Emerging and Difficult to Treat Nontuberculous Mycobacteria Infections

Abstract

Nontuberculous mycobacteria [NTM] are a large group of environmental organisms [>150 species] that are distributed worldwide, but only a few are pathogenic and known to cause human diseases. They are widely distributed in waterways and soil and susceptible people become infected mainly from repeated inhalation of bioaerosols. The global epidemiology of NTM infections is not well delineated as they are not reportable to public health services, but the incidence of NTM lung disease is increasing in the United States and in many other countries. Chronic, debilitating lung disease is the most common manifestations of NTM infections. Of concern is the global outbreak of the novel mycobacteria, Mycobacterium chimaera, from contaminated heater cooler units in cardiac surgery units resulting in cardiac and extracardiac diseases or manifestations. Mycobacterium abscessus complex infections, primarily cause disease in the immunosuppressed with pulmonary or extrapulmonary infections, are the most difficult to treat due to its multidrug resistance pattern. This chapter will review Mycobacterium avium complex [MAC] lung infections, M. abscessus and M. chimaera infections.