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The importance of early diagnosis of Mycobacterium abscessus complex in patients with cystic fibrosis
Author(s) -
Ravnholt Cecilie,
Kolpen Mette,
Skov Marianne,
Moser Claus,
Katzenstein Terese L.,
Pressler Tania,
Høiby Niels,
Qvist Tavs
Publication year - 2018
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/apm.12903
Subject(s) - mycobacterium abscessus , cystic fibrosis , medicine , intensive care medicine , disease , nontuberculous mycobacteria , asymptomatic , immunology , mycobacterium , pathology , tuberculosis
Mycobacterium abscessus complex can cause severe lung infections and has proven to be a serious threat to patients with cystic fibrosis and a challenge for clinicians due to difficulties in timely diagnosis and complex multidrug treatment regimes. Mycobacterial culture is the gold standard for diagnosis, but in most cystic fibrosis centers it is performed less frequently than culture for other pathogens. Consensus today recommends just one annual mycobacterial culture for asymptomatic patients with cystic fibrosis, a strategy likely to lead to diagnostic delays. Postponement of diagnosis might be the deciding factor in whether an early colonization turns into chronic infection. This review highlights the latest developments in knowledge about the pathogenicity and clinical consequences of M. abscessus complex pulmonary disease, addressing the central theme of why pulmonary infection requires early identification and aggressive antibiotic treatment. The window of opportunity, before M. abscessus complex transforms from a mucosal colonizer to a chronic biofilm infection, is where microbial eradication is most likely to be successful, making early diagnosis essential for improved outcomes.