Orujyan Davit, Narinyan William, Rangarajan Subhapradha, Rangchaikul Patrida, Prasad Chaya, Saviola Beatrice, Venketaraman Vishwanath
College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA.
Vaccines (Basel). 2022 Mar 3;10(3):390. doi: 10.3390/vaccines10030390.
The genus mycobacterium includes several species that are known to cause infections in humans. The microorganisms are classified into tuberculous and non-tuberculous based on their morphological characteristics, defined by the dynamic relationship between the host defenses and the infectious agent. Non-tuberculous mycobacteria (NTM) include all the species of mycobacterium other than the ones that cause tuberculosis (TB). The group of NTM contains almost 200 different species and they are found in soil, water, animals-both domestic and wild-milk and food products, and from plumbed water resources such as sewers and showerhead sprays. A systematic review of Medline between 1946 and 2014 showed an 81% decline in TB incidence rates with a simultaneous 94% increase in infections caused by NTM. Prevalence of infections due to NTM has increased relative to infections caused by TB owing to the stringent prevention and control programs in Western countries such as the USA and Canada. While the spread of typical mycobacterial infections such as TB and leprosy involves human contact, NTM seem to spread easily from the environment without the risk of acquiring from a human contact except in the case of in patients with cystic fibrosis, where human transmission as well as transmission through fomites and aerosols has been recorded. NTM are opportunistic in their infectious processes, making immunocompromised individuals such as those with other systemic infections such as HIV, immunodeficiencies, pulmonary disease, or usage of medications such as long-term corticosteroids/TNF-α inhibitors more susceptible. This review provides insight on pathogenesis, treatment, and BCG vaccine efficacy against and some important NTM infections.
分枝杆菌属包括几种已知可引起人类感染的菌种。这些微生物根据其形态特征分为结核分枝杆菌和非结核分枝杆菌，其形态特征由宿主防御与感染因子之间的动态关系所定义。非结核分枝杆菌（NTM）包括除引起结核病（TB）的分枝杆菌以外的所有分枝杆菌菌种。NTM组包含近200种不同的菌种，它们存在于土壤、水、家养和野生动物、牛奶和食品中，以及来自下水道和淋浴喷头喷雾等管道水资源中。对1946年至2014年间Medline的系统评价显示，结核病发病率下降了81%，同时NTM引起的感染增加了94%。由于美国和加拿大等西方国家严格的预防和控制计划，NTM感染的患病率相对于结核病引起的感染有所增加。虽然结核病和麻风病等典型分枝杆菌感染的传播涉及人与人之间的接触，但NTM似乎很容易从环境中传播，除了囊性纤维化患者外，一般不会通过人与人之间的接触感染，在囊性纤维化患者中，已记录到人际传播以及通过污染物和气溶胶传播。NTM在其感染过程中具有机会性，使免疫功能低下的个体，如患有其他全身感染（如HIV）、免疫缺陷、肺部疾病或使用长期皮质类固醇/TNF-α抑制剂等药物的个体更容易感染。本综述提供了关于发病机制、治疗以及卡介苗对结核病和一些重要NTM感染的疗效的见解。
