Lungenerkrankung durch seltenere nicht-tuberkulöse Mykobakterien – Neue internationale Empfehlungen

Was ist neu?

Therapie von NTM-Infektionen Für die Behandlung von NTM-Infektionen der Lungen stehen erstmals Evidenz-basierte internationale Leitlinien zur Verfügung. Nach der ersten Publikation der neuen ATS/ERS/ESCMID- und IDSA-Leitlinien zur Behandlung von Lungenerkrankungen durch M. avium complex, M. kansasii, M. xenopi und M. abscessus von 2020 liegen nun weitere Empfehlungen zur Behandlung von selteneren Lungenerkrankungen durch NTM vor.

Relevante NTM-Spezies Die neuen Empfehlungen umfassen Lungenerkrankungen durch die schnellwachsenden Mykobakterien M. chelonae und M. fortuitum sowie durch die langsam-wachsenden Mykobakterien M. genavense, M. gordonae, M. malmoense, M. simiae und M. szulgai.

Abstract

The spectrum of pulmonary disease caused by nontuberculous mycobateria (NTM) is diverse, and each species requires species-specific therapy. With the new ATS/ERS/ESCMID/IDSA guideline on the management of pulmonary disease caused by NTMs covering only the most common pathogens, namely M. avium complex (MAC), M. kansasii, M. xenopi, and M. abscessus, it was necessary to write treatment recommendations for pulmonary disease caused by rarer NTM species that were still represented in the old 2007 guideline.

The panel of guideline committee members from the ATS, ERS, ESCMID, and IDSA- therefore, independently of the professional societies, again conducted systematic literature reviews to develop evidence-based recommendations for the treatment of lung disease caused by seven additional organisms: M. chelonae, M. fortuitum, M. genavense, M. gordonae, M. malmoense, M. simiae, and M. szulgai. A German summary of these international recommendations is presented here.

Schlüsselwörter

Nicht tuberkulöse Mykobakterien - Lungenerkrankung - M. chelonae - M. fortuitum - M. genavense - M. malmoense - M. simiae - M. szulgai - M. gordonae

Key words

Nontuberculous Mycobacteria - pulmonary disease - M. chelonae - M fortuitum - M. genavense - M. malmoense - M. simiae - M. szulgai - M. gordonae

• Literatur

• 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 (04) 905-913
• 2 Daley CL, Iaccarino JM, Lange C. et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Eur Respir J 2020; 56 (01)
• 3 Griffith DE, Aksamit T, Brown-Elliott BA. et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007; 175 (04) 367-416
• 4 Lange C, Bottger EC, Cambau E. et al. Consensus management recommendations for less common non-tuberculous mycobacterial pulmonary diseases. Lancet Infect Dis 2022;
• 5 Griffith DE, Girard WM, Wallace RJ. et al. Clinical features of pulmonary disease caused by rapidly growing mycobacteria. An analysis of 154 patients. Am Rev Respir Dis 1993; 147 (05) 1271-1278
• 6 van Ingen J, de Zwaan R, Dekhuijzen RP. et al. Clinical relevance of Mycobacterium chelonae-abscessus group isolation in 95 patients. J Infect 2009; 59: 324-331
• 7 Banerjee R, Hall R, Hughes GR. Pulmonary Mycobacterium fortuitum infection in association with achalasia of the oesophagus. Case report and review of the literature. Br J Dis Chest 1970; 64: 112-118
• 8 Park S, Suh GY, Chung MP. et al. Clinical significance of Mycobacterium fortuitum isolated from respiratory specimens. Respir Med 2008; 102: 437-442
• 9 Lessing MP, Walker MM. Fatal pulmonary infection due to Mycobacterium fortuitum. J Clin Pathol 1993; 46: 271-272
• 10 Szturmowicz M, Siemion-Szczesniak I, Wyrostkiewicz D. et al. Factors predisposing to non-tuberculous mycobacterial lung disease in the patients with respiratory isolates of non-tuberculous mycobacteria. Adv Respir Med 2018;
• 11 Morimoto K, Kazumi Y, Shiraishi Y. et al. Clinical and microbiological features of definite Mycobacterium gordonae pulmonary disease: the establishment of diagnostic criteria for low-virulence mycobacteria. Trans R Soc Trop Med Hyg 2015; 109: 589-593
• 12 Mahmood M, Ajmal S, Abu Saleh OM. et al. Mycobacterium genavense infections in non-HIV immunocompromised hosts: a systematic review. Infect Dis (Lond) 2018; 50: 329-339
• 13 Rammaert B, Couderc LJ, Rivaud E. et al. Mycobacterium genavense as a cause of subacute pneumonia in patients with severe cellular immunodeficiency. BMC Infect Dis 2011; 11: 311
• 14 Hoefsloot W, van Ingen J, Andrejak C. et al. The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples: an NTM-NET collaborative study. Eur Respir J 2013; 42: 1604-1613
• 15 Hoefsloot W, Boeree MJ, van Ingen J. et al. The rising incidence and clinical relevance of Mycobacterium malmoense: a review of the literature. Int J Tuberc Lung Dis 2008; 12: 987-993
• 16 Valero G, Peters J, Jorgensen JH. et al. Clinical isolates of Mycobacterium simiae in San Antonio, Texas. An 11-yr review. Am J Respir Crit Care Med 1995; 152: 1555-1557
• 17 van Ingen J, Boeree MJ, Dekhuijzen PN. et al. Clinical relevance of Mycobacterium simiae in pulmonary samples. Eur Respir J 2008; 31: 106-109
• 18 van Ingen J, Boeree MJ, de Lange WC. et al. Clinical relevance of Mycobacterium szulgai in The Netherlands. Clin Infect Dis 2008; 46: 1200-1205
• 19 Maloney JM, Gregg CR, Stephens DS. et al. Infections caused by Mycobacterium szulgai in humans. Rev Infect Dis 1987; 9: 1120-1126