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The Rise of Non-Tuberculosis Mycobacterial Lung Disease
Champa N Ratnatunga1,2,3,4, Viviana P Lutzky4, Andreas Kupz1,2
1The Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia.
Abstract:
The incidence and number of deaths from non-tuberculous mycobacterial (NTM) disease have been steadily increasing globally. These lesser known "cousins" of Mycobacterium tuberculosis (TB) were once thought to be harmless environmental saprophytics and only dangerous to individuals with defective lung structure or the immunosuppressed. However, NTM are now commonly infecting seemingly immune competent children and adults at increasing rates through pulmonary infection. This is of concern as the pathology of NTM is difficult to treat. Indeed, NTM have become extremely antibiotic resistant, and now have been found to be internationally dispersed through person-to-person contact. The reasons behind this NTM increase are only beginning to be elucidated. Solutions to the problem are needed given NTM disease is more common in the tropics. Importantly, 40% of the world's population live in the tropics and due to climate change, the Tropics are expanding which will increase NTM infection regions. This review catalogs the global and economic disease burden, at risk populations, treatment options, host-bacterial interaction, immune dynamics, recent developments and research priorities for NTM disease.
Insights
Non-tuberculous mycobacterial (NTM) disease is a growing global health threat, increasingly affecting even healthy individuals. Urgent research is needed to combat antibiotic-resistant NTM infections, especially with climate change expanding tropical regions.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Non-tuberculous mycobacterial (NTM) infections, once considered rare, are rising globally.
- Previously thought to affect only the immunocompromised or those with lung issues, NTM now impacts healthy populations via pulmonary routes.
- NTM infections are increasingly antibiotic-resistant and spreading through human contact.
Purpose of the Study:
- To review the global disease burden and economic impact of NTM infections.
- To identify at-risk populations and current treatment strategies for NTM disease.
- To explore host-bacterial interactions, immune responses, and future research priorities for NTM.
Main Methods:
- Literature review of global NTM disease incidence and mortality.
- Analysis of risk factors, including environmental and climate change influences.
- Synthesis of current treatment options and emerging research findings.
Main Results:
- NTM disease incidence and mortality are increasing worldwide.
- Pulmonary NTM infections are rising in seemingly immunocompetent individuals.
- Antibiotic resistance and person-to-person transmission are significant concerns.
- Climate change is expanding tropical regions, likely increasing NTM prevalence.
Conclusions:
- NTM disease represents a significant and escalating global health challenge.
- Effective treatment strategies are hampered by antibiotic resistance and limited understanding of host-pathogen dynamics.
- Further research into NTM pathogenesis, transmission, and novel therapies is critical, particularly in the context of climate change and expanding endemic regions.
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