About Pulmonary Nontuberculous Mycobacteria (NTM)

On this page:
About pulmonary NTM
Transmission of pulmonary NTM
People most at risk
Treatment of pulmonary NTM
Tracking pulmonary NTM
More about pulmonary NTM

About pulmonary NTM

• Nontuberculous mycobacteria (NTM) are opportunistic bacteria that are widespread and naturally occur in the environment, especially in soil and water.
• Pulmonary NTM infections, which occur in the lungs, result from inhalation of airborne particles containing the bacteria.
  • Pulmonary specimens include sputum samples, tracheal secretions, lung biopsies and bronchoalveolar lavage.
• The prevalence of human disease and death associated with pulmonary NTM has increased over the last two decades. The reason for this is unknown.
• Symptoms of pulmonary NTM infection are similar to those of tuberculosis and include cough with sputum production, shortness of breath, tiredness or fatigue, fever, unplanned weight loss, lack of appetite, night sweats, and coughing up blood.

Transmission of pulmonary NTM

• Pulmonary NTM infections result from inhalation of airborne particles containing the bacteria.
• Reported healthcare-associated outbreaks of pulmonary NTM have been caused by numerous factors involved with patient care.
  • These have included the water supply linked to a common patient shower, a contaminated hospital ice machine, a hydrotherapy pool in which children with cystic fibrosis were regular users, contaminated aqueous solution or contaminated potable water used in the processing of reusable dialysis filters, contaminated peritoneal dialysis machines, and contaminated bronchoscopes.

People most at risk

• Pulmonary NTM infection can present at any age, but it is most common in patients over 50 years of age.
• People who have an existing lung disease are at increased risk for pulmonary NTM infection:
  • Bronchiectasis (enlargement of the airways)
  • Chronic obstructive pulmonary disease (COPD)
  • Cystic fibrosis
    • Person-to-person transmission of pulmonary NTM is rare; however, there have been reports of potential transmission of mycobacterium species in institutions caring for cystic fibrosis patients.
  • Alpha-1 antitrypsin deficiency
  • People who have a prior infection with tuberculosis
• However, emerging data suggest that many persons without such existing conditions may be genetically susceptible to pulmonary NTM infection.

Treatment of pulmonary NTM

• Treatment of pulmonary NTM generally requires consultation with a specialist.
• NTM are often resistant to many antibiotics. Treatment varies depending on the individual patient infected and the body site of infection. Treatment frequently requires a combination of 2 to 3 antibiotics for a prolonged period of time (months to a year).

Tracking pulmonary NTM

• MDH began conducting sentinel laboratory-based surveillance on October 1, 2019, among residents of Hennepin and Ramsey counties.
• At this time, surveillance for pulmonary NTM is reportable via the laboratories that identify the organism.

More about pulmonary NTM

• CDC: Nontuberculous Mycobacteria (NTM) Infections
  NTM overview, symptoms, and more information for clinicians and public health professionals