Consensus management recommendations for less common non-tuberculous mycobacterial pulmonary diseases - 23/06/22

Doi : 10.1016/S1473-3099(21)00586-7

Christoph Lange, ProfMD ^a,^b,^c,⁎ , Erik C Böttger, ProfMD ^d, Emmanuelle Cambau, ProfMD ^e, David E Griffith, ProfMD ^f, Lorenzo Guglielmetti, MD ^e,^h, Jakko van Ingen, ProfMD ⁱ, Shandra L Knight, MS ^g, Theodore K Marras, MD ^j, Kenneth N Olivier, MD ^k, Miguel Santin, MD ^l, Jason E Stout, ProfMD ^m, Enrico Tortoli, ScD ⁿ, Dirk Wagner, ProfMD ^o, Kevin Winthrop, ProfMD ^p, Charles L Daley, ProfMD ^f
on behalf of the
expert panel group for management recommendations in non-tuberculous mycobacterial pulmonary diseases^{^†}
Members listed in the Supplementary Material

Christoph Lange, Claire Andrejak, Erik Böttger, Emmanuelle Cambau, David Griffith, Lorenzo Guglielmetti, Jakko van Ingen, Shandra Knight, Philip Leitman, Theodore K. Marras, Kenneth N. Olivier, Miguel Santin, Jason E. Stout, Enrico Tortoli, Dirk Wagner, Richard J. Wallace, Kevin Winthrop, Charles Daley

^a Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany

^b German Center for Infection Research (DZIF), Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany

^c Baylor College of Medicine, Houston, TX, USA

^d Institute of Medical Microbiology, National Reference Center for Mycobacteria, University of Zurich, Zurich, Switzerland

^e National Reference Center for Mycobacteria and Antimycobacterial Resistance, AP-HP GHU Nord, Mycobacteriology, Inserm, IAME UMR 1137, University of Paris, Paris, France

^f National Jewish Health and University of Colorado Health Sciences, Denver, CO, USA

^g Library and Knowledge Services, Denver, CO, USA

^h Sorbonne University, Inserm, Centre for Immunology and Infectious Diseases, Paris, France

ⁱ Radboud Center for Infectious Diseases, Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, Netherlands

^j Department of Medicine, University of Toronto and University Health Network, Toronto, ON, Canada

^k Pulmonary Branch, National Heart, Lung and Blood Institute, Bethesda, MD, USA

^l Service of Infectious Diseases, Bellvitge University Hospital-IDIBELL, University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain

^m Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA

ⁿ Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy

^o Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany

^p Divisions of Infectious Diseases, Schools of Public Health and Medicine, Oregon Health and Science University, Portland, OR, USA

^* Correspondence to: Prof Christoph Lange Division of Clinical Infectious Diseases, Research Center Borstel, 23845 Borstel, Germany Division of Clinical Infectious Diseases Research Center Borstel Borstel 23845 Germany

Summary

The 2020 clinical practice guideline for the treatment of non-tuberculous mycobacterial pulmonary disease (NTM-PD) by the American Thoracic Society, European Respiratory Society, European Society of Clinical Microbiology and Infectious Diseases, and Infectious Diseases Society of America; and the 2017 management guideline by the British Thoracic Society covered pulmonary diseases in adults caused by Mycobacterium avium complex, Mycobacterium kansasii, Mycobacterium xenopi, and Mycobacterium abscessus. In order 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, our expert panel group performed systematic literature searches to provide management guidance for pulmonary diseases caused by seven additional organisms: Mycobacterium chelonae, Mycobacterium fortuitum, Mycobacterium genavense, Mycobacterium gordonae, Mycobacterium malmoense, Mycobacterium simiae, and Mycobacterium szulgai. Treatment recommendations were developed by a structured consensus process. The evidence from the scientific literature published in English for treatment recommendations for pulmonary diseases caused by other NTM species was of very low quality, with the exception of M malmoense, and based on the evaluation of case reports and case series. For M malmoense, results from two randomised controlled trials and three retrospective cohort studies provided a better evidence base for treatment recommendations, although the evidence was still of low quality.

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Vol 22 - N° 7

P. e178-e190 - juillet 2022 Retour au numéro

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