We all hear about bacterial infections all the time. But there are some types of bacteria that we don't talk about much, but can cause certain health problems, especially for people with weakened immune systems. Today, we're going to talk about a group of bacteria that normally live in the environment, but sometimes enter our bodies and cause infections.
What is this NTM?
Simply put, NTM is an abbreviation for Nontuberculous Mycobacteria . This is a group of bacteria. You may have heard of tuberculosis and leprosy. NTM is a group of mycobacteria that are related to the bacteria that cause those diseases, but do not cause those two diseases.
These bacteria can be found almost anywhere in the environment. They live especially in soil, dust, and water. Most of the time, even if these bacteria enter our bodies, we will not get sick. However, some people, especially those with weak immune systems, can get infected.
What parts of the body can an NTM infection affect?
- Lungs: The most common type of infection is lung infections.
- Blood
- Bones (for short, bones)
- Lymph nodes (swelling)
- Skin and soft tissue
In most cases, a healthy person with a good immune system rarely develops an infection outside of the lungs. However, in someone with a weak immune system, this infection can spread (disseminated) throughout the body.
What are the symptoms of an NTM infection?
There are several common symptoms of NTM infection. However, since these symptoms can also be seen in many other diseases, the presence of these symptoms alone does not necessarily indicate an NTM infection.
Common features are:
- Fever coming on
- Fatigue
- Weight loss
- Swollen lymph nodes
In addition to these common symptoms, other specific symptoms may also appear depending on the location of the infection. Let's take a look at what they are.
| Site of infection | Specific symptoms that may be seen |
|---|---|
| Skin | Pain, redness, swelling, sores or ulcers, rash. |
| Bones and joints (Musculoskeletal) | Joint pain and joint stiffness. |
| Lungs | Cough (sometimes with blood in the mucus), difficulty breathing. |
How does this NTM infection occur?
As we mentioned before, this bacteria is in our environment, so there are several ways we can get it into our bodies.
- Through water: By drinking, bathing, or showering water containing NTM bacteria.
- By breathing: By breathing in bacteria in the environment. This risk is especially high for someone who already has lung disease.
- Through medical devices: Through some medical devices inserted into the body (for example, tubes such as a central venous line) or surgical instruments.
- Through needles: Through dirty needles used to inject drugs, inject drugs, or get tattoos.
The important thing is that it can take a long time for these bacteria to enter the body and cause symptoms. Therefore, it can be difficult to find out exactly where and how you got the infection.
Is this contagious from person to person?
No. NTM infections are very rarely transmitted from one person to another. Therefore, it is not considered a contagious disease.
Who is most at risk?
Although this bacteria is all around us, not all of us get sick. However, some people are at higher risk of developing this infection.
| Risk factor | Description |
|---|---|
| Weakened immune system | If you have HIV, cancer, or another condition that weakens your immune system. |
| Immune-suppressing drugs | If you are taking immunosuppressive medications. |
| Pre-existing lung disease | If you have lung diseases such as cystic fibrosis, bronchiectasis, asthma or emphysema. |
| Devices inserted into the body | If you have tubes in your body (e.g. central venous line, breathing tube, feeding tube). |
Additionally, women with a low body mass index (BMI) and other health conditions such as GERD (acid reflux disease) and scoliosis are at increased risk of developing pulmonary NTM infections.
How do you find this, Doctor?
Because the symptoms of an NTM infection are similar to other diseases, several tests are needed to diagnose it accurately. The doctor will follow these steps:
1. Asking about your symptoms: We will listen carefully to find out about your discomfort.
2. Checking your health history: Asking about other illnesses you have and medications you are taking.
3. Exclusion of other diseases: Make sure you don't have other common infections or medical conditions.
4. Specialized tests: A blood, tissue sample, or sputum sample is sent for a laboratory test (`culture`) to look for NTM bacteria.
Diagnostic tests
- Chest X-ray
- CT scan
- Bronchoscopy: A procedure in which a small tube with a camera is passed into the lungs for examination.
- Biopsy: Taking a small piece of tissue from the infected area for examination.
- Acid-fast bacilli test: Detection of mycobacteria in a sputum, blood, or tissue sample.
The only way to know if you have an NTM infection is to see a doctor and get the necessary tests. You cannot determine this on your own.
What are the treatments for this?
Treating NTM infections is a long-term process. Doctors usually prescribe a combination of two or three types of antibiotics . These medications may need to be taken for as long as 12 months to completely clear up the infection.
In some cases, surgery may be necessary to remove damaged tissue. For lung infections, breathing exercises and treatments to help clear mucus are also recommended.
Are there any side effects of the treatment?
Yes. Taking antibiotics for a long time can cause some side effects. Therefore, if you experience any unusual symptoms while taking the medication, you should tell your doctor immediately.
Possible side effects:
- Hearing impairment
- Vision changes
- Heart rhythm abnormalities (`Long QT syndrome`)
- Liver or kidney damage
When should you seek medical advice?
If you have a lung condition, a weakened immune system, have had surgery, or have a medical device inserted into your body, ask your doctor about the possible symptoms of an infection. If you experience any suspicious symptoms, do not delay seeking medical advice.
When should you go to the Emergency Treatment Unit (ETU)?
If you have any of the following severe symptoms, go to a hospital's Emergency Department (ETU) immediately.
| Severe symptom | Description |
|---|---|
| High fever | If the fever is higher than 40 degrees Celsius (103 Fahrenheit). |
| Severe difficulty breathing | If it's too hard to breathe. |
| Chest pain | If you have severe chest pain. |
| Confusion | If you have a memory lapse, a lack of memory of place or time. |
| Infection of a wound | If a surgical site or wound is red, swollen, painful, or not healing. |
How can I protect myself from this infection?
If you have a lung condition or a weakened immune system, you can reduce your risk by avoiding places where NTM bacteria are common.
- Avoid using hot tubs: especially those in indoor, enclosed spaces.
- Avoid cold mist sprayers: Minimize the use of sprayers that produce fine droplets that can be inhaled.
- Be careful when working with soil: Wear a face mask and gloves, especially when working with potting soil.
- Avoid getting tattoos: There is a risk of infection from using dirty equipment.
NTM infections are a relatively rare condition. But if you do get one, the diagnosis and treatment process can take time. So it's important to be patient. Take your medication as prescribed by your doctor, for the full duration. Tell your doctor about any discomfort you experience during treatment.
Take-Home Message
- NTM is a type of mycobacteria that does not cause tuberculosis or leprosy, but lives in the environment (soil, water).
- These infections are not usually transmitted from one person to another.
- People with weakened immune systems and those with lung disease are at higher risk of NTM infections.
- Symptoms such as cough, fever, fatigue, and weight loss may occur, and medical tests are essential for an accurate diagnosis.
- Treatment will require months of antibiotics, and it is very important to follow medical advice.
- If severe symptoms occur, you should immediately go to a hospital's Emergency Treatment Unit (ETU).
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