Journal Article

Pulmonary nontuberculous mycobacterial infections among women with cystic fibrosis and non-cystic fibrosis bronchiectasis

Jones, Morgan C., Kasperbauer, Shannon, Gross, Jane E., Prevots, D. Rebecca, Buige, Ashley

2025

Overview

Nontuberculous mycobacteria (NTM) are ubiquitous, opportunistic pathogens that can cause lung disease in people with non-cystic fibrosis bronchiectasis (NCFB) and cystic fibrosis (CF). The incidence of NTM pulmonary infections and lung disease has continued to increase worldwide over the last decade among both groups. Notably, women with NCFB NTM pulmonary disease (NTM-PD) bear a disproportionate burden with NTM rates increasing in this population as well as having consistently higher incidence of NTM-PD compared to men. In contrast, among people with CF, an overall increased risk among women has not been observed. In the United States, the majority of people with CF are taking highly effective cystic fibrosis transmembrane conductance regulator (CFTR) modulators, and these numbers are increasing worldwide. The long-term impact of CFTR modulator medications on NTM infections is not entirely understood. Guidelines for the screening, diagnosis, and management of NTM-PD exist for people with NCFB and CF, but do not consider unique implications relevant to women. This review highlights aspects of NTM-PD among women with NCFB and CF, including the epidemiology of NTM infection, special considerations for treatment, and unmet research needs relevant to women with NTM-PD. Nontuberculous mycobacterial lung infections in women Nontuberculous mycobacteria (NTM) are bacteria that can cause lung disease in people with non-cystic fibrosis bronchiectasis (NCFB) and cystic fibrosis (CF). The incidence of NTM pulmonary infections and lung disease has continued to increase worldwide over the last decade among both groups. Notably, women with NCFB NTM pulmonary disease (NTM-PD) are more likely than men to get infected with NTM and to get disease. In contrast, among people with CF, women and men are equally likely to get NTM infection and disease. More people with CF across the globe are getting highly effective treatment using CF transmembrane conductance regulator (CFTR) modulators. We don’t understand how these medications will affect the chance of getting NTM infections if people take them for many years. Guidelines for the screening, diagnosis, and management of NTM-PD exist for people with NCFB and CF, but do not consider unique implications relevant to women. This review highlights aspects of NTM-PD among women with NCFB and CF, including the epidemiology of NTM infection, special considerations for treatment, and unmet research needs relevant to women with NTM-PD.

• Publisher: SAGE Publications,SAGE Publishing
• Subject: Anti-Bacterial Agents - therapeutic use / Bronchiectasis - drug therapy / Bronchiectasis - epidemiology / Bronchiectasis - microbiology / Cystic Fibrosis - diagnosis / Cystic Fibrosis - drug therapy / Cystic Fibrosis - epidemiology / Cystic Fibrosis - physiopathology / Cystic Fibrosis Transmembrane Conductance Regulator - metabolism / Female / Humans / Incidence / Mycobacterium Infections, Nontuberculous - diagnosis / Mycobacterium Infections, Nontuberculous - drug therapy / Mycobacterium Infections, Nontuberculous - epidemiology / Mycobacterium Infections, Nontuberculous - microbiology / Nontuberculous Mycobacteria - isolation & purification / Risk Factors / Sex Factors / Women's Research In: Therapeutic Advances in Respiratory Disease