Non-tuberculous Mycobacteria [NTM]

Non- Tuberculosis Mycobacteria (NTM) are Mycobacteria other than Mycobacteria tuberculosis (MOTT) that are ubiquitously distributed in environment. They are also called atypical mycobacteria or anonymous mycobacteria.

They are known to cause human disease. Most commonly, NTM infects skin, soft tissue, lymph nodes, wounds, bones, joints and implant devices.

Although the pathogen is different, most of the time, the disease manifestation resembles that of MTB. Hence it gains importance in the National TB Elimination Program (NTEP), as one of the differential diagnoses for tuberculosis.

Characteristics of Non-Tuberculosis Mycobacteria (NTM) 

• NTM survives outside human or animal host.
• They usually are non-pathogenic and commonly affect individual who are immune-compromised or have injury, except for few of the NTM species which affect immune- competent individuals.
• NTM are commensal organisms which inhabit the respiratory passage.
• NTM consists of more than 160 different species of bacteria.
• Their existence in the environment varies from place to place.
• The most common species causing NTM is the Mycobacteria avium complex.

Diseases Caused by NTM

• Non-tuberculosis mycobacteria can cause pulmonary infections which are rare but may have presenting symptoms similar to tuberculosis.
• Everyone comes in contact with NTM but very few people develop NTM diseases.
• Some individuals are at a higher risk of developing pulmonary NTM diseases such as patients with bronchiectasis, chronic obstructive lung disease, cystic fibrosis, alpha-1 antitrypsin deficiency or who have had tuberculosis in the past.
• Among the immune-compromised or patients with AIDS, individuals may develop pulmonary NTM as part of disseminated NTM infections.

Resources

• Guidelines for Programmatic Management of Drug Resistant Tuberculosis in India-March 2021
• American Thoracic Society Patient Education Series, 2017

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