Department of Medicine, National Jewish Health, Denver, Colorado, USA.
Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Clin Infect Dis. 2020 Aug 14;71(4):905-913. doi: 10.1093/cid/ciaa1125.
Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.
非结核分枝杆菌（NTM）代表了超过 190 个种和亚种，其中一些可以在所有年龄段的人群中引起疾病，并影响肺部和肺外部位。本指南重点关注成人（无囊性纤维化或人类免疫缺陷病毒感染）由最常见的 NTM 病原体引起的肺部疾病，如缓慢生长的 NTM 中的鸟分枝杆菌复合群、堪萨斯分枝杆菌和胞内分枝杆菌，以及快速生长的 NTM 中的脓肿分枝杆菌。一个专家组由领先的国际呼吸医学和传染病学会（ATS、ERS、ESCMID、IDSA）精心挑选，包括肺病、传染病和临床微生物学、实验室医学以及患者权益方面的专家。围绕 22 个 PICO（人群、干预、对照、结局）问题中的每一个进行了系统评价，并使用 GRADE（推荐评估、制定和评价）方法制定、撰写和分级推荐。提供了 31 条关于治疗 NTM 肺部疾病的基于证据的建议。本指南旨在供治疗 NTM 肺部疾病的医疗保健专业人员使用，包括传染病和肺病专家。
