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Semin Respir Crit Care Med 2023; 44(02): 287-296
DOI: 10.1055/s-0042-1759883
Review Article

Nontuberculous Mycobacteria in Cystic Fibrosis in the Era of Cystic Fibrosis Transmembrane Regulator Modulators

Andrew Burke
1   Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia
2   Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
,
Rachel M. Thomson
1   Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia
3   Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Greenslopes, Queensland, Australia
,
Claire E. Wainwright
5   Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Australia
6   Children's Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Australia
,
Scott C. Bell
1   Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia
6   Children's Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Australia
7   Translational Research Institute, Woolloongabba, Australia
› Author Affiliations
Funding S.C.B., C.E.W., R.M.T. acknowledge funding by the NHMRC (grant numbers: 1102494 and 1152249) and CF Foundation (U.S.; grant numbers: BELL19A0 and WAINWR19A0). R.M.T. acknowledges funding from a Queensland Advancing Clinical Research Fellowship.
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Abstract

Nontuberculous mycobacteria (NTM) are a group of mycobacteria which represent opportunistic pathogens that are of increasing concern in people with cystic fibrosis (pwCF). The acquisition has been traditionally though to be from environmental sources, though recent work has suggested clustered clonal infections do occur and transmission potential demonstrated among pwCF attending CF specialist centers. Guidelines for the screening, diagnosis, and identification of NTM and management of pwCF have been published. The emergence of CF-specific therapies, in particular cystic fibrosis transmembrane regulator (CFTR) modulator drugs, have led to significant improvement in the health and well-being of pwCF and may lead to challenges in sampling the lower respiratory tract including to screen for NTM. This review highlights the epidemiology, modes of acquisition, screening and diagnosis, therapeutic approaches in the context of improved clinical status for pwCF, and the clinical application of CFTR modulator therapies.

Keywords

cystic fibrosis - nontuberculous mycobacteria - Mycobacterium abscessus - Mycobacterium avium complex - CFTR modulator - epidemiology - environmental exposure


Publication History

Article published online:
17 January 2023

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