Mycobactéries et mucoviscidose : état des lieux et recommandations récentes

Non-tuberculous mycobacteria (NTM) represent a recent threat to patients with cystic fibrosis (CF). Cystic fibrosis is a Mendelian deficit, at the level of the cftr gene, encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein. There is a peculiar link between CF and NTM. Indeed, the incidence of pulmonary NTM infections has increased in recent years, with two predominant NTM: Mycobacterium avium complex and the complex Mycobacterium abscessus. Clinical support, biological diagnostic and therapeutic aspects are complex. Pre-existing impairment of respiratory function of patients with CF, the presence in the environment of the NTM, make difficult the accountability of NTM isolated from the sputum of patients. Multidrug resistance to antibiotics of isolated NTM also complicates the treatment of these infections. It did not exist until today's national and international recommendations regarding the handling of patients with CF and infected by NTM. Two recent publications comprising diagnostic, clinical and therapeutic support present now expert advices that will help in the future to better understand the impact of NTM in altering ventilatory functions in patients suffering from CF.