Resumen de Opportunistic mycobacterial diseases
Steven Cowman, Robert Wilson, Michael R. Loebinger
Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause a variety of infections including pulmonary disease, the prevalence of which is increasing. Although patients with immunodeficiency or chronic lung disease are most often affected, individuals with no apparent underlying predisposition can also develop infection. The most common species causing NTM pulmonary disease in the UK are Mycobacterium avium complex, Mycobacterium abscessus, Mycobacterium kansasii, Mycobacterium xenopi and Mycobacterium malmoense. Their ubiquitous nature makes them frequent contaminants, and the diagnosis of pulmonary disease requires firm evidence of infection with supportive clinical and radiological features. The management of NTM pulmonary disease is challenging as patients can remain stable for prolonged periods and treatment can be poorly tolerated. Treatment varies according to the species but involves prolonged courses of a combination of antibiotics. NTM are often drug resistant, and surgery can be considered in selected cases. Treatment outcomes are inferior to tuberculosis, and cure is sometimes not attainable.
