The complexities and challenges of preventing and treating nontuberculous mycobacterial diseases

Baldwin, Susan L.; Larsen, Sasha E.; Ordway, Diane; Cassell, Gail H.; Coler, Rhea N.

doi:10.1371/journal.pntd.0007083

Cited by 101 publications

(107 citation statements)

References 156 publications

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“…Other studies in the mouse models or murine cells models of NTM infection have shown the importance of CCL2, CCL5, and TLR signaling via MAPK, MyD88, and NFκβ for disease protection (86)(87)(88). Robust mouse models for M. avium infection exist though currently, it is difficult to initiate infection, maintain infection, and measure immune responses in MABS mouse models (89,90). While comparisons between immune competent and immune deficient mouse models have provided insight into immune dysfunctions associated with DNTM (90), the chronic stages of PNTM infection, which are of current clinical relevance are not yet fully reproducible in mice.…”

Section: The Immune Response In Pulmonary Ntm Infectionmentioning

confidence: 99%

The Rise of Non-Tuberculosis Mycobacterial Lung Disease

et al. 2020

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Section: The Immune Response In Pulmonary Ntm Infectionmentioning

confidence: 99%

The Rise of Non-Tuberculosis Mycobacterial Lung Disease

et al. 2020

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“…Members of the MAC group are considered less pathogenic (more opportunistic) with different behaviors than those seen with MTBC. There has been a trend of an increased rate of non-tuberculosis mycobacteria (NTM) infection diagnoses in recent years [8]. This is due to better clinical awareness and recognition of presentations and improved laboratory diagnostic methods in immunocompromised and immunocompetent patients.…”

Section: Introductionmentioning

confidence: 99%

Targeted Combination Antibiotic Therapy Induces Remission in Treatment-Naïve Crohn’s Disease: A Case Series

et al. 2020

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Prospective trials of anti-mycobacterial antibiotic therapy (AMAT) have proven efficacious in Crohn’s disease (CD) but use as first-line treatment in CD has not been evaluated. This paper reports the outcomes of patients with CD treated with first-line AMAT. This paper consists of a case series of treatment-naïve CD patients who received AMAT as first-line treatment between 2007 and 2014 at a single center. AMAT treatment consisted of rifabutin, clofazimine and clarithromycin, plus either ciprofloxacin, metronidazole or ethambutol. Symptoms, inflammatory blood markers, colonoscopy and histology results, in addition to, the Crohn’s Disease Activity Index (CDAI) were tabulated from patients’ clinical records, and descriptive statistics were conducted. A Wilcoxon signed-rank test assessed the difference in CDAI scores before and while on AMAT. The statistical significance was set at 5%. Clinical remission (CDAI < 150) with rapid improvement in clinical symptoms and inflammatory markers was seen in all eight patients receiving AMAT as sole therapy by 6 weeks. In all eight patients, the median CDAI score decreased significantly, from 289 prior to treatment to 62 at the 12-month follow-up (p < 0.001). Follow-up colonoscopies showed healing of CD ulcers, no visible mucosal inflammation, restoration of normal vascular patterns and complete mucosal healing on histology samples. AMAT as first-line therapy demonstrated a rapid improvement of Crohn’s disease (not previously seen when used as second-line therapy).

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“…The nontuberculous mycobacteria (NTM) is defined as any mycobacterial pathogen excluding Mycobacterium tuberculosis or Mycobacterium leprae. Because many NTM species have been identified, diagnosis is difficult and successful treatment for NTM infection is also complicated [1]. Though aerosol inhalation and water distribution systems are known as the main transmission routes of NTM disease, skin and soft tissue NTM infection is commonly related with invasive procedures or trauma [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Delayed Nontuberculous Mycobacterium Manifestation 1 Year after a Dog Bite on the Hand

2020

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Nontuberculous mycobacteria infection can show various clinical manifestations as over 190 different species of nontuberculous mycobacteria have been identified. Among them, skin and soft tissue infections are commonly related with invasive procedures or trauma. The typical incubation period of rapidly growing mycobacteria is 3 to 6 weeks, whereas slowly growing mycobacteria takes 32 to 265 days of incubation. There have been a few cases of nontuberculous mycobacterium skin and soft tissue infections associated with animal bites, but none of them, not even mycobacteria with slow growth, had incubated for more than a year from the initial trauma. We present our case of delayed manifestation of nontuberculous mycobacterium skin and soft tissue infections at a year after receiving a dog bite on the hand. This case serves as a reminder that patients with delayed onset of local inflammation and granulation tissue on the hand must be reviewed for history of any previous trauma at the wound site and evaluated for the possibility of concealed nontuberculous mycobacterium infection.

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The complexities and challenges of preventing and treating nontuberculous mycobacterial diseases

Cited by 101 publications

References 156 publications

The Rise of Non-Tuberculosis Mycobacterial Lung Disease

The Rise of Non-Tuberculosis Mycobacterial Lung Disease

Targeted Combination Antibiotic Therapy Induces Remission in Treatment-Naïve Crohn’s Disease: A Case Series

Delayed Nontuberculous Mycobacterium Manifestation 1 Year after a Dog Bite on the Hand

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