There are more than 100 species of NTM, but in the U.S. the most frequently isolated species associated with disease are M. avium complex (MAC), M. marinum (skin and soft tissue infections), M. kansasii (southern states), and M. xenopi (states along the Canadian border). The class of rapidly growing mycobacteria, including M. abscessus, M. chelonae, and M. fortuitum, are also important causes of NTM disease.
Extrapulmonary NTM disease manifests as cutaneous, bone, joint, lymph node, or central nervous system (CNS) disease. Cutaneous infections typically result from either direct inoculation during trauma, surgical or medical procedures, exposures to whirlpool baths, or other settings such as nail salons or tattoo procedures. Isolated lymphadenitis occurs in otherwise healthy children, generally under 5 years of age. Disseminated extrapulmonary disease generally only occurs in immunocompromised patients (e.g., HIV, transplant, cancer, end-stage renal disease, others) and typically results from infection via the gastrointestinal tract with hematogenous spread of organism.
Health Care Providers and Clinical Laboratories
Health care providers and clinical laboratories are required by law to report all cases and test results indicative of and specific for
extrapulmonary nontuberculous mycobacteria (NTM) within one working day.
For Local Health Departments
M. chimaera and Sorin Stockert 3T heater-cooler device
CDC is advising hospitals to alert patients who have had open-heart surgery involving the Sorin Stockert 3T heater-cooler device that they may be at risk for developing a life-threatening infection from M. chimaera, which is a species of non-tuberculous mycobacterium (NTM).
Suggested Resources for Hospitals:
To assist hospitals in their outreach, the CDC has produced a Toolkit (pdf), which includes:
- An embargoed advisory from the CDC,
- Suggested next steps,
- Talking points for hospitals that have and have not used the device,
- A sample patient notification letter,
- A sample primary health care provider notification letter,
- A sample letter to patients to take to their health care provider, and
- Contact information if you have further questions.