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Semin Respir Crit Care Med 2003; 24(6): 693-702
DOI: 10.1055/s-2004-815665
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Nontuberculous Mycobacteria in Cystic Fibrosis

Jerry A. Nick
  • Division of Pulmonary Science and Critical Care Medicine, University of Colorado School of Medicine, Denver, Colorado, and Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado
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Publication History

Publication Date:
15 January 2004 (online)

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ABSTRACT

Nontuberculous mycobacteria (NTM) are widely distributed in our modern enviroment. Therefore, it is not suprising that these organisms are commonly present in sputum from cystic fibrosis (CF) patients. In the setting of CF lung disease, the significance of NTM in respiratory secretions is a major diagnostic challenge. The usual signs, symptoms, and radiographic features of NTM disease are also characteristic of CF lung disease; thus it is difficult to determine whether the NTM are a saprophytic contaminant or an active pathogen. Although many CF patients appear to tolerate the presence of the NTM without clear evidence of disease, some suffer accelerated progression of lung disease that cannot be solely attributed to CF and appear to benefit from antimycobacterial treatment. Standard CF care should be reemphasized in patients with NTM infection, especially aggressive bronchial hygiene. Specific guidelines for antimycobacterial therapy in CF patients have not been determined, and potential complications of treatment are significant. Hence, patients offered antimycobacterial treatment must be selected carefully. An initial approach to treatment of CF patients is based on guidelines developed for the general population.

KEYWORDS

Cystic fibrosis (CF) - nontuberculous mycobacteria (NTM) - Mycobacterium avium complex - Mycobacterium abscessus

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