Mycobacterial Disease: Evolving Concepts

This issue of Seminars in Respiratory and Critical Care Medicine reviews the broad spectrum of both pulmonary and extrapulmonary infections caused by Mycobacterium tuberculosis and nontuberculous mycobacteria (NTM). Although Seminars has addressed mycobacterial infections previously, our knowledge of these infections has increased considerably. We have included topics such as epidemiology, novel diagnostic methods, the challenges of determining whom to treat and how to treat, medical and surgical management, and pulmonary and extrapulmonary disease. We have invited international experts to write these up-to-date reviews based on their research or clinical expertise and extensive experience within this field.

Patrick A. Flume, MD

Kevin L. Winthrop, MD, MPH

Tuberculosis (TB) remains a major health issue around the world, and this issue updates the epidemiology for TB in general with particular attention to multidrug-resistant (MDR) TB. Diagnostic strategies for TB continue to evolve, as does the therapeutic landscape including surgical options. We have invited the authors to provide in-depth reviews of TB, highlighting the changing epidemiology, advances in diagnosis, and treatment of both TB and latent tuberculosis infection (LTBI).

While TB will always garner attention, it is the NTM that has risen in relevance in the last decade, particularly in regions with low TB prevalence. The reasons for rising NTM incidence are multifactorial, and for the most part, both the diagnosis and treatment of NTM can often be more challenging than TB. We have devoted the majority of this issue to NTM given its rise in importance, asking the authors to provide an update on its epidemiology, as well as the evolving treatment and management strategies used in such patients. The decision to treat NTM infections is not as clear cut as it is for TB, and the issues that influence those decisions are exposed herein.

In summary, this issue of Seminars will hopefully make clear the challenges of managing patients with mycobacterial infections, addressing the complicated diagnostic and treatment approaches required to manage and prevent these infections. We would like to thank all the contributors for their enthusiasm and hard work. We also extend our thanks to Joseph P. Lynch, Editor-in-Chief of Seminars in Respiratory and Critical Care Medicine, as well as all those at the Editorial Office for their expertise in producing this issue of Seminars in Respiratory and Critical Care Medicine.