Empfehlungen zur Diagnostik und Therapie nichttuberkulöser Mykobakteriosen des Deutschen Zentralkomitees zur Bekämpfung der Tuberkulose (DZK) und der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin (DGP)

Zusammenfassung

Die nichttuberkulösen Mykobakteriosen umfassen eine Gruppe von Erkrankungen, die von Mykobakterien verursacht werden, die nicht dem Mycobacterium (M.) tuberculosis-Komplex und nicht M. leprae zugerechnet werden und durch eine breite Vielfalt in Hinsicht auf ihr Vorkommen und ihre Anpassungen an spezifische Umweltbedingungen charakterisiert sind. Einige Spezies können definierte Krankheitsbilder insbesondere bei Patienten mit systemischer Immunsuppression, vorbestehenden Lungenerkrankungen oder genetisch bedingter erhöhter Empfänglichkeit hervorrufen. Weltweit wird eine Zunahme der Prävalenz und der Bedeutung dieser Erregergruppe beobachtet. Die vorliegenden Empfehlungen fassen aktuelle Aspekte der Epidemiologie, der Pathogenese, Klinik, Diagnostik einschließlich mikrobiologischer Diagnostik und Resistenztestung, sowie der speziesabhängigen Therapie bei nichttuberkulösen Mykobakteriosen zusammen. Außerdem werden die besonderen Aspekte der Diagnostik und Therapie im Kindesalter und bei HIV-infizierten Patienten dargestellt.

Abstract

Nontuberculous mycobacterioses comprise a group of diseases caused by mycobacteria which do not belong to the Mycobacterium (M.) tuberculosis complex and are not ascribed to M. leprae. These mycobacteria are characterized by a broad variety as to environmental distribution and adaptation. Some of the species may cause specific diseases, especially in patients with underlying immunosuppressive diseases, chronic pulmonary diseases or genetic predisposition, respectively. Worldwide a rising prevalence and significance of nontuberculous mycobacterioses can be recognized. The present recommendations summarise actual aspects of epidemiology, pathogenesis, clinical aspects, diagnostics – especially microbiological methods including susceptibility testing –, and specific treatment for the most relevant species. Diagnosis and treatment of nontuberculous mycobacterioses during childhood and in HIV-infected individuals are described in separate chapters.

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