CLINICAL MICROBIOLOGY REVIEWS, Apr. 1996, p. 177–215 Vol. 9, No. 2 0893-8512/96/$04.0010 Copyright q 1996, American Society for Microbiology Epidemiology of Infection by Nontuberculous Mycobacteria JOSEPH O. FALKINHAM III* Department of Biology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061-0406 INTRODUCTION .......................................................................................................................................................178 The Nontuberculous Mycobacteria.......................................................................................................................178 Nontuberculous Mycobacterial Disease before the AIDS Epidemic................................................................179 Nontuberculous Mycobacterial Disease after the AIDS Epidemic ..................................................................179 Current Trends in the Epidemiology of Nontuberculous Mycobacterial Disease .........................................179 Chemotherapy of Nontuberculous Mycobacterial Infections............................................................................180 Detection, Recovery, and Identification of Nontuberculous Mycobacteria.....................................................181 Ecology and Physiology of Nontuberculous Mycobacteria................................................................................181 Virulence of Nontuberculous Mycobacteria ........................................................................................................182 Taxonomy of Nontuberculous Mycobacteria.......................................................................................................183 Genetics of Nontuberculous Mycobacteria..........................................................................................................183 Tools for Epidemiologic Investigations of Nontuberculous Mycobacteria .....................................................184 EPIDEMIOLOGY OF MYCOBACTERIUM KANSASII..........................................................................................185 Epidemiology of M. kansasii Infection..................................................................................................................185 Characteristics of M. kansasii ...............................................................................................................................186 Sources of M. kansasii ............................................................................................................................................186 Risk Factors for M. kansasii Infection .................................................................................................................186 Chemotherapy of M. kansasii Infection................................................................................................................186 EPIDEMIOLOGY OF MYCOBACTERIUM MARINUM ........................................................................................187 Epidemiology of M. marinum Infection................................................................................................................187 M. marinum Infection in Fish ...............................................................................................................................187 Characteristics of M. marinum .............................................................................................................................187 Sources of M. marinum ..........................................................................................................................................187 Risk Factors for M. marinum Infection ...............................................................................................................187 Chemotherapy of M. marinum Infection..............................................................................................................187 EPIDEMIOLOGY OF THE MYCOBACTERIUM AVIUM COMPLEX ...............................................................187 Case History of an M. avium Complex Infection in an AIDS Patient.............................................................187 Epidemiology of M. avium Complex Infection ....................................................................................................188 Polyclonal M. avium Complex Infection in AIDS Patients ...............................................................................189 Characteristics of the M. avium Complex ...........................................................................................................189 Physiologic Ecology of the M. avium Complex....................................................................................................189 Sources of the M. avium Complex ........................................................................................................................190 Route of M. avium Complex Infection .................................................................................................................190 Risk Factors for M. avium Complex Infection....................................................................................................190 Chemotherapy and Prophylaxis of M. avium Complex Infection.....................................................................191 EPIDEMIOLOGY OF MYCOBACTERIUM PARATUBERCULOSIS....................................................................191 Epidemiology of M. paratuberculosis Infection ....................................................................................................191 Characteristics of M. paratuberculosis ..................................................................................................................192 Sources of M. paratuberculosis...............................................................................................................................192 Risk Factors for M. paratuberculosis Infection....................................................................................................192 EPIDEMIOLOGY OF MYCOBACTERIUM SCROFULACEUM ...........................................................................192 Case History of an M. scrofulaceum Infection.....................................................................................................192 Epidemiology of M. scrofulaceum Infection .........................................................................................................192 Characteristics of M. scrofulaceum .......................................................................................................................192 Sources of M. scrofulaceum ....................................................................................................................................193 Risk Factors for M. scrofulaceum Infection .........................................................................................................193 Chemotherapy of M. scrofulaceum Infection........................................................................................................193 EPIDEMIOLOGY OF MYCOBACTERIUM SIMIAE .............................................................................................193 Case History of a Mixed M. simiae and M. avium Infection.............................................................................193 Epidemiology of M. simiae Infection ....................................................................................................................193 Characteristics of M. simiae ..................................................................................................................................194 Sources of M. simiae...............................................................................................................................................194 Risk Factors for M. simiae Infection....................................................................................................................194 Chemotherapy of M. simiae Infection ..................................................................................................................194 EPIDEMIOLOGY OF MYCOBACTERIUM MALMOENSE ..................................................................................194 * Mailing address: Department of Biology, Virginia Tech, Blacks- burg, VA 24061-0406. Phone: (703) 231-5931. Fax: (703) 231-9307. Electronic mail address: [email protected]. 177 178 FALKINHAM CLIN.MICROBIOL.REV. Case History of an M. malmoense Infection in an AIDS Patient .....................................................................194 Epidemiology of M. malmoense Infection.............................................................................................................194 Characteristics of M. malmoense...........................................................................................................................195 Sources of M. malmoense........................................................................................................................................195 Risk Factors for M. malmoense Infection ............................................................................................................195 Chemotherapy of M. malmoense Infection...........................................................................................................195 EPIDEMIOLOGY OF MYCOBACTERIUM SZULGAI ..........................................................................................195