Non-tuberculous Mycobacteria (NTM) represent an escalating public health challenge that warrant attention from clinicians, researches, and public health officials. Alongside the notorious tuberculosis and leprosy, NTM belong to the same family of Mycobacteriaceae. Unlike their pathogenic relatives, NTM represents a diverse group of free-living environmental organisms that were once considered harmless saprophytes, but they are now recognized as significant opportunistic pathogens capable of causing a wide range of infections, most commonly causing NTM pulmonary disease (NTM-PD) in susceptible hosts, and less commonly in otherwise healthy individuals. Extra-pulmonary NTM diseases are increasingly reported, which are often related to medical procedures. With improved diagnostic techniques, heightened awareness among healthcare providers, changes in environmental exposure, and an aging population with more individuals susceptible to NTM infections, its global incidence has been on a rise. However, the published data may have underestimated its true incidence due to underdiagnoses and it not being a notifiable disease.
To date, approximately 200 different species of NTM have been identified. The clinical management of NTM-PD could be challenging. The presenting symptoms are often non-specific. Isolation of NTM from respiratory samples does not always indicate active disease, complicating treatment decisions. Diagnosing NTM-PD requires combination of clinical, radiological, and microbiological assessment, which could be complex and require input from respiratory specialist. Furthermore, they are notoriously difficult to treat, with high rates of antibiotic resistance and require prolonged, complex treatment regimens which could lead to significant side effects and poor patient adherence. Variable treatment response and reinfection could be frustrating to both physicians and patients.
As such, NTM infection represent a significant public health concern that requires ongoing researches to improve diagnostic efficacy, develop new effective therapeutic strategies, and identify efficient preventive strategies. Multidisciplinary collaboration among clinicians, epidemiologists, and microbiologists would be essential in tackling this growing burden.
