10 research outputs found
Non-tuberculous mycobacterial pulmonary infections
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Previous issue date: 2018University of Dundee. Hospital and Medical School. Scottish Centre for Respiratory Research. Dundee, United Kingdom.Mayo Clinic College of Medicine. Rochester, MN, USA.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ, Brasil.Hospital Universitario de Monterrey. Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias. Monterrey, Nuevo León UANL, Mexico.Centro Hospitalar Vila Nova de Gaia. Respiratory Department. Espinho, Portugal.Non-tuberculous mycobacterial (NTM) infections are increasingly rapidly worldwide.
The reason for this phenomenon is unclear, but may include the ageing population, the
increasing use of immunosuppressive drugs, the increasing prevalence of diseases that confer
susceptibility to NTM, such as COPD and bronchiectasis, and growing testing for NTM. Awareness
of the NTM related diseases is rising but is still suboptimal. Guidelines from the American
Thoracic Society and Infectious Diseases Society of America have provided a framework for evaluating
disease and evaluating care. Compliance with these guidelines is, however, very poor
globally.
NTM infections are amongst the most challenging cases that respiratory and infectious
diseases physicians face. The challenges include intrinsic antibiotic resistance, complex
drug regimens, poor tolerability and significant side effects associated with therapy and
poor response rates. The decision to initiate treatment is therefore often difficult
and requires careful evaluation of benefits and risks. Optimal management of NTM infections
requires multidisciplinary care with close collaboration between physicians, microbiologists,
physiotherapist/allied health professionals, primary care physicians and the patient.
There remains a need for greater research into the epidemiology, clinical evaluation and
treatment of NTM pulmonary disease. Randomised clinical trials are now being conducted which
may provide useful data on the effectiveness of some new and existing therapies.
In this review, we discuss the growing importance of NTM pulmonary disease and the opportunities
for progress in clinical research for these conditions