Mycobacteria are a type of bacteria that can cause infections in humans. There are more than 120 identified species of Mycobacteria, with a minority of those being associated with illnesses in human beings. Most mycobacteria are not harmful, but some can cause serious illness, particularly in people with weakened immune systems or pre-existing lung diseases. Nontuberculous mycobacteria (NTM) are a type of mycobacteria that can cause chronic respiratory infections. These infections can be difficult to treat once they have successfully infected a host and require long-term antibiotic treatment. In some cases, nontuberculous mycobacteria infections can be fatal.
Nontuberculous mycobacteria infections are difficult to treat because the bacteria are naturally resistant to many antibiotics. Treatment usually involves a combination of drugs over a long period. This means that to successfully treat nontuberculous mycobacteria, in many cases patients will be on multiple antibiotics or other medications at one time. Even after getting treated, nontuberculous mycobacteria infections can be recurrent. This is due to the difficulty in irradiating nontuberculous mycobacteria infections in infected patients. Patients will be monitored through sputum cultures and once a negative culture is achieved, the patient will then continue antibiotics or other treatments for sometimes even up to a year.
The reason that nontuberculous mycobacteria can be considered a chronic respiratory infection is because in many cases patients experience prolonged periods of discomfort and symptoms. These symptoms may improve at times but can also worsen later.
People with chronic lung diseases such as COPD or bronchiectasis are at increased risk for developing a nontuberculous mycobacteria infection. People with weakened immune systems are also at higher risk [1]. The best way to prevent a nontuberculous mycobacteria infection is to minimize exposure to contaminated water or soil [1].
How do Nontuberculous Mycobacteria Cause Infections?
Nontuberculous mycobacteria (NTM) are a group of mycobacteria closely related to the bacteria that cause tuberculosis. However, nontuberculous mycobacteria do not cause tuberculosis. Instead, they can cause a range of other respiratory infections, most commonly bronchitis and pneumonia.
Nontuberculous mycobacteria infections are often chronic and last for a long time or come back after treatment. They can be difficult to treat because nontuberculous mycobacteria are resistant to many antibiotics [2]. Many nontuberculous mycobacteria are intrinsically resistant to antibiotics due to various mechanisms such as a thick cell wall that is in many cases impermeable, creation of proteins that target antibiotics, and more. Antibiotic resistance can also be developed over time due to prolonged exposure to antibiotics, which is required to treat nontuberculous mycobacteria infections.
People with chronic lung diseases such as COPD or cystic fibrosis are at increased risk for nontuberculous mycobacteria infections. This is because their lungs are weakened, making it easier for nontuberculous mycobacteria to actively infect lung tissue. People who have had lung surgery or smoke cigarettes are also at increased risk.
What are the Symptoms of a Nontuberculous Mycobacteria Infection?
In general, the symptoms of a nontuberculous mycobacteria (NTM) infection are like those of other lung infections, such as bronchitis and pneumonia. They can include coughing, shortness of breath, fatigue, and weight loss [1].
However, nontuberculous mycobacteria infections tend to be more protracted than other lung infections, often lasting for months or even years. In some cases, nontuberculous mycobacteria infections can become chronic and require being treated long-term.
Nontuberculous mycobacteria infections can also cause other respiratory problems, such as pulmonary nodules (small growths in the lungs) and cavitary lesions (enlarged air spaces in the lungs). These respiratory complications can lead to further symptoms, such as chest pain and difficulty breathing.
If you think you may have an NTM infection, it is important to see your doctor for prompt diagnosis and treatment. Early diagnosis and treatment are essential for preventing serious respiratory complications from developing.
How is an NTM Infection Treated?
Nontuberculous mycobacteria (NTM) infections are treated differently than tuberculosis (TB) infections because different types of bacteria cause them. Nontuberculous mycobacteria infections are usually treated with a combination of two or more antibiotics, depending on the type of NTM causing the infection. Treatment can take several months and even in some cases years to complete [2].
In some cases, surgery may be necessary to remove infected tissue [3]. People with nontuberculous mycobacteria infections may also need breathing treatments or oxygen therapy. It is important to finish all antibiotics prescribed, even if you start feeling better, to ensure the infection is completely gone.
Prevention of Nontuberculous Mycobacteria Infections
Nontuberculous mycobacterial (NTM) infections are relatively rare but can become a chronic and difficult to treat disease. The best way to prevent nontuberculous mycobacteria infections is by avoiding exposure to the bacteria, making sure to wash your hands when you have been in contact with potting soils and peat moss. If you are using a humidifier, always make sure to always use sterilized water. If you are a smoker, quitting now is the best defense against the contraction of a nontuberculous mycobacteria infection.
Prevention of Nontuberculous Mycobacteria is Important for Several Reasons
There are several reasons to avoid nontuberculous mycobacteria infections. First, the bacteria are naturally resistant to many antibiotics, making treatment difficult [2]. Second, treatment usually involves a combination of drugs over a long period, which can be cumbersome for patients [3]. Third, even with treatment, nontuberculous mycobacteria infections can be recurrent, due to the difficulty in irradiating the bacteria in infected patients [2]. Finally, patients need to be monitored through sputum cultures and once a negative culture is achieved, they will need to continue on antibiotics or other treatments for sometimes even up to a year [3].
Conclusion
Nontuberculous mycobacteria are a type of bacteria that can cause chronic respiratory infections also known as nontuberculous mycobacterial lung disease. If you think you may have a nontuberculous mycobacteria infection, it is important to see a doctor as soon as possible. These infections can be difficult to treat and often require long-term remediation and close monitoring by your doctor. By beginning getting treated early, you can avoid complications and improve your chances of the infection not developing into nontuberculous mycobacterial lung disease.
References
- “Nontuberculous Mycobacteria (NTM) Infections.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 12 Aug. 2019, https://www.cdc.gov/hai/organisms/nontuberculous-mycobacteria.html
- “Organisms – NTM – Clinicians.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 12 Aug. 2019, https://www.cdc.gov/hai/organisms/ntm/clinicians.html
- Mirabal, Arian Bethencourt, and Gustavo Ferrer. “Lung Nontuberculous Mycobacterial Infections – Statpearls – NCBI Bookshelf.” National Library of Medicine, 28 Jan. 2022, https://www.ncbi.nlm.nih.gov/books/NBK551583/
- “NTM Info and Research Inc. – Nontuberculous Mycobacteria.” English, https://ntminfo.org/