Pneumologie 2013; 67(11): 605-633
DOI: 10.1055/s-0033-1344790
Empfehlungen
© Georg Thieme Verlag KG Stuttgart · New York

Empfehlungen zur Diagnostik und Therapie nichttuberkulöser Mykobakteriosen des Deutschen Zentralkomitees zur Bekämpfung der Tuberkulose (DZK) und der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin (DGP)

Recommendations for Diagnosis and Treatment of Nontuberculous Mycobacterioses of the German Central Committee against Tuberculosis and the German Respiratory Society
N. Schönfeld*
1   Klinik für Pneumologie, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin
,
W. Haas**
2   Abteilung für Infektionsepidemiologie, Fachgebiet für respiratorisch übertragbare Erkrankungen, Robert Koch-Institut, Berlin
,
E. Richter**
3   Forschungszentrum Borstel, Nationales Referenzzentrum für Mykobakterien
,
T. T. Bauer
1   Klinik für Pneumologie, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin
4   Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose, Berlin
,
L. Bös
4   Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose, Berlin
,
S. Castell
4   Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose, Berlin
5   Abteilung für Epidemiologie, Helmholtz-Zentrum für Infektionsforschung, Braunschweig
,
B. Hauer
2   Abteilung für Infektionsepidemiologie, Fachgebiet für respiratorisch übertragbare Erkrankungen, Robert Koch-Institut, Berlin
,
K. Magdorf †
6   Klinik für Pädiatrie m. S. Pneumologie und Immunologie, Charité Universitätsmedizin Berlin
,
W. Matthiessen
7   Fachkrankenhaus Coswig, Zentrum für Pneumologie und Thoraxchirurgie
,
H. Mauch
8   Institut für Mikrobiologie, Immunologie und Laboratoriumsmedizin, HELIOS Klinikum Emil von Behring, Berlin
,
A. Reuß
2   Abteilung für Infektionsepidemiologie, Fachgebiet für respiratorisch übertragbare Erkrankungen, Robert Koch-Institut, Berlin
,
S. Rüsch-Gerdes
3   Forschungszentrum Borstel, Nationales Referenzzentrum für Mykobakterien
,
P. Zabel
9   Forschungszentrum Borstel, Medizinische Klinik
10   Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
,
K. Dalhoff**
10   Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
,
T. Schaberg**
11   Zentrum für Pneumologie, Agaplesion Diakonieklinikum Rotenburg
,
R. Loddenkemper*
4   Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose, Berlin
› Author Affiliations
Further Information

Publication History

Publication Date:
06 November 2013 (online)

Zusammenfassung

Die nichttuberkulösen Mykobakteriosen umfassen eine Gruppe von Erkrankungen, die von Mykobakterien verursacht werden, die nicht dem Mycobacterium (M.) tuberculosis-Komplex und nicht M. leprae zugerechnet werden und durch eine breite Vielfalt in Hinsicht auf ihr Vorkommen und ihre Anpassungen an spezifische Umweltbedingungen charakterisiert sind. Einige Spezies können definierte Krankheitsbilder insbesondere bei Patienten mit systemischer Immunsuppression, vorbestehenden Lungenerkrankungen oder genetisch bedingter erhöhter Empfänglichkeit hervorrufen. Weltweit wird eine Zunahme der Prävalenz und der Bedeutung dieser Erregergruppe beobachtet. Die vorliegenden Empfehlungen fassen aktuelle Aspekte der Epidemiologie, der Pathogenese, Klinik, Diagnostik einschließlich mikrobiologischer Diagnostik und Resistenztestung, sowie der speziesabhängigen Therapie bei nichttuberkulösen Mykobakteriosen zusammen. Außerdem werden die besonderen Aspekte der Diagnostik und Therapie im Kindesalter und bei HIV-infizierten Patienten dargestellt.

Abstract

Nontuberculous mycobacterioses comprise a group of diseases caused by mycobacteria which do not belong to the Mycobacterium (M.) tuberculosis complex and are not ascribed to M. leprae. These mycobacteria are characterized by a broad variety as to environmental distribution and adaptation. Some of the species may cause specific diseases, especially in patients with underlying immunosuppressive diseases, chronic pulmonary diseases or genetic predisposition, respectively. Worldwide a rising prevalence and significance of nontuberculous mycobacterioses can be recognized. The present recommendations summarise actual aspects of epidemiology, pathogenesis, clinical aspects, diagnostics – especially microbiological methods including susceptibility testing –, and specific treatment for the most relevant species. Diagnosis and treatment of nontuberculous mycobacterioses during childhood and in HIV-infected individuals are described in separate chapters.

* federführend


** bei einzelnen Kapiteln federführend


 
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