Mycobactéries non tuberculeuses et mucoviscidose

Non-tuberculous mycobacteria (NTM) have emerged as important pathogens in cystic fibrosis (CF) patients, and have been isolated with prevalence ranging from 10 to 15% of patients. Mycobacteria belonging to the abscessus-chelonae complex (rapidly growing mycobacteria) or the avium-intracellulare complex (slowly growing mycobacteria) represent the most commonly isolated pathogens. Risk factors for NTM isolates in CF patients are older age, malnutrition and chronic airway colonisation with Aspergillus fumigatus. Studies are warranted to evaluate the impact of therapies (e. g., inhaled or systemic antibiotics, long-term macrolides, steroids) currently used in CF patients on NTM prevalence and their antibiotic susceptibility. Current diagnostic criteria for NTM infection have been established in non-CF patients and are difficult to apply to this population due to the overlap of clinical and radiological signs of CF and NTM infection. Some CF patients develop NTM infection that is responsible for increasing symptoms, airway structural damage and worsening lung function; these patients should receive prolonged antimycobacterial therapies. In other patients, despite repeated NTM isolation, the need for sustained therapy with its potential side effects is questionable. Appropriate studies will be required to evaluate diagnostic and treatment criteria for NTM infection in CF patients.