that respiratory and infectious diseases physicians face. The challenges include intrinsic antibiotic resistance, complex drug regimens, poor tolerability and significant side effects associated with therapy and poor response rates. The decision to initiate treatment is therefore often difficult and requires careful evaluation of benefits and risks. Optimal management of NTM infections requires multidisciplinary care with close collaboration between physicians, microbiologists, physiotherapist/allied health professionals, primary care physicians and the patient.

There remains a need for greater research into the epidemiology, clinical evaluation and treatment of NTM pulmonary disease. Randomised clinical trials are now being conducted which may provide useful data on the effectiveness of some new and existing therapies.

In this review, we discuss the growing importance of NTM pulmonary disease and the opportunities for progress in clinical research for these conditions.

Keywords
NTM guidelines, Bronchiectasis, COPD research, Antibiotics
Pulmonol 2018;24:120-31 - Vol. 24 Num.2 DOI: 10.1016/j.pulmoe.2017.12.005
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