NTMF: Nontuberculous mycobacteria Free
Nontuberculous mycobacteria (NTM), or atypical mycobacteria or mycobacteria
other than tuberculosis (MOTT), are mycobacteria which do not cause tuberculosis
or Hansen's disease (leprosy).
Introduction
Over the past 25 years, there has been a dramatic increase in the number of NTM
cases seen by clinicians across the United States and Canada.
The correct name of NTM is "nontuberculous mycobacteria." There is no such
bacteria called "nontuberculosis microbacteria."
See Mycobacterium for more information about this genus and a list of species.
Medical classification
Mycobacteria are a family of small, rod-shaped bacilli that can be classified
into 3 main groups for the purpose of diagnosis and treatment:
Mycobacterium tuberculosis complex which can cause tuberculosis: M.
tuberculosis, M. bovis, M. africanum, , M. microti and M. canetti.
M. leprae which causes Hansen's disease or leprosy.
Nontuberculous mycobacteria (NTM) are all the other mycobacteria which can cause
pulmonary disease resembling tuberculosis, lymphadenitis, skin disease, or
disseminated disease. Pulmonary NTM infections include: MAC (mycobacterium avian
complex), which includes M. avium and M. intracellulare; faster-growing M.
abscessus, M. chelonae, and M. fortuitum; and less common strains such as M.
kansasii and M. xenopi.
Unlike TB and leprosy, which are primarily spread by human-to-human contact, NTM
is believed to be contracted from the environment, hence its alternative label,
"environmental bacteria." NTM is believed to exist naturally in soil and water.
Diagnosis
Epidemiology: typical NTM patient is female, over age 50, caucasian, slender
body habitus, negligible history of smoking.
Symptoms: Dry cough which becomes very wet, sometimes blood is coughed up;
fever, chills, night sweats; recurrent bronchitis or pneumonia; vague malaise
and diminished energy.
Tests: NTM diagnosis requires a high-resolution CT scan of the lungs and Acid
Fast Bacilli test of sputum (growth of NTM bacteria will take several weeks or
more to occur and sample must be in a cultural media specific to mycobacteria).
NTM do not take up a Gram stain (Gram neutral).
Possible Predisposing or Co-existing Conditions: Cystic Fibrosis (including
adult onset); Alpha-1 Antitrypsin Deficiency; Primary ciliary diskinesia (Kartagener's
Syndrome); GERD; scoliosis; allergies.
