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[Atypical mycobacterial infections]

B Dautzenberg1, A Mercat

  • 1Service de Pneumologie, Groupe hospitalier Pitié-Salpêtrière, Paris.

Presse Medicale (Paris, France : 1983)
|October 22, 1994
PubMed
Summary

Non-tuberculous mycobacterial infections, once rare, are now common in patients with human immune deficiency virus (HIV). Research is advancing diagnostics and treatments for these opportunistic infections.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Immunology

Context:

  • Non-tuberculous mycobacterial infections (NTMIs) were infrequent before the acquired immune deficiency syndrome (AIDS) epidemic.
  • NTMIs are now frequently encountered, particularly in human immune deficiency virus (HIV)-positive individuals.
  • Mycobacterium kansasii, M. avium, and M. xenopi are the primary causes of pulmonary NTMIs in non-AIDS patients.

Purpose:

  • To review the epidemiology, diagnosis, and treatment of non-tuberculous mycobacterial infections.
  • To highlight the impact of the AIDS epidemic on NTMIs.
  • To discuss advancements in diagnostic tools and therapeutic agents for NTMIs.

Summary:

  • The AIDS epidemic has increased NTMIs incidence tenfold, with disseminated Mycobacterium avium complex (MAC) infections affecting 15% of end-stage AIDS patients.
  • Standardized treatment for Mycobacterium xenopi and M. avium infections is lacking, while M. kansasii infections are treated with rifampin, isoniazid, and ethambutol.
  • New diagnostic methods like blood culture media and polymerase chain reaction (PCR), along with novel drugs (macrolides, rifampicin-related agents, quinolones), are emerging.

Impact:

  • The rise in NTMIs due to HIV has spurred significant research and development in diagnostics and therapeutics.
  • Emerging treatments like clarithromycin, azithromycin, rifabutin, and new quinolones offer improved therapeutic options for NTMIs.
  • Advancements in diagnostics and drug discovery are crucial for managing the increasing burden of NTMIs in immunocompromised populations.

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