Nontuberculous mycobacterial infections of the lung

There is an increasing appreciation for the role of nontuberculous mycobacteria (NTM) as pathogens causing pulmonary disease, disseminated disease, or both in immunocompetent and immunocompromised individuals. Species previously considered nonpathogenic have been shown to cause pulmonary infection. The majority of immunocompetent patients with NTM pulmonary infection have underlying lung disease. New diagnostic techniques such as gene probes, gas-liquid and high-pressure chromatography, and polymerase chain reaction offer significant advantages in the rapid identification of NTM species. Some of these techniques allow identification of mycobacteria directly from clinical specimens. The fluoroquinolones, rifabutin, and newer macrolides offer advances in the treatment of infections that are caused by NTM and are resistant to the traditional antimycobacterial drugs.