Non-tuberculous Mycobacterial Infections in Thoracic Transplant Candidates and Recipients
Purpose of Review To review and discuss the epidemiology, risk factors, clinical presentation, diagnosis, and treatment of non-tuberculous mycobacteria (NTM) in thoracic transplantation. Recent Findings Non-tuberculous mycobacteria are ubiquitous but are an uncommon cause of disease after solid orga...
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Published in | Current infectious disease reports Vol. 20; no. 6; p. 14 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
New York
Springer US
01.06.2018
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Purpose of Review
To review and discuss the epidemiology, risk factors, clinical presentation, diagnosis, and treatment of non-tuberculous mycobacteria (NTM) in thoracic transplantation.
Recent Findings
Non-tuberculous mycobacteria are ubiquitous but are an uncommon cause of disease after solid organ transplantation. The incidence of infection is higher in thoracic transplant recipients than in abdominal transplant recipients, with most cases seen after lung transplantation. It is associated with increased morbidity and, occasionally, mortality. Infection in the pre-transplant setting can occur in lung transplant candidates, often posing a dilemma regarding transplant listing. Disease manifestations are diverse, and pulmonary disease is the most common. Diagnosis requires a high index of suspicion. Treatment requires a multiple-drug combination and is limited by drug-drug interactions and tolerability.
Mycobacterium abscessus
is a challenge in lung transplant recipients, due to its intrinsic resistance and propensity to relapse even after prolonged therapy.
Mycobacterium chimaera
is an emerging pathogen associated with contamination of heater-cooler units and is described to cause disease months after cardiothoracic surgery.
Summary
NTM infections in thoracic organ transplant recipients are uncommon but are associated with substantial morbidity and mortality. Data from larger multicenter studies is needed to better define the epidemiology of NTM in thoracic transplantation, best treatment options, and the management of infected transplant candidates. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 |
ISSN: | 1523-3847 1534-3146 |
DOI: | 10.1007/s11908-018-0619-8 |