Diagnosis of Nontuberculous Mycobacterial Infections

Jakko van Ingen, MD, PhD


Semin Respir Crit Care Med. 2013;34(1):103-109. 

In This Article


The nontuberculous mycobacteria (NTM) are a grouping of all Mycobacterium species other than the obligate pathogens M. tuberculosis complex and M. leprae. They are typically environmental organisms residing in soil and natural as well as treated water.[1] Although generally of low pathogenicity to humans, NTM can cause a wide array of clinical diseases; pulmonary disease is most frequent, followed by lymphadenitis in children, skin disease (by M. marinum, particularly in fish tank fanciers), and other extrapulmonary or disseminated infections in the severely immunocompromised.[2] Of the >140 NTM species now reported in the literature, some 25 species have been strongly associated with these NTM diseases; the remainder are true environmental organisms rarely encountered in clinical samples.

NTM differ strongly in their growth rate, temperature tolerance, and drug susceptibility.[1–4] Owing to the differences in patient populations with their underlying lung diseases or immunodeficiencies as well as between the causative mycobacteria, diagnosis of NTM disease is complex and requires good communication between clinicians, radiologists, and microbiologists.