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Causes

Causes Of NTM Lung Disease

Nontuberculous (NTM) mycobacteria are naturally occurring bacteria commonly found in water (both natural sources and treated tap water) and soil in the environment.2 Most NTM species do not cause infections in humans, but some do including:1

  • Mycobacterium avium complex (MAC), the most common1
    • Mycobacterium avium
    • Mycobacterium avium intracellulare (also known as MAI)
  • Mycobacterium abscessus
  • Mycobacterium kansasii
  • Mycobacterium xenopi

NTM are also referred to as atypical mycobacteria, mycobacteria other than tuberculosis (MOTT), or environmental mycobacteria.3

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Environmental Sources

You or your child may become infected with NTM mycobacteria when you breathe in droplets of water and particles of soil in the air (for example during showers and baths, and activities like gardening). Biofilm in sink faucets and showerheads can act as a breeding ground for mycobacteria.4

What is biofilm?

A biofilm is a thin, slimy film of microorganisms that forms on a surface. Biofilms are made up of bacteria, fungi, and other microorganisms that secrete a sticky, protective layer of extracellular polymeric substances (EPS). These substances help the microorganisms to adhere to the surface and to each other, forming a cohesive community.

References

1. Nontuberculous Mycobacterial Lung Disease. National Organization for Rare Disorders (NORD). (Last accessed February 23, 2024).

2. What is NTM? Bronchiectasis and NTM 360°. COPD Foundation. (Last accessed January 17, 2024).

3. Nontuberculous Mycobacteria (NTM) Infections. CDC Centers for Disease Control and Prevention. (Last accessed January 17, 2024).

4. Joseph O Falkinham. Environmental Sources of Nontuberculous Mycobacteria. Clinics in Chest Medicine 2014;36(1):35-41.

5. Jyotsna Bhattacharya,  , et al. Nontuberculous Mycobacterial Infections in Children. Pediatrics In Review 2019;40(4):179-190. 

6. Nutrition Guide. NTM Info & Research, Inc. (Last accessed January 17, 2024).

7. NTM Lung Disease Treatment. NTM Info & Research, Inc.  - Medications (Last accessed January 17, 2024).

8. NTM Lung Disease Treatment. NTM Info & Research, Inc. - Reducing Exposure (Last accessed January 17, 2024).

9. Joseph O Falkinham. Reducing Human Exposure to Mycobacterium avium. Annals of the American Thoracic Society 2013;10(4):378-382.

10. O'Donnell DE, Parker CM.  COPD exacerbations 3: Pathophysiology. Thorax 2006;61:354-361. 

11. Wolkove N,   et al.  Use of a Mucus Clearance Device Enhances the Bronchodilator Response in Patients With Stable COPD. CHEST 2002;121(3):702-707.

12. NTM Info & Research, Inc. (Last accessed January 17, 2024). 

13. NTM Info & Research, Inc. (Last accessed February 23, 2024).