Floto, R. Andres and Olivier, Kenneth N. and Saiman, Lisa and Daley, Charles L. and Herrmann, Jean-Louis and Nick, Jerry A. and Noone, Peadar G. and Bilton, Diana and Corris, Paul and Gibson, Ronald L. and Hempstead, Sarah E. and Koetz, Karsten and Sabadosa, Kathryn A. and Sermet-Gaudelus, Isabelle and Smyth, Alan R. and Van Ingen, Jakko and Wallace, Richard J. and Winthrop, Kevin L. and Marshall, Bruce C. and Haworth, Charles S.
US Cystic Fibrosis Foundation and European Cystic
Fibrosis Society consensus recommendations for the
management of non-tuberculous mycobacteria
in individuals with cystic fibrosis.
Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause chronic pulmonary infection, particularly in individuals with preexisting 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 US Cystic Fibrosis Foundation (CFF) and the European Cystic Fibrosis Society (ECFS) 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. Population, Intervention, Comparison, Outcome (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 USA 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.
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