[Non tuberculous mycobacterial infections]

Area of Science:

• Infectious Diseases
• Immunology
• Microbiology

Background:

• Non-tuberculous mycobacterial (NTM) infections, or atypical mycobacterial infections, are caused by environmental mycobacteria.
• These infections are increasingly prevalent, particularly in non-HIV immunocompromised patients, and can affect various tissues like lungs, skin, and bones.
• Distinguishing NTM infection from colonization is critical for accurate diagnosis and treatment.

Purpose of the Study:

• To highlight the growing incidence of NTM infections and their varied clinical presentations.
• To emphasize the challenges in treating NTM infections, including common therapeutic failures despite new antibiotics.
• To underscore the importance of identifying underlying immunological deficiencies in patients with recurrent or severe NTM infections.

Main Methods:

• Review of current literature on NTM infections.
• Analysis of clinical presentations and treatment outcomes.
• Discussion of diagnostic criteria for differentiating infection from colonization.
• Exploration of potential therapeutic strategies, including novel agents and immunotherapies.

Main Results:

• NTM infections are rising, affecting diverse patient groups including those in internal medicine and geriatric wards.
• Therapeutic failures are common due to factors like long treatment durations, adverse effects, and drug interactions.
• Identifying immunological deficiencies, particularly in interferon and interleukin pathways, is vital for non-immunosuppressed patients with recurrent NTM infections.

Conclusions:

• Investigating immunological deficiencies is essential for non-immunosuppressed individuals experiencing NTM infections.
• Adjuvant interferon-gamma therapy may be beneficial for refractory pulmonary and disseminated NTM infections.
• Emerging therapeutic molecules show promise for treating specific atypical mycobacterial infections.