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Audit, research and guideline update
US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis: executive summary
  1. R Andres Floto1,2,
  2. Kenneth N Olivier3,
  3. Lisa Saiman4,
  4. Charles L Daley5,
  5. Jean-Louis Herrmann6,7,
  6. Jerry A Nick8,
  7. Peadar G Noone9,
  8. Diana Bilton10,
  9. Paul Corris11,
  10. Ronald L Gibson12,
  11. Sarah E Hempstead13,
  12. Karsten Koetz14,
  13. Kathryn A Sabadosa13,
  14. Isabelle Sermet-Gaudelus15,
  15. Alan R Smyth16,
  16. Jakko van Ingen17,
  17. Richard J Wallace18,
  18. Kevin L Winthrop19,
  19. Bruce C Marshall20,
  20. Charles S Haworth2
  1. 1Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
  2. 2Cambridge Centre for Lung Infection, Papworth Hospital, Cambridge, UK
  3. 3Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
  4. 4Department of Pediatrics, Columbia University Medical Center, Pediatric Infectious Diseases, New York, New York, USA
  5. 5Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, Colorado, USA
  6. 6INSERM U1173, UFR Simone Veil, Versailles-Saint-Quentin University, Saint-Quentin en Yvelines, France
  7. 7AP-HP, Service de Microbiologie, Hôpital Raymond Poincaré, Garches, France
  8. 8Department of Medicine, National Jewish Health, Denver, Colorado, USA
  9. 9Division of Pulmonary and Critical Care Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  10. 10Department of Respiratory Medicine, Royal Brompton Hospital, London, UK
  11. 11Department of Respiratory Medicine, Freeman Hospital High Heaton, Newcastle, UK
  12. 12Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
  13. 13The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
  14. 14Department of Pediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden
  15. 15Service de Pneumo-Pédiatrie, Université René Descartes, Hôpital Necker-Enfants Malades, Paris, France
  16. 16Division of Child Health, Obstetrics & Gynaecology, University of Nottingham, Nottingham, UK
  17. 17Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
  18. 18Department. of Microbiology, University of Texas Health Science Center, Tyler, Texas, USA
  19. 19Divisions of Infectious Diseases, Public Health and Preventive Medicine, Oregon Health and Science University, Portland, Oregon, USA
  20. 20Cystic Fibrosis Foundation, Bethesda, Maryland, USA
  1. Correspondence to Dr R Andres Floto, Cambridge Institute for Medical Research, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK; arf27{at}


Non-tuberculous 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 (PD) 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 US Cystic Fibrosis Foundation (CFF) and the European Cystic Fibrosis Society (ECFS) convened a panel of 19 experts to develop consensus recommendations for the screening, investigation, diagnosis and management of NTM-PD in individuals with CF. PICO (population, intervention, comparison, outcome) methodology and systematic literature reviews were employed to inform draft recommendations, which were then modified to achieve consensus and subsequently circulated for public consultation within the USA and European CF communities. We have thus generated a series of pragmatic, evidence-based recommendations as an initial step in optimising management for this challenging condition.

  • Atypical Mycobacterial Infection
  • Cystic Fibrosis
  • Respiratory Infection

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