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Related Experiment Videos

Nontuberculous mycobacterial infections

D R Guay1

  • 1Section of Clinical Pharmacology, St. Paul-Ramsey Medical Center, MN 55101, USA.

The Annals of Pharmacotherapy
|July 1, 1996
PubMed
Summary

Nontuberculous mycobacterial infections are increasing, especially in immunocompromised individuals. Early diagnosis and susceptibility testing improve treatment outcomes for these complex infections.

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Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Nontuberculous mycobacterial (NTM) infections, excluding Mycobacterium avium complex (MAC), are increasingly recognized.
  • Immunosuppression, particularly from organ transplantation and HIV infection, contributes to the rising incidence of NTM diseases.
  • A diverse range of NTM species can cause localized, organ-specific, and systemic infections.

Purpose of the Study:

  • To comprehensively review the epidemiology, clinical manifestations, diagnostic approaches, and treatment strategies for NTM infections beyond MAC.
  • To highlight the evolving significance of NTM in clinical practice.

Main Methods:

  • A systematic literature search of English-language publications on NTM (excluding MAC) was conducted using MEDLINE.
  • Relevant articles were identified through the initial search and by examining reference lists of pertinent publications.
  • Information deemed pertinent by the author was selected for inclusion in the review.

Main Results:

  • NTM infections have gained prominence, linked to advancements in immunosuppressive therapies.
  • Pathogenic NTM species cause a broad spectrum of infections with varied clinical presentations.
  • Organisms display species-specific susceptibility patterns to antimicrobials, complicating treatment.
  • Effective management often necessitates prolonged treatment courses and may require adjunctive surgical interventions.
  • Key antimicrobials include cefoxitin, imipenem/cilastatin, aminoglycosides, tetracyclines, macrolides, trimethoprim/sulfamethoxazole, and traditional antimycobacterials.

Conclusions:

  • NTM are significant pathogens in both immunocompetent and immunocompromised populations.
  • Rapid diagnostic and susceptibility testing enable earlier and more effective treatment initiation.
  • Limited therapeutic options exist for many NTM infections, with some requiring non-traditional antimicrobial agents.

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