An expert panel steps in The Lancet Infectious Diseases recommendations for the treatment of lung disease caused by less common non-tuberculous mycobacteria not covered in the 2020 ATS/ERS/ESCMID/IDSA guideline.
The 2020 guideline for the treatment of non-tuberculous mycobacterial lung disease (NTM-PD) from the American Thoracic Society, European Respiratory Society, European Society of Clinical Microbiology and Infectious Diseases, and the Infectious Diseases Society of America; and the 2017 guideline from the British Thoracic Society treated lung diseases in adults caused by Mycobacterium avium-complex, Mycobacterium kansasii, Mycobacterium xenopi in Mycobacterium abscessus. To provide evidence-based recommendations for the treatment of less common non-tuberculous mycobacterial (NTM) species in adult patients without cystic fibrosis or HIV infection, an expert panel comprising members of the ATS/ERS/ESCMID/IDSA 2020 guideline committee conducted a systematic literature review to develop guidelines for lung disorders caused by 7 additional organisms: Mycobacterium chelonae, Mycobacterium fortuitum, Mycobacterium genavense, Mycobacterium gordonae, Mycobacterium malmoense, Mycobacterium simiae in Mycobacterium szulgai.
Treatment recommendations were developed through a structured consensus process. The evidence from the scientific literature published in English for the treatment of lung diseases caused by 6 of these NTM species was of very low quality, with the exception of M. malmoense, and was based on the evaluation of case reports and case series. In front of M. malmoense the results of 2 randomized controlled trials and 3 retrospective cohort studies provided a better evidence base for treatment recommendations, although the evidence was still of low quality.
Bron:
Lange C, Böttger EC, Cambau E, et al. Consensus management recommendations for less common non-tuberculous mycobacterial pulmonary diseases. Lancet Infect Dis. 2022;22:e178-90.