Nontuberculous Mycobacteria

Abstract

Nontuberculous mycobacteria (NTM) are potential respiratory pathogens in cystic fibrosis (CF). To assess the species-specific prevalence and risk factors for acquisition, we conducted a prospective, cross-sectional study of the prevalence of NTM and clinical features of patients at 21 U.S. centers. Almost 10% of patients with CF who were 10 years or older were included (n = 986). The overall prevalence of NTM in sputum was 13.0% (range by center, 7-24%). Mycobacterium avium complex (72%) and Mycobacterium abscessus (16%) were the most common species. When compared with patients with CF without NTM, culture-positive subjects were older (26 vs. 22 years, p < 0.001), had a higher FEV1 (60 vs. 54%, p < 0.01), higher frequency of Staphylococcus aureus (43 vs. 31%, p < 0.01), and lower frequency of Pseudomonas aeruginosa (71 vs. 82%, p < 0.01). Molecular typing revealed that almost all patients within each center had unique NTM strains. In summary, NTM are common in patients with CF, but neither person-to-person nor nosocomial acquisition explained the high prevalence. Older age was the most significant predictor for isolation of NTM. The clinical significance of NTM in CF is incompletely defined, but patients with these organisms should be monitored with repeat cultures.

Boosting Effect of 2-Phenylquinoline Efflux Inhibitors in Combination with Macrolides against Mycobacterium smegmatis and Mycobacterium avium

“…5,9,12,13 Their clinical relevance is arising due to severe opportunistic infections in human immunodeficiency virus (HIV) infected patients and other immunocompromised individuals (M. avium) as well as in immunocompetent individuals (M. intracellulare). 14−16 Furthermore, MAC is one of the most common isolated species in cystic fibrosis and chronic obstructive pulmonary disease patients 17,18 as well as in skin, soft-tissue infections, and lymphadenitis. 19 The recommended treatment for MAC infections consists of a macrolide, such as AZT or CLA, in combination with ethambutol and a rifamycin during at least one year until culture conversion.…”

Radiological Features of Cystic Fibrosis

“…HRCT signs are often subtle and include one or more of the following: small centrilobular nodules and nodular changes in the periphery of the lungs, tree-in-bud opacities, new lung abscesses (Field et al, 2004;Olivier et al, 2003). Presence of one of more of these radiological signs together with chest and systemic symptoms that do not respond to anti-pseudomonas antibiotics would justify the start of treatment.…”

Multidrug-Resistant Tuberculosis in an Adult with Cystic Fibrosis

“…The association between infection from nontuberculous mycobacteria and cystic fibrosis (CF) is well established [1,2,3,4,5]. In France, the prevalence was reported to be 6.6% [1], whereas in the USA, nontuberculous mycobacteria were cultured from 13% of CF patients more than 10 years old [2].…”

“…In France, the prevalence was reported to be 6.6% [1], whereas in the USA, nontuberculous mycobacteria were cultured from 13% of CF patients more than 10 years old [2]. On the other hand, tuberculosis (TBC) has only rarely been described in patients with CF [6,7,8,9].…”