Though rare, NTM infections can cause severe skin and lung symptoms that can be challenging to treat. Early diagnosis and antibiotic treatment are essential to avoid complications and improve your outlook.
Nontuberculosis mycobacteria (NTM) are common bacteria that can result in an infection. They usually affect people with a weakened immune system. NTM infections are often challenging to diagnose and treat.
In this article, we explore the common types of NTM and how they can affect your health.
NTM is a group of bacteria found in soil, water, and dust. There are more than 190 species of NTM, but the most common ones include:
Mycobacterium avium complex (MAC)
MAC consists of many species,
NTM can enter your lungs if you breathe next to contaminated water, soil, or dust. In essence, everyone can breathe in NTM. Most of the time, they do not cause infections, but some people are at greater risk.
NTM infections can affect anyone, but specific people are more likely to develop the infection. You may be at higher risk if you:
- have an autoimmune disorder, like rheumatoid arthritis
- have an immunodeficiency disorder, like HIV
- are taking immune-suppressing medications
- have a damaged lung from diseases such as cystic fibrosis, bronchiectasis, or COPD
- are in postmenopause
- are over 65 years old
- use an internal medical device, such as a ventilator or catheter
Common symptoms of NTM infections include:
- chronic cough with mucus and, later, blood
- weight loss
- night sweats
- loss of appetite
- shortness of breath
- chest pain
- recurring respiratory infections
Seek emergency medical care if you have any severe symptoms, such as chest pain or trouble breathing.
NTM infections can be challenging to diagnose because they grow slowly and can show similar symptoms to other lung diseases. Because of this, doctors have to use various methods to diagnose them.
First, a doctor will perform a physical exam and ask about your medical history. They may also order lab tests. These tests may
- sputum culture, to identify the type of NTM in your lungs
- bronchoscopy, which involves inserting a thin tube with a camera into your lungs to look for signs of infection
- imaging, such as X-ray or CT scan, to help detect lung changes due to NTM infections
- tissue biopsy, to confirm an NTM diagnosis and determine the most effective treatment
Treatment for an NTM infection depends on its type and severity. It may require therapy for up to a year or even longer, especially if your doctor finds it difficult to treat.
Generally, a doctor will prescribe a combination of three to four antibiotics, such as:
- macrolides (azithromycin, clarithromycin)
- rifamycins (rifampin, rifabutin)
- aminoglycosides (streptomycin, tobramycin)
- fluoroquinolones (moxifloxacin, ciprofloxacin)
Taking multiple antibiotics can help reduce the chances of the infection becoming resistant to one of the antibiotics.
You may need surgery if tissues or organs become infected.
The outlook for people with NTM infections is generally positive. However, it depends on the severity of the infection and whether it affects other organs.
For example, according to a 2022 review, the 5-year all-cause mortality rate for people with lung disease from NTM ranges from 13–45%, which was double that of people who did not have an NTM infection.
Consider speaking with a doctor immediately if you notice symptoms, such as coughing up blood, shortness of breath, chest pain, or fever that lasts more than a few days. The earlier you get a diagnosis and treatment, the better your chances of avoiding serious complications.
The best way to prevent NTM infections is to practice good hygiene and avoid contact with contaminated water or soil. Ensure all your taps and water appliances are installed and working correctly, as these can be sources of NTM infection. You may also want to avoid swimming in untreated water or improperly chlorinated pools.
If your plumbing at home can sustain long durations of boiling water, consider setting your water heating above 176°F (80°C) and running every tap for at least 20 minutes. Doing this occasionally can help destroy any of the NTM in the piping systems, at the disadvantage of water waste and increased electrical costs.
Also, consider talking with a doctor about medications that may increase your risk of developing an NTM infection.
Here are some frequently asked questions about NTM.
Are nontuberculosis mycobacteria infections curable?
Yes, NTM infections
Are NTM diseases fatal?
Not all NTM diseases are fatal, but some can cause severe illness and even death if left untreated. It is vital to seek medical attention as soon as possible if you experience symptoms of an NTM infection.
Are NTM diseases hereditary?
NTM infections can be challenging to diagnose and treat. However, a cure is possible, especially if the infection is detected early and you follow your doctor’s suggestions.