Shifting paradigms of nontuberculous mycobacteria in cystic fibrosis

Abstract

Important paradigms of pulmonary disease with nontuberculous mycobacteria (NTM) are currently shifting based on an increasing attention within the field of cystic fibrosis (CF). These shifts are likely to benefit the management of all patients with pulmonary NTM, regardless of underlying pathology. Currently several key areas are being revised: The first outbreak of human NTM transmission has been proven and new evidence of biofilm growth in vivo has been demonstrated. A better understanding of the clinical impact of NTM infection has led to increased diagnostic vigilance and new recommendations for lung transplantation are under way. While recent changes have reinvigorated the interest in NTM disease, the challenge remains, whether such advances can be successfully translated into improved management and care.

Molecular epidemiology of Mycobacterium abscessus complex isolates in Ireland

“…Twenty surveys reporting M. abscessus complex prevalence in CF patients since 1980 (nineteen summarized in [36], plus the most recent survey [37]) show large geographical variations within and between countries (median prevalence 3.3%, range 0-9.1%, IQR 1.52%-5.74%). Nine out of the eighteen CF patients infected with M. abscessus complex bacteria (50%) were also culture positive for Aspergillus (Table 2).…”

Host-pathogen interplay in the respiratory environment of cystic fibrosis

“…Several organisms, including S. maltophilia , were initially considered to be harmless colonizers of the lung, however, newer data suggest they may participate in pulmonary deterioration in CF lung disease [10]. The perception of NTM disease has undergone a notable shift as well [11]. NTM, such as Mycobacterium abscessus Complex and Mycobacterium avium Complex, are now recognized as insidious opportunists, rather than colonizers, that can lead to increased morbidity and mortality in CF, and identification and speciation are important for tailoring therapy.…”

Serodiagnosis ofMycobacterium abscessuscomplex infection in cystic fibrosis

“…Mycobacterium abscessus complex (MABSC) is the dominant form of NTM in European patients with CF and new evidence of increasing incidence rates, human-to-human transmission and a detrimental effect on lung function has reinvigorated interest in these ubiquitous mycobacteria [2][3][4]. The pathogenesis of MABSC is not well understood but is a research priority, as there might be a window of opportunity for eradication [5] or suppression [6] at an early stage of infection.…”