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[Non tuberculous mycobacterial diseases].

Homa Adle-Biassette1, Michel Huerre, Guillaume Breton

  • 1Service d'Anatomie et de Cytologie Pathologiques, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018 Paris cedex 18.

Annales De Pathologie
|August 12, 2003
PubMed
Summary

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Non-tuberculous mycobacteria (NTM) are opportunistic pathogens. The AIDS epidemic significantly increased NTM infections, particularly disseminated disease in immunocompromised individuals, altering disease epidemiology.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Immunology

Context:

  • Non-tuberculous mycobacteria (NTM) are a diverse group of approximately 80 described species, distinct from the Mycobacterium tuberculosis complex.
  • Historically, NTM infections were localized to specific sites like lungs, skin, or lymph nodes.
  • The advent of the AIDS epidemic profoundly altered the landscape of NTM diseases, leading to increased incidence and dissemination.

Purpose:

  • To review the changing epidemiology of non-tuberculous mycobacteria (NTM) diseases.
  • To highlight the impact of the AIDS epidemic on NTM infections.
  • To discuss diagnostic approaches for NTM diseases, especially in immunocompromised patients.

Summary:

  • NTM are opportunistic pathogens with varying virulence, causing diseases like tuberculosis, leprosy, and Buruli ulcer.

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  • Prior to the AIDS epidemic, NTM infections were typically localized; however, AIDS has led to a dramatic increase in NTM diseases, with 25-50% of AIDS patients in Europe and the USA infected.
  • NTM infections in AIDS patients often present as disseminated disease, with outcomes dependent on the patient's immune status and the specific NTM species.
  • Diagnosis is challenging due to co-infections and requires integrated clinical, radiological, microbiological, and pathological findings.
  • Microbiological identification of Mycobacterium species via culture remains the gold standard, complemented by pathological examination for rapid assessment and virulence evaluation.

    • Impact:

    • The AIDS epidemic has significantly increased the prevalence and severity of non-tuberculous mycobacteria (NTM) infections.
    • Understanding the immunological basis of NTM disease is crucial for prognosis and treatment.
    • Accurate and timely diagnosis, integrating multiple findings, is essential for managing NTM infections, particularly in immunocompromised populations.