{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T18:21:15Z","timestamp":1776709275157,"version":"3.51.2"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"22","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Was ist neu?<\/jats:title>\n                  <jats:p>Bronchiektasen sind mit dem h\u00f6chsten Risiko f\u00fcr NTM-PD assoziiert (OR 21,5). Weitere Risikofaktoren: fr\u00fchere Tuberkulose, interstitielle Lungenerkrankungen, chronisch obstruktive Lungenerkrankung (COPD), Asthma, zystische Fibrose (CF), variables Immundefekt-Syndrom (CVID), \u03b11-Antitrypsin-Mangel. Systemische Immunsuppression und inhalative Kortikosteroide gelten als relevante Risikofaktoren. Bestimmte Patient*innen mit NTM-PD zeigen charakteristische Merkmale wie eine schlanke Statur, Pectus excavatum und CFTR-Mutationen.<\/jats:p>\n                  <jats:p>NTM-PD ist durch 3 Kriterien definiert: klinische Symptome, radiologische Ver\u00e4nderungen und den mikrobiologischen Erregernachweis. H\u00e4ufigste Erreger: Mycobacterium-avium-Komplex (MAC), Mycobacterium kansasii und Mycobacterium abscessus.<\/jats:p>\n                  <jats:p>Der serologische anti-GPL-IgA-Test erm\u00f6glicht die Unterscheidung zwischen Kolonisation und Erkrankung. Ein neuer, serumbasierter CRISPR-Cas-Test auf MAC-cfDNA zeigt &gt;90% Sensitivit\u00e4t und &gt;97% Spezifit\u00e4t. Die Konzentration zirkulierender cfDNA korreliert mit dem Therapie-Ansprechen. Die klassische Sputumkultur bleibt essenziell f\u00fcr eine Speziesdiagnostik und Resistenztestung.<\/jats:p>\n                  <jats:p>Die Standardtherapie von NTM besteht in der Regel aus einer langdauernden Kombinationstherapie mit einem Makrolid und weiteren Antibiotika, angepasst an Spezies und Resistenzlage. ALIS (inhalatives liposomales Amikacin) zeigte in der ARISE-Studie eine signifikant h\u00f6here Kulturkonversion bei refrakt\u00e4rer MAC-Erkrankung. Rifampicin wird bei MAC wegen der unzureichenden Wirkspiegel kritisch hinterfragt. Mycobacterium abscessus bleibt therapeutisch besonders herausfordernd. Therapiepl\u00e4ne erfordern eine spezies- und resistenzbasierte Auswahl der Antibiotika-Kombination. Die Vertr\u00e4glichkeit der Langzeit-Therapie ist limitiert und eine engmaschige klinische \u00dcberwachung ist erforderlich. Mycobacterium xenopi ist prognostisch ung\u00fcnstiger; hier lautet die Therapie-Empfehlung: mindestens 3 Substanzen plus ggf. parenterales Amikacin.<\/jats:p>","DOI":"10.1055\/a-2502-6525","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T23:58:13Z","timestamp":1761695893000},"page":"1360-1366","source":"Crossref","is-referenced-by-count":1,"title":["Nichttuberkul\u00f6se Mykobakterien: diagnostische Herausforderungen und individualisierte Therapieans\u00e4tze"],"prefix":"10.1055","volume":"150","author":[{"given":"Elena","family":"Terhalle","sequence":"additional","affiliation":[{"name":"Pneumologie S\u00fcderelbe, Facharztpraxis f\u00fcr Pneumologie, Infektiologie und Allergologie, Hamburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Rademacher","sequence":"additional","affiliation":[{"name":"Pneumologie S\u00fcderelbe, Facharztpraxis f\u00fcr Pneumologie, Infektiologie und Allergologie, 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