TAILIEUCHUNG - Chapter 160. Nontuberculous Mycobacteria

The designation nontuberculous mycobacteria (NTM) encompasses the mycobacterial species other than organisms of the Mycobacterium tuberculosis complex and M. leprae. The NTM are distributed widely in the environment, are typically acquired from environmental sources, and therefore are also referred to as environmental mycobacteria. Most species are less virulent for humans than M. tuberculosis. Thus symptomatic infections are often associated with local or generalized defects in host defenses. . | Chapter 160. Nontuberculous Mycobacteria The designation nontuberculous mycobacteria NTM encompasses the mycobacterial species other than organisms of the Mycobacterium tuberculosis complex and M. leprae. The NTM are distributed widely in the environment are typically acquired from environmental sources and therefore are also referred to as environmental mycobacteria. Most species are less virulent for humans than M. tuberculosis. Thus symptomatic infections are often associated with local or generalized defects in host defenses. Because isolation of NTM from a clinical specimen may represent true infection colonization or environmental contamination strict criteria are required to assess the clinical significance of a positive culture. Although the 90 species of NTM have been associated with a wide variety of infections most infections are due to a relatively limited number of species that cause characteristic patterns of disease Table 1601 . Table 160-1 Main Species of Nontuberculous Mycobacteria NTM and Patterns of Disease Patterns of Disease Species Grow Environme Cutane Pulmon Dissemina Other th on Solid Medi a ntal ous Reservoir ary ted M. avium Slow Hot water -systems natural water soil Lymphade nitis M. intracellul are Slow Hot water -systems natural water soil Lymphade nitis M. kansasii Slow Potable and -natural - water M. Rapid Potable and - Sporotrich abscessus natural oid spread M. water soil chelonae M. fortuitum M. Slow Fish tanks -- Sporotrich marinum salt water oid spread M. Slow Natural -- quot Bur ulcerans water uli ulcer quo t osteomyelit is Symbols indicate relative prevalence among NTM infections of the indicated species and pattern of disease most common common reported but uncommon - rare or not reported. Microbiology Like M. tuberculosis NTM organisms are acid-fast bacilli AFB resisting decolorization after staining. NTM have conventionally been characterized by the time required for clinical specimens to yield visible growth on solid media.

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