Unidad de Infección Bronquial Crónica, Bronquiectasias y Fibrosis Quística, Servicio de Neumología, Hospital Ramón y Cajal, Madrid, España.
Servicio de Neumología, Hospital Ramón y Cajal, Madrid, España.
Med Clin (Barc). 2018 Mar 9;150(5):191-197. doi: 10.1016/j.medcli.2017.07.010. Epub 2017 Sep 18.
The most common infections caused by nontuberculous mycobacteria (NTM) are lung infections. The microorganisms causing these infections most frequently are Mycobacterium avium complex, Mycobacterium kansasii and Mycobacterium abscessus complex. Their incidence has increased in the last three decades. After identifying an NTM in the respiratory tract, clinical and radiological aspects must be considered to determine if isolations are clinically relevant. Predisposing conditions that could contribute to infection must also be investigated. Pulmonary disease due to NTM is presented in three clinical forms: a) pneumonitis due to hypersensitivity; b) fibrocavitary form; and c) nodular-bronchiectasic. The diagnosis of respiratory disease due to NTM does not make it obligatory to immediately initiate treatment. Before initiating the latter, other factors must be considered, such as age, comorbidities, life expectancy, due to the prolonged nature of treatments, with potential side effects and, in many cases, only a slight response to the treatment.
非结核分枝杆菌（NTM）引起的最常见感染是肺部感染。引起这些感染的微生物最常见的是鸟分枝杆菌复合群、堪萨斯分枝杆菌和脓肿分枝杆菌复合群。在过去三十年中，它们的发病率有所增加。在呼吸道中发现 NTM 后，必须考虑临床和影像学方面的因素，以确定分离物是否具有临床相关性。还必须调查可能导致感染的易患因素。非结核分枝杆菌引起的肺部疾病表现为三种临床形式：a）过敏引起的肺炎；b）纤维空洞性形式；和 c）结节支气管扩张性。非结核分枝杆菌引起的呼吸道疾病的诊断并不一定需要立即开始治疗。在开始治疗之前，必须考虑其他因素，如年龄、合并症、预期寿命，因为治疗时间长，可能有副作用，而且在许多情况下，对治疗的反应只有轻微。
