Department of Infectious Diseases, Fundacion Vicente Ferrer, Rural Development Trust Hospital, Bathalapalli, Anantapur District, Andhra Pradesh, India.
Curr Opin Pulm Med. 2010 May;16(3):251-6. doi: 10.1097/MCP.0b013e3283378fa3.
Although the incidence of tuberculosis has reduced in developed countries, there is a growing interest in nontuberculous mycobacteria (NTM) as a cause of lung disease. However, NTM are a heterogeneous group and most of the data come from only three species: Mycobacterium avium complex, Mycobacterium kansasii and Mycobacterium abscessus. Still, information about these three species is confusing because it is based mainly on retrospective studies and series of clinical cases performed in developed countries. In recent years, new information has appeared about other species and the pathogenesis of NTM.
Epidemiological studies show that NTM infection is a worldwide phenomenon with an increasing presence in developing countries perhaps because of the implementation of tap water. Women with characteristic phenotype are at higher risk of acquiring NTM infection along with patients with defects on cystic fibrosis transmembrane conductance regulators. New studies on Mycobacterium fortuitum, Mycobacterium xenopi, Mycobacterium szulgai and Mycobacterium simiae indicate that the American Thoracic Society criteria for diagnosing NTM disease may not be useful for all species of NTM.
New multicentric and prospective studies are needed to clarify the pathogenesis and treatment of NTM. These organisms form a numerous and heterogeneous group and each species should be studied separately.
尽管发达国家的结核病发病率有所下降，但人们对非结核分枝杆菌（NTM）作为肺部疾病病因的兴趣日益浓厚。然而，NTM 是一组异质性群体，大多数数据仅来自三种物种：鸟分枝杆菌复合群、堪萨斯分枝杆菌和脓肿分枝杆菌。尽管如此，关于这三种物种的信息仍然令人困惑，因为这些信息主要基于发达国家进行的回顾性研究和临床病例系列。近年来，关于其他物种和 NTM 发病机制的新信息不断出现。
流行病学研究表明，NTM 感染是一种全球性现象，在发展中国家的存在呈上升趋势，这可能是由于自来水的普及。具有特征表型的女性以及囊性纤维化跨膜电导调节因子缺陷的患者感染 NTM 的风险更高。对偶发分枝杆菌、食酸分枝杆菌、绍氏分枝杆菌和猿猴分枝杆菌的新研究表明，美国胸科学会诊断 NTM 疾病的标准可能不适用于所有 NTM 物种。
需要开展新的多中心和前瞻性研究来阐明 NTM 的发病机制和治疗方法。这些生物体形成了一个数量众多且异质性的群体，每个物种都应单独进行研究。
