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Review
. 2025 Apr 1;38(2):169-175.
doi: 10.1097/QCO.0000000000001101. Epub 2025 Feb 10.

Mycobacterium abscessus group pulmonary disease

David E Griffith  1
Affiliations
Review

Mycobacterium abscessus group pulmonary disease

David E Griffith. Curr Opin Infect Dis. .

Abstract

Purpose of review: Mycobacterium abscessus is the second most isolated nontuberculous mycobacterial (NTM) respiratory pathogen in United States. It is also among the most difficult to treat NTM respiratory pathogens. The purpose of this review is to highlight current opportunities and limitations in the management of M. abscessus pulmonary disease and ways to optimize therapy to avoid treatment choices that make management of these patients even more difficult.

Recent findings: The main themes of the manuscript emphasize recognition of M. abscessus drug resistance mechanisms and their implication for limiting M. abscessus treatment response. The dichotomy between favorable outcomes for macrolide-susceptible vs. macrolide-resistant M. abscessus isolates is discussed in detail as well as the limitations in our current in-vitro susceptibility testing of M. abscessus isolates.

Summary: Predictably favorable treatment outcomes for patients with M. abscessus pulmonary disease remain elusive. New antibiotic combinations offer promise but await clinical testing in prohibitively expensive trials. Some new approaches such as phage therapy have been introduced, but so far, none are universally available or reliably effective. Clinicians and patients are left to struggle with imperfect treatment strategies in the hopes that some will emerge to justify larger treatment trials.

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References

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    1. Daley CL, Iaccarino JM, Lange C, et al. Treatment of nontuberculous Mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline. Clin Infect Dis 2020; 71:e1–e36.
    1. Choi H, Jhun BW, Kim SY, et al. Treatment outcomes of macrolide-susceptible Mycobacterium abscessus lung disease. Diagn Microbiol Infect Dis 2018; 90:293–295.
    1. Choi H, Kim SY, Kim DH, et al. Clinical characteristics and treatment outcomes of patients with acquired macrolide-resistant Mycobacterium abscessus lung disease. Antimicrob Agents Chemother 2017; 61:e01146–e1217.
    1. Bents SJ, Mercaldo RA, Powell C, et al. Nontuberculous mycobacterial pulmonary disease (NTM PD) incidence trends in the United States, 2010-2019. BMC Infect Dis 2024; 24:1094.

MeSH terms