Current and future management of non-tuberculous mycobacterial pulmonary disease (NTM-PD) in the UK

BMJ Open Respir Res. 2020 Jun;7(1):e000591. doi: 10.1136/bmjresp-2020-000591.

Abstract

A rising number of non-tuberculous mycobacterial (NTM) isolates are being identified in UK clinical practice. There are many uncertainties around the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD), including its epidemiology, diagnosis, treatment and prevention. Regional variations in how patients with NTM-PD are managed reflects the lack of standardised pathways in the UK. Service optimisation and multidisciplinary working can improve the quality of care for patients with NTM-PD, including (1) better identification of patients at risk of NTM-PD and modification of risk factors where applicable; (2) standardisation of reference laboratory testing to offer clinicians access to accurate and prompt information on NTM species and drug sensitivities; (3) development of recognised specialist NTM nursing care; (4) standardisation of NTM-PD imaging strategies for monitoring of treatment and disease progression; (5) establishment of a hub-and-spoke model of care, including clear referral and management pathways, dedicated NTM-PD multidisciplinary teams, and long-term patient follow-up; (6) formation of clinical networks to link experts who manage diseases associated with NTM; (7) enabling patients to access relevant support groups that can provide information and support for their condition; and (8) development of NTM research groups to allow patient participation in clinical trials and to facilitate professional education.

Keywords: bacterial infection; bronchiectasis; imaging/CT MRI; immunodeficiency; infection control; opportunist lung infections; rare lung diseases; respiratory Infection.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Biomedical Research / trends
  • Disease Progression
  • Female
  • Humans
  • Mycobacterium Infections, Nontuberculous / diagnosis
  • Mycobacterium Infections, Nontuberculous / epidemiology*
  • Mycobacterium Infections, Nontuberculous / prevention & control
  • Mycobacterium Infections, Nontuberculous / therapy*
  • Nontuberculous Mycobacteria / isolation & purification
  • Quality of Health Care / organization & administration*
  • Quality of Health Care / trends
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / epidemiology*
  • Tuberculosis, Pulmonary / prevention & control
  • Tuberculosis, Pulmonary / therapy*
  • United Kingdom