Non-tuberculous mycobacterial pulmonary disease (NTM-PD): Epidemiology, diagnosis and multidisciplinary management

Kumar, Kartik; Ponnuswamy, Aravind; Capstick, Toby GD; Chen, Christabelle; McCabe, Douglas; Hurst, Rhys; Morrison, Lisa; Moore, Fiona; Gallardo, Matt; Keane, Jennie; Harwood, Shirley; Sinnett, Tanya; Bryant, Sarah; Breen, Ronan; Kon, Onn Min; Lipman, Marc; Loebinger, Michael R; Dhasmana, Devesh J

doi:10.1016/j.clinme.2024.100017

Cited by 6 publications

(2 citation statements)

References 34 publications

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“…Although it was believed that NTM only infected immunocompromised individuals, it became evident that immunocompetent individuals are also targeted [93]. Combining the high levels of NTM ingested with tap water in comparison to those inhaled from aerosols [94], with their apparent ability to travel between organs within the human body, tap water could hypothetically also be an alternative source of lung infections.…”

Section: Nontuberculous Mycobacteria: Environmentally Versatile Oppor...mentioning

confidence: 99%

Drinking Water Microbiota, Entero-Mammary Pathways and Breast Cancer: Focus on Nontuberculous Mycobacteria

Maranha,

Alarico,

Nunes-Costa

et al. 2024

Preprint

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The prospect of drinking water serving as a conduit for gut bacteria, artificially selected by disinfection strategies and lack of monitoring at the point of use, is concerning. Certain opportunistic pathogens, notably some nontuberculous mycobacteria (NTM), often exceed coliform bacteria levels in drinking water, posing safety risks. NTM and other microbiota resist chlorination and thrive in plumbing systems. When inhaled, opportunistic NTM can infect the lungs of immunocompromised or chronically ill patients, and the elderly, primarily postmenopausal women. When ingested with drinking water, NTM often survive stomach acidity, reach the intestines, migrate to other organs using immune cells as vehicles, potentially colonizing tumor tissue, including in breast cancer. The link between the microbiome and cancer is not new, yet the recognition of intratumoral microbiomes is a recent development. Breast cancer risk rises with age, and NTM infections emerged as a concern among breast cancer patients. In addition to studies hinting at a potential association between chronic NTM infections and lung cancer, NTM have also been detected in breast tumors at levels higher than normal adjacent tissue. Evaluating the risks of continued ingestion of contaminated drinking water is paramount, especially given the ability of various bacteria to migrate from the gut to breast tissue via entero-mammary pathways. This underscores a pressing need to revise water safety monitoring guidelines and delve into hormonal factors, which includes addressing the disproportionate impact of NTM infections and breast cancer on women and examining the potential health risks posed by the cryptic and unchecked microbiota from drinking water.

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Section: Nontuberculous Mycobacteria: Environmentally Versatile Oppor...mentioning

confidence: 99%

Drinking Water Microbiota, Entero-Mammary Pathways and Breast Cancer: Focus on Nontuberculous Mycobacteria

Maranha,

Alarico,

Nunes-Costa

et al. 2024

Preprint

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“…Therefore, the initiation of NTM treatment should be carefully considered and guided by an accurate diagnosis. However, clinical manifestations, smear microscopy, and medical imaging of NTM pulmonary disease and pulmonary tuberculosis (TB) largely overlap 7 – 9 . This may lead to misdiagnosis of NTM infection as TB.…”

Section: Introductionmentioning

confidence: 99%

Discovery of urinary biosignatures for tuberculosis and nontuberculous mycobacteria classification using metabolomics and machine learning

Anh,

Phat,

Thu

et al. 2024

Sci Rep

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Nontuberculous mycobacteria (NTM) infection diagnosis remains a challenge due to its overlapping clinical symptoms with tuberculosis (TB), leading to inappropriate treatment. Herein, we employed noninvasive metabolic phenotyping coupled with comprehensive statistical modeling to discover potential biomarkers for the differential diagnosis of NTM infection versus TB. Urine samples from 19 NTM and 35 TB patients were collected, and untargeted metabolomics was performed using rapid liquid chromatography-mass spectrometry. The urine metabolome was analyzed using a combination of univariate and multivariate statistical approaches, incorporating machine learning. Univariate analysis revealed significant alterations in amino acids, especially tryptophan metabolism, in NTM infection compared to TB. Specifically, NTM infection was associated with upregulated levels of methionine but downregulated levels of glutarate, valine, 3-hydroxyanthranilate, and tryptophan. Five machine learning models were used to classify NTM and TB. Notably, the random forest model demonstrated excellent performance [area under the receiver operating characteristic (ROC) curve greater than 0.8] in distinguishing NTM from TB. Six potential biomarkers for NTM infection diagnosis, including methionine, valine, glutarate, 3-hydroxyanthranilate, corticosterone, and indole-3-carboxyaldehyde, were revealed from univariate ROC analysis and machine learning models. Altogether, our study suggested new noninvasive biomarkers and laid a foundation for applying machine learning to NTM differential diagnosis.

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Treat staff like they make a difference, and they will

Emmanuel

2024

Clinical Medicine

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Non-tuberculous mycobacterial pulmonary disease (NTM-PD): Epidemiology, diagnosis and multidisciplinary management

Cited by 6 publications

References 34 publications

Drinking Water Microbiota, Entero-Mammary Pathways and Breast Cancer: Focus on Nontuberculous Mycobacteria

Drinking Water Microbiota, Entero-Mammary Pathways and Breast Cancer: Focus on Nontuberculous Mycobacteria

Discovery of urinary biosignatures for tuberculosis and nontuberculous mycobacteria classification using metabolomics and machine learning

Treat staff like they make a difference, and they will

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