Mycobacterial Diseases
Open Access

Non-Tuberculosis Lung Infections in Women and Older Adults

Gurrey Mylonkai^{* *}Correspondence: Gurrey Mylonkai, Department of Infectious Diseases, Saint Louis University, Missouri, USA, Email:

Author info »

Description

Lung infections caused by Non-Tuberculosis Mycobacteria (NTM) are on the rise, particularly affecting women and older adults. Unlike Mycobacterium tuberculosis, which causes Tuberculosis (TB), NTM comprises a group of bacteria commonly found in soil, water, and dust. These bacteria can lead to a range of lung infections, some of which are difficult to treat and manage. The two most common types that infect the lungs are Mycobacterium avium complex (MAC) and Mycobacterium abscessus. These bacteria are naturally present in our environment and can be inhaled easily. However, they do not typically cause illness in healthy people. NTM infections primarily affect those with weakened immune systems or damaged lung tissue, which explains why older adults and individuals with chronic lung conditions are more susceptible. Symptoms of NTM lung infections can include a persistent cough, fatigue, shortness of breath, weight loss, and fever. Diagnosing these infections often requires imaging studies like CT scans and laboratory analysis of sputum samples. Treatment can be challenging, involving prolonged courses of multiple antibiotics tailored to the specific NTM species. Early detection and management are essential to prevent complications, especially in high-risk individuals. Raising awareness about NTM and its risk factors is vital for improving outcomes.

Increasing of NTM infections and effect on women

The rise in NTM infections may be attributed to several factors. First, as the global population ages, there is a larger number of individuals with age-related immune decline and pre-existing lung conditions, like Chronic Obstructive Pulmonary Disease (COPD) and bronchiectasis, which increase susceptibility to NTM infections. Second, there is increased awareness and better diagnostic tools that allow for more accurate detection of these infections. Additionally, improved medical care and treatments for chronic illnesses mean people are living longer, but with conditions that make them vulnerable to NTM. Recent research has shown that women, especially those over 50, are more prone to NTM infections than men. Several theories aim to explain this trend: Hormonal changes in postmenopausal women may influence susceptibility to NTM infections by weakening immune defenses or altering lung structure. Women tend to have smaller airways than men, which may make it more challenging to clear mucus and bacteria effectively. This characteristic may predispose women to infections by allowing bacteria to remain in the lungs longer, leading to colonization and infection. Bronchiectasis is a chronic lung condition characterized by damage to the airways, leading to thickened walls, mucus buildup, and infections. Women are more likely than men to develop bronchiectasis, which is a known risk factor for NTM infections. The scarring and abnormal lung structure seen in bronchiectasis create an environment where bacteria can thrive.

Age related susceptibility and treatment

Older adults, regardless of gender, are at higher risk of developing NTM infections due to changes in immune function and lung health. As people age, their immune system naturally declines, making it less effective at fighting infections. This decline makes older adults more vulnerable to opportunistic infections like those caused by NTM. Many older adults have existing lung conditions such as COPD or emphysema, which damage lung tissue and impair the ability to clear out pathogens. These conditions also lead to structural changes in the lungs, creating a more hospitable environment for NTM bacteria. Over a lifetime, people are exposed to various environmental sources of NTM bacteria, including soil, water, and dust, increasing their likelihood of infection. Daily habits like gardening, showering, or using hot tubs can bring individuals into contact with NTM, heightening exposure risk over time. Treating NTM infections is challenging for a few reasons. First, NTM bacteria are naturally resistant to many common antibiotics, making them difficult to eradicate. Second, treatment often requires a prolonged course of multiple antibiotics, which can lead to side effects, particularly in older patients. Treatment plans may last for a year or more, and the long duration can be hard to tolerate. Additionally, because NTM infections are chronic and often recur, patients may need to manage ongoing symptoms and frequent treatments, which can impact quality of life.

Conclusion

The increasing prevalence of NTM lung infections among women and older adults highlights the need for greater awareness and targeted health strategies. Understanding the factors that make these groups more susceptible such as hormonal changes, immune decline, and structural lung differences can guide better prevention and treatment efforts. Regular screening, early detection, and addressing risk factors like bronchiectasis and chronic lung diseases can help reduce the impact of NTM lung disease on vulnerable populations.