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Review
. 2021 Nov 1;27(6):586-592.
doi: 10.1097/MCP.0000000000000816.

Nontuberculous mycobacteria in cystic fibrosis

Jerry A Nick  1   2 , Charles L Daley  1   2 , Patricia M Lenhart-Pendergrass  2   3 , Rebecca M Davidson  4
Affiliations
Review

Nontuberculous mycobacteria in cystic fibrosis

Jerry A Nick et al. Curr Opin Pulm Med. .

Abstract

Purpose of review: Nontuberculous mycobacteria (NTM) are challenging infections among people with cystic fibrosis (pwCF) as the source, modes of transmission, and best practices for diagnosis and treatment are not known. Investigators have defined aspects of NTM infection that are unique to the CF population, as well as features shared with other conditions at risk. This review describes recent advances in our understanding of NTM infection among pwCF.

Recent findings: The presence of dominant circulating clones of Mycobacterium abscessus within the CF community worldwide continue to be described, as well as pathogen phenotypes that could evoke greater environmental fitness and infectivity. The risk of direct or indirect transmission between pwCF remains an active focus of investigation, with divergent findings and conclusions reached in a site-specific fashion. Derived largely from studies in non-CF populations, new clinical guidelines are now available. A wide variety of agents are in preclinical development or early phase trials with promising findings, and new therapeutic targets have been identified as our understanding of the complex biology of NTM continues to expand.

Summary: Significant challenges remain in the fight against NTM, however, recent advances in our understanding of the genetics, epidemiology and pathophysiology of pulmonary NTM infection in pwCF are leading efforts to improve clinical care.

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References

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    1. Winthrop KL, Marras TK, Adjemian J, et al. Incidence and prevalence of nontuberculous mycobacterial lung disease in a large U.S. Managed Care Health Plan, 2008-2015. Ann Am Thorac Soc 2020; 17:178–185.
    1. Low D, Wilson DA, Flume PA. Screening practices for nontuberculous mycobacteria at US cystic Fibrosis Centers. J Cyst Fibros 2020; 19:569–574.
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    1. Olivier KN, Griffith DE, Eagle G, et al. Randomized trial of liposomal amikacin for inhalation in nontuberculous mycobacterial lung disease. Am J Respir Crit Care Med 2017; 195:814–823.

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