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Editorials |

The Growing Challenge of Nontuberculous MycobacteriaThe Challenge of Nontuberculous Mycobacteria

Neil W. Schluger, MD, FCCP
Author and Funding Information

From the Department of Medicine, the Department of Epidemiology, and the Department of Environmental Health Science, Columbia University, College of Physicians and Surgeons, Mailman School of Public Health.

CORRESPONDENCE TO: Neil W. Schluger, MD, FCCP, Columbia University Medical Center, PH-8 E, Room 101, 622 W 168th St, New York, NY 10032; e-mail: ns311@cumc.columbia.edu


FINANCIAL/NONFINANCIAL DISCLOSURES: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(3):529-530. doi:10.1378/chest.14-0279
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Over the past several years, there has been an increasing appreciation of the burden of pulmonary disease caused by nontuberculous mycobacteria (NTM) in both the general population1-3 and in patients receiving immunosuppressive drugs. Soon after the first tumor necrosis factor-α antagonist was introduced into clinical use, the increased risk of mycobacterial infections, TB especially, in patients receiving these agents was recognized.4 Physicians are by now well sensitized to the importance of screening patients with various rheumatic and other systemic inflammatory conditions for TB prior to initiation of treatment with tumor necrosis factor-α blockers. Nearly every practicing pulmonologist by now is aware of the challenges of treating patients with Mycobacterium avium, Mycobacterium xenopi, Mycobacterium abscessus, Mycobacterium kansasii, Mycobacterium fortuitum, and others. It is well appreciated, through both large epidemiologic studies and individual experience, that in economically developed countries that generally have low incidence rates of TB, the burden of NTM infections far outstrips that of TB. Much less well understood, however, are the particular risk factors for developing infections with NTM, the natural history of these infections, and the best approaches to treatment. In this issue of CHEST (see page 563), Brode and colleagues5 make an important contribution to our understanding of the epidemiology of NTM infections and they point the way to important avenues of future research.

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