The history of Nontuberculous Mycobacteria (NTM) dates back to the late 19th century when "tuberculosis" in chickens was first described in 1868.1 By 1890, this organism was recognized in the laboratory to be distinct, or different, from M. tuberculosis, the cause of tuberculosis. The organism that caused disease in chickens was later identified to be M. avium. Because these organisms did not cause characteristic disease when injected into guinea pigs, they were recognized as distinct from M. tuberculosis and were not believed to cause disease in humans.
Remarkably it was not until the 1930s that NTM were recognized to cause disease in humans. One of the first cases of lung disease due to M. avium complex (MAC) was described in 1943 in a man with underlying silicosis (a form of lung disease). By the 1950s, pulmonary disease due to NTM became more commonly recognized and accounted for approximately 1-2 percent of admissions to tuberculosis sanatoriums in the southeastern United States.
Interest in NTM increased when HIV infected patients began to develop infections distributed throughout the body due to various NTM species, particularly M. avium.2 As antiretroviral drugs (medications for the treatment of infection by retroviruses, primarily HIV) became available, the incidence of disseminated (infection with mycobacteria that spreads to many areas of the body simultaneously) MAC decreased.
We are now seeing an increase in the number of cases of pulmonary disease due to NTM, particularly among postmenopausal Caucasian women. In addition, there are increasingly frequent reports of NTM infections involving skin, soft tissues and bone/joints.
- Wallace R. History of MAC. (www.maclungdisease.org)
- Griffith DE, Aksamit T, Brown-Elliot BA, Catanzaro A, Daley C, Gordin F, Holland SM, Horsburgh R, Huitt G, Iademarco MF, Iseman M, Olivier K, Ruoss S, C. Fordham von Reyn, Wallace RJ, Winthrop K on behalf of the ATS Mycobacterial Diseases Subcommittee. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007;175:367-416.