Clinics in chest medicine
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Nontuberculous mycobacteria (NTM) include over 150 species. The source for human infection is the environment. NTM are normal inhabitants of soil and drinking water. ⋯ Treatment requires multiple antibiotics. NTM patients are innately sensitive to NTM infection, resulting in reinfection. Knowledge of the sources of NTM can reduce exposure to environmental NTM.
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The most common nontuberculous mycobacterial (NTM) lung pathogen, Mycobacterium avium complex (MAC), requires antibiotic treatment regimens that are long and often arduous. M kansasii is the slowly growing NTM pathogen with the most predictably successful treatment outcomes, whereas other slowly growing NTM pathogens such as M xeonpi, M szulgai, and M malmoense are less predictably responsive to antibiotic regimens. M simiae is the most difficult of the common slowly growing NTM pathogens to eradicate. Surgical intervention for slowly growing mycobacterial lung infection has proved beneficial for some patients, but the optimal candidates and timing for surgical intervention remain unknown.
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Clinics in chest medicine · Mar 2015
ReviewSurgical approach to pulmonary nontuberculous mycobacterial infections.
The incidence of pulmonary nontuberculous mycobacterial disease is increasing. Despite aggressive medical therapy, a subset of patients will experience treatment failure or suffer disabling or life-threatening symptoms. ⋯ More data are needed to confirm this approach. For those with nontuberculous mycobacterial infection, treatment in a multidisciplinary setting including surgeons familiar with operative techniques specific to infectious lung disease will improve patient care.
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Clinics in chest medicine · Mar 2015
ReviewNontuberculous mycobacterial infections in cystic fibrosis.
Nontuberculous mycobacteria (NTM) are important emerging cystic fibrosis (CF) pathogens. Factors including the steady aging of the CF population, the apparent increase of NTM in the environment, and the potential for patient-to-patient transmission, may contribute to increased acquisition. Diagnosis of NTM disease is challenging due to disease overlap; thus, comprehensive care of the CF patient must be optimized to assess the clinical impact of the NTM (indolent versus active), and to improve response to treatment. The development of a CF-specific approach to the diagnosis and treatment of NTM infection is a research priority for the CF community.
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Clinics in chest medicine · Mar 2015
ReviewMedications and monitoring in nontuberculous mycobacteria infections.
The treatment of infections caused by nontuberculous mycobacteria (NTM) is challenging because multidrug regimens with limited efficacy and considerable toxicity are required. Current treatment of NTM is largely empiric. ⋯ With this information, clinicians can make the most of the limited options available. Considerable research is needed to optimize the treatment of NTM.