Nontuberculous Mycobacteria (NTM): Properties, Pathogenic genera and their diseases

We have already discussed the common properties and classification of Nontuberculous Mycobacteria (NTM) in previous blog post. In this post you can find information regarding pathogenic genera, their epidemiology and types of disease caused by them.

Mycobacterium avium-intracellularae complex (MAC): Nonphotochromogens

These Non Tuberculous Mycobacteria (NTM) are classified as Nonphotochromogens in Runyon classification. M avium complex were first recognized as human pathogens in 1990s.  They are the important pathogen in immunocompromised and immunocompetent  populations.

They are ubiquitous in the environmental sources including natural waters; soil etc.  Taxonomically, the M. avium-intracellularae complex comprises M. avium, M. intracellularae, M. paratuberculosis, M. lepraemurium and the “wood pigeon” bacillus.

These organisms’ causes opportunistic infections in the immunocompromised patients such as individuals infected with HIV. The lungs are primarily affected, but infection can spread to other organs as well. Disseminated disease is seen in case of AIDS patient.

Mycobacterium fortuitum complex (Rapid growers)

It is a group of free living; rapid growing NTM. The colonies of these organisms appear on solid media in 7 days or less. They constitute the second major group of NTM.

They have been found in soils, marshes, rivers etc. People acquire the infection when organisms gain entry into the host by inoculation into skin and subcutaneous trauma, injections, or surgery or through animal contact.

Injection site abscesses among drug users are the most common form of this disease but the pulmonary infection occurs occasionally. Infection can also be associated with implanted devices.  Little is known about the pathogenesis of these organisms.

Of the potentially pathogenic, rapidly growing NTM, M. fortuitum, M. chelonae, and M. abscessus constitute approximately 97% of disease.

Mycobacterium scrofulaceum (Scotochromogens)

It is a NTM classified as Scotochromogens and is found in raw milk, soil, water and in dairy products.
It is the most common cause of granulomatous cervical lymphadenitis in children. The disease is characterized by enlarged lymph nodes, which may ulcerate or form draining sinus tracts.

Among the NTM classified as Photochromogens, M. kansasii, M. marinum are the major potential pathogens. M. asiaticum, M. intermedium are found to be associated with pulmonary disease.

  1. Mycobacterium Kansasii
    Causes chronic pulmonary disease as well as infections of the skin and subcutaneous lymph nodes.
    The disease tends to progress slowly and is susceptible to usual mycobacterial drugs.
  2. Mycobacterium marinum
    It grows much lower temperatures than other mycobacteria (i.e. around 30oC) and is present in both fresh and salt water.  It causes nodular ulcerative lesions of the skin at the site of trauma. The infection may spread to the liver through lymphatic circulation.


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