Treatment Strategy for Pulmonary Mycobacteriosis: the Challenge of Drug Resistance

Abstract

The pulmonary disease caused by nontuberculous mycobacteria (NTM) is a chronic respiratory infection resulting in declining lung function, worsening life quality, and increasing mortality rates. Most patients with pulmonary nontuberculous mycobacteriosis (PNTM) have concomitant chronic diseases (bronchiectatic disease, COPD, diabetes mellitus, etc.) PNTM is a refractory disease as mycobacteria are located intracellularly in alveolar macrophages. Mycobacteria can develop a biofilm, which impedes antibiotic penetration and protects them. Treatment for PNTM is long-term with low effectiveness due to innate or acquired mycobacterial resistance. The article outlines the modern concepts of drug resistance development in NTM, refractoriness of the disease, and the current mechanisms to overcome it.