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US Cystic Fibrosis Foundation and European Cystic Fibrosis Society Consensus Recommendations for the Management of Nontuberculous Mycobacteria in Individuals with Cystic Fibrosis.

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Authors

Floto, R Andres 
Olivier, Kenneth N 
Saiman, Lisa 
Daley, Charles L 
Herrmann, Jean-Louis 

Abstract

Nontuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause chronic pulmonary infection, particularly in individuals with pre-existing inflammatory lung disease such as cystic fibrosis (CF). Pulmonary disease caused by NTM has emerged as a major threat to the health of individuals with CF but remains difficult to diagnose and problematic to treat. In response to this challenge, the U.S. Cystic Fibrosis Foundation and the European Cystic Fibrosis Society convened an expert panel of specialists to develop consensus recommendations for the screening, investigation, diagnosis and management of NTM pulmonary disease in individuals with CF. Nineteen experts were invited to participate in the recommendation development process. PICO methodology and systematic literature reviews were employed to inform draft recommendations. An anonymous voting process was used by the committee to reach consensus. All committee members were asked to rate each statement on a scale of 0, completely disagree, to 9, completely agree, with 80% or more of scores between 7 and 9 being considered 'good' agreement. Additionally the committee solicited feedback from the CF communities in the U.S. and Europe and considered the feedback in the development of the final recommendation statements. Three rounds of voting were conducted to achieve 80% consensus for each recommendation statement. Through this process, we have generated a series of pragmatic, evidence-based recommendations for the screening, investigation, diagnosis, and treatment of NTM infection in individuals with CF as an initial step in optimising management for this challenging condition. 4 BACKGROUND: Epidemiology of nontuberculous mycobacteria in

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Keywords

cystic fibrosis, Nontuberculous mycobacteria

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BMJ
Sponsorship
Cystic Fibrosis Foundation; European Cystic Fibrosis Society, The Wellcome Trust & Cambridge NIHR BRC (RAF); Intramural program of the National Heart, Lung, and Blood Institute, NIH (KNO); Vaincre La Mucoviscidose (VLMIC1014 and RF20120600689) and the Région Ile-de-France Domaine d’Intérêt Majeur Maladies Infectieuses et Emergentes (JLH); CF Foundation Clinical Research Award (NICK13A0) (JAN); Imperial College London NIHR Respiratory BRU (DB);.