Current and future management of non-tuberculous mycobacterial pulmonary disease (NTM-PD) in the UK

Marc Lipman (Lead / Corresponding author), Joanne Cleverley, Tom Fardon, Besma Musaddaq, Daniel Peckham, Roald van der Laan, Paul Whitaker, Jacqui White

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Abstract

A rising number of non-tuberculous mycobacterial (NTM) isolates are being identified in UK clinical practice. There are many uncertainties around the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD), including its epidemiology, diagnosis, treatment and prevention. Regional variations in how patients with NTM-PD are managed reflects the lack of standardised pathways in the UK. Service optimisation and multidisciplinary working can improve the quality of care for patients with NTM-PD, including (1) better identification of patients at risk of NTM-PD and modification of risk factors where applicable; (2) standardisation of reference laboratory testing to offer clinicians access to accurate and prompt information on NTM species and drug sensitivities; (3) development of recognised specialist NTM nursing care; (4) standardisation of NTM-PD imaging strategies for monitoring of treatment and disease progression; (5) establishment of a hub-and-spoke model of care, including clear referral and management pathways, dedicated NTM-PD multidisciplinary teams, and long-term patient follow-up; (6) formation of clinical networks to link experts who manage diseases associated with NTM; (7) enabling patients to access relevant support groups that can provide information and support for their condition; and (8) development of NTM research groups to allow patient participation in clinical trials and to facilitate professional education.

Original languageEnglish
Article numbere000591
Number of pages8
JournalBMJ Open Respiratory Research
Volume7
Issue number1
Early online date21 Jun 2020
DOIs
Publication statusPublished - 21 Jun 2020

Keywords

  • bacterial infection
  • bronchiectasis
  • imaging/CT MRI
  • immunodeficiency
  • infection control
  • opportunist lung infections
  • rare lung diseases
  • respiratory Infection

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