Abstract
As a result of their underlying lung disease, patients with cystic fibrosis (CF) have
a higher risk of developing nontuberculous mycobacteria (NTM) infections compared
with the general population. Although NTM may be present intermittently in low amounts
in the airways of CF patients without an apparent clinical effect, progressive respiratory
decline due to NTM disease may also occur. Identifying this latter group of patients
can be challenging for clinicians because the usual symptoms exhibited by infected
individuals without CF may be difficult to distinguish from the baseline respiratory
dysfunction of a patient with CF. The distinction, however, is of utmost importance
because those patients with clinical worsening may benefit considerably from antimycobacterial
treatment. For CF patients under evaluation for lung transplantation, NTM can play
a critical role in determining overall outcomes, and treatment in the pre- and post-transplant
period may be vital to success. A general approach to NTM in CF thus involves surveillance
to detect NTM, careful monitoring for associated clinical decline, and consideration
of treatment given for those with an otherwise unexplained deterioration. In this
review, the epidemiology and clinical course of NTM in CF is described with an algorithm
for management proposed.
Keywords
cystic fibrosis - nontuberculous mycobacteria - mycobacterium infections -
Mycobacterium avium complex -
Mycobacterium abscessus
