Prevalence of Nontuberculous Mycobacteria in Cystic Fibrosis Clinics, United Kingdom, 2009

Seddon, Paul; Fidler, Katy; Raman, S; Wyatt, Hilary; Ruiz, Gary; Elston, Caroline; Perrin, Felicity; Gyi, Khin M.; Bilton, Diana; Drobniewski, Francis; Newport, Melanie J.

doi:10.3201/eid1907.120615

Cited by 46 publications

(25 citation statements)

References 15 publications

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“…We reported a higher number of MAC (56%) than MABSC (38%). These data are usually observed in North American CF populations [5,10,11] but not in European ones [8,24,25,[28][29][30]. Cases with MAC had more NTM-PD than MABSC (37.3 vs 27.8%).…”

Section: Discussionmentioning

confidence: 56%

High incidence of non-tuberculous mycobacteria-positive cultures among adolescent with cystic fibrosis

Cavalli

Reynaud

Bricca

et al. 2017

Journal of Cystic Fibrosis

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Section: Discussionmentioning

confidence: 56%

High incidence of non-tuberculous mycobacteria-positive cultures among adolescent with cystic fibrosis

Cavalli

Reynaud

Bricca

et al. 2017

Journal of Cystic Fibrosis

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“…NTM infections are increasingly being reported in adults with CF , but children are also vulnerable . The frequency of NTM infections in CF children from the UK has been estimated at 3.3% . BCG infection has never been reported in these patients, even in countries with mandatory BCG vaccination policies and a relatively high prevalence of CF, such as France.…”

Section: Inherited Conditions Affecting the Lungs And Conferring A Prmentioning

confidence: 99%

Inherited and acquired immunodeficiencies underlying tuberculosis in childhood

Boisson–Dupuis

Bustamante

El-Baghdadi

et al. 2015

Immunological Reviews

183

152

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Summary Tuberculosis (TB), caused by Mycobacterium tuberculosis (M.tb) and a few related mycobacteria, is a devastating disease, killing more than a million individuals per year worldwide. However, its pathogenesis remains largely elusive, as only a small proportion of infected individuals develop clinical disease either during primary infection or during reactivation from latency or secondary infection. Subacute, hematogenous, and extrapulmonary disease tends to be more frequent in infants, children, and teenagers than in adults. Life-threatening primary TB of childhood can result from known acquired or inherited immunodeficiencies, although the vast majority of cases remain unexplained. We review here the conditions conferring a predisposition to childhood clinical diseases caused by mycobacteria, including not only M.tb but also weakly virulent mycobacteria, such as BCG vaccines and environmental mycobacteria. Infections with weakly virulent mycobacteria are much rarer than TB, but the inherited and acquired immunodeficiencies underlying these infections are much better known. Their study has also provided genetic and immunological insights into childhood TB, as illustrated by the discovery of single-gene inborn errors of IFN-γ immunity underlying severe cases of TB. Novel findings are expected from ongoing and future human genetic studies of childhood TB in countries that combine a high proportion of consanguineous marriages, a high incidence of TB, and an excellent clinical care, such as Iran, Morocco, and Turkey.

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“…The largest studies with 3805, 10,527, and 13,593 patients reported an NTM prevalence of 5 [10], 20 [11], and 3 % [8•], respectively (Table1). Overall, the estimated NTM prevalence in CF is approximately 9 % [8•, 9–19].…”

Section: Ntm Epidemiologymentioning

confidence: 99%

“…Geographic variation in NTM prevalence in CF exists within and between countries [10, 12, 16]. This may be due to differences in screening, laboratory techniques, or local NTM subtype prevalence in the environment [16, 22].…”

Section: Ntm Epidemiologymentioning

confidence: 99%

“…1) [9, 10, 15, 16, 24]. Furthermore, there has been an increase in MABSC reported in several centers [12, 16, 19], possibly due to improvements in MABSC identification techniques (16S ribosomal RNA is better at distinguishing MAC from MABSC), increased environmental MABSC, and/or patient-to-patient transmission (although uncommon) [25, 26, 27•].

Fig.…”

Section: Ntm Epidemiologymentioning

confidence: 99%

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Nontuberculous Mycobacteria in Cystic Fibrosis

Skolnik

Kirkpatrick

Quon

2016

Curr Treat Options Infect Dis

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Opinion statementNontuberculous mycobacteria (NTM) are found in approximately 10 % of cystic fibrosis (CF) patients, but only a portion will develop NTM disease. The management of CF lung disease should be optimized, including antibiotic therapy targeted to the individual’s usual airway bacteria, prior to considering treatment for NTM lung disease. Those who meet criteria for NTM lung disease may not necessarily require treatment and could be monitored expectantly if symptoms and radiographic findings are minimal. However, the presence of Mycobacterium abscessus complex (MABSC), severe lung disease, and/or anticipated lung transplant should prompt NTM therapy initiation. For CF patients with Mycobacterium avium complex (MAC), recommended treatment includes triple antibiotic therapy with a macrolide, rifampin, and ethambutol. Azithromycin is generally our preferred macrolide in CF as it is better tolerated and has fewer drug-drug interactions. MABSC treatment is more complex and requires an induction phase (oral macrolide and two IV agents including amikacin) as well as a maintenance phase (nebulized amikacin and two to three oral antibiotics including a macrolide). The induction phase may range from one to three months (depending on infection severity, treatment response, and medication tolerability). For both MAC and MABSC, treatment duration is extended 1-year post-culture conversion. However, in patients who do not achieve culture negative status but tolerate therapy, we consider ongoing treatment for mycobacterial suppression and prevention of disease progression.

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Prevalence of Nontuberculous Mycobacteria in Cystic Fibrosis Clinics, United Kingdom, 2009

Cited by 46 publications

References 15 publications

High incidence of non-tuberculous mycobacteria-positive cultures among adolescent with cystic fibrosis

High incidence of non-tuberculous mycobacteria-positive cultures among adolescent with cystic fibrosis

Inherited and acquired immunodeficiencies underlying tuberculosis in childhood

Nontuberculous Mycobacteria in Cystic Fibrosis

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