A Growing Problem
How has NTM affected your practice? Answer the question below and see how other physicians around the country have answered.
How many cases of NTM do you see per year?
Who is affected by nontuberculous mycobacteria infections
Incidence of NTM infections
A survey conducted in 2014 estimates that there are almost 20,000 patients in Europe who have been diagnosed with a pulmonary infection caused by nontuberculous mycobacteria (NTM). Since this disease is not notifiable, the actual number of infections could be higher.5, 6
Patients with bronchiectasis, COPD, asthma, cystic fibrosis, and emphysema, for example, have a significantly higher risk of developing illness due to the structural lung damage already present. They are more at risk of becoming infected with NTM.3, 9, 10, 11
Mycobacterium avium complex (MAC) is one of the most frequently identified species in pulmonary NTM infections.12
The typical NTM patient
The following characteristics are typical of patients with a pulmonary NTM infection:3, 9, 10, 11, 12
- Middle-aged or older
- Chronic cough and debilitating fatigue
- Existing comorbidities such as
- Lack of response to previous courses of antibiotic treatment
The severity and progression of a pulmonary infection caused by NTM depends on both the patient type, and the NTM species.
Mycobacterium avium complex (MAC), for example, is one of the most frequently identified species in pulmonary NTM infections. An infection with MAC classically presents as two different clinical presentations.12
- Fibrocavitary: typically affects male patients in their late 40s, often smokers or former smokers who consume alcohol excessively.12
- Nodular Bronchiectasis: Mainly affects postmenopausal women with low BMI who do not smoke. These women have no previous history of lung disease; however, they suffer from a chronic cough that may not respond to treatment with antibiotics. This form of the disease is sometimes referred to as "Lady Windermere" syndrome, with a lower rate of progression than the fibrocavitary form. High-resolution computed tomography (HRCT) show the characteristic pattern of small nodular densities of centrilobular structures in conjunction with cylindrical bronchiectasis. This is also known as the "Tree-in-bud" pattern.12