Patient groups:
(1) normal host defenses
(2) local immunosuppression
(3) systemic immunosuppression
Diseases associated with local immunosuppression:
(1) alcoholism
(2) bronchiectasis
(3) cyanotic heart disease
(4) cystic fibrosis
(5) previous mycobacterial disease
(6) pulmonary fibrosis
(7) smoking
(8) chronic obstructive pulmonary disease
Diseases associated with systemic immunosuppression:
(1) acute or chronic leukemia
(2) malignant lymphoma
(3) solid organ transplant recipient
(4) systemic immunosuppression
Criteria for diagnosis of nontuberculous mycobacterial pulmonary disease:
(1) using single bronchial washing
(2) using multiple respiratory cultures in 1 year
(3) tissue biopsy
Criteria for single bronchial washing - both of the following:
(1) culture positive for nontuberculous mycobacteria
(2) one of the following:
(2a) AFB smear with grade 2+ to +4 acid fast bacilli
(2b) normal host defenses and culture growth 2+ to 4+
(2c) local immunosuppression and culture growth 2+ to 4+
(2d) systemic immunosuppression and culture growth 1+ to 4+
Criteria for multiple respiratory cultures - both of the following:
(1) >= 3 respiratory samples (sputum and/or washings) in past year
(2) one of the following:
(2a) >= 3 cultures positive for nontuberculous mycobacteria and all AFB smears negative
(2b) >= 2 cultures positive for nontuberculous mycobacteria and >= 1 AFB positive
Criteria for tissue biopsy - one of the following:
(1) any growth of a nontuberculous mycobacteria from a lung biopsy
(2) lung disease with a positive culture for a nontuberculous mycobacterium from a usually sterile extrapulmonary site
(3) both of the following:
(3a) >= 1 respiratory culture for nontuberculous mycobacterium
(3b) granuloma and/or AFB detected in lung biopsy
