这是用户在 2024-12-1 11:34 为 https://app.immersivetranslate.com/pdf-pro/a03871ec-a1ae-482b-b5a3-e768565369ad 保存的双语快照页面，由 沉浸式翻译 提供双语支持。了解如何保存？

Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline
非结核分枝杆菌肺病的治疗：官方 ATS/ERS/ESCMID/IDSA 临床实践指南

Charles L. Daley 1 , 2 , 26 1 , 2 , 26 ^(1,2,26){ }^{1,2,26}, Jonathan M. laccarino 3 3 ^(3){ }^{3}, Christoph Lange 4 , 5 , 6 , 7 , 26 4 , 5 , 6 , 7 , 26 ^(4,5,6,7,26){ }^{4,5,6,7,26} Emmanuelle Cambau 8 , 26 8 , 26 ^(8,26){ }^{8,26}, Richard J. Wallace Jr 9 , 26 9 , 26 ^(9,26){ }^{9,26}, Claire Andrejak 10 , 11 10 , 11 ^(10,11){ }^{10,11}, Erik C. Böttger 12 12 ^(12){ }^{12}, Jan Brozek (12) David E. Griffith 14 14 ^(14){ }^{14}, Lorenzo Guglielmetti 0 8 , 15 0 8 , 15 0^(8,15)0^{8,15}, Gwen A. Huitt 0 1 , 2 0 1 , 2 0^(1,2)0^{1,2}, Shandra L. Knight 16 16 ^(16){ }^{16}, Philip Leitman 17 17 ^(17){ }^{17}, Theodore K. Marras 18 ′ ′ 18 ′ ′ ^(18^('')){ }^{18{ }^{\prime \prime}}, Kenneth N. Olivier (1) 19 19 ^(19){ }^{19}, Miguel Santin ( 20 20 ^(20){ }^{20}, Jason E. Stout ( ) 21 ( ) 21 ^(()^(21)){ }^{()^{21}}, Enrico Tortoli ) 22 ) 22 )^(22))^{22}, Jakko van Ingen ( 23 23 (^(23):}\left(^{23}\right., Dirk Wagner 0 24 0 24 0^(24)\mathbb{0}^{24}𝟘 and Kevin L. Winthrop 25 25 ^(25){ }^{25}
Charles L. Daley 1 , 2 , 26 1 , 2 , 26 ^(1,2,26){ }^{1,2,26} ， Jonathan M. laccarino 3 3 ^(3){ }^{3} ， Christoph Lange 4 , 5 , 6 , 7 , 26 4 , 5 , 6 , 7 , 26 ^(4,5,6,7,26){ }^{4,5,6,7,26} Emmanuelle Cambau 8 , 26 8 , 26 ^(8,26){ }^{8,26} ， Richard J. Wallace Jr 9 , 26 9 , 26 ^(9,26){ }^{9,26} ， Claire Andrejak 10 , 11 10 , 11 ^(10,11){ }^{10,11} ， Erik C. Böttger 12 12 ^(12){ }^{12} ， Jan Brozek （12） David E. Griffith 14 14 ^(14){ }^{14} ， Lorenzo Guglielmetti 0 8 , 15 0 8 , 15 0^(8,15)0^{8,15} ， Gwen A. Huitt 0 1 , 2 0 1 , 2 0^(1,2)0^{1,2} ， Shandra L. Knight 16 16 ^(16){ }^{16} ， Philip Leitman 17 17 ^(17){ }^{17} ， Theodore K. Marras 18 ′ ′ 18 ′ ′ ^(18^('')){ }^{18{ }^{\prime \prime}} ， Kenneth N. Olivier （1） 19 19 ^(19){ }^{19} ， Miguel Santin （ 20 20 ^(20){ }^{20} ， Jason E. Stout ( ) 21 ( ) 21 ^(()^(21)){ }^{()^{21}} ， Enrico Tortoli ) 22 ) 22 )^(22))^{22} ， Jakko van Ingen ( 23 23 (^(23):}\left(^{23}\right. ， Dirk Wagner 0 和 Kevin L. Winthrop 25 25 ^(25){ }^{25}

@ERSpublications

The official ATS/ERS/ESCMID/IDSA clinical practice guidelines provide 31 evidence-based recommendations for the treatment of nontuberculous mycobacterial (NTM) pulmonary disease https://bit.ly/3fOEwlc
官方 ATS/ERS/ESCMID/IDSA 临床实践指南为非结核分枝杆菌 （NTM） 肺病的治疗提供了 31 条循证建议 https://bit.ly/3fOEwlc
Cite this article as: Daley CL, Iaccarino JM, Lange C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Eur Respir J 2020; 56: 2000535 [https://doi.org/10.1183/13993003.00535-2020].
引用本文为： Daley CL， Iaccarino JM， Lange C， et al.非结核分枝杆菌肺病的治疗：官方 ATS/ERS/ESCMID/IDSA 临床实践指南。欧洲呼吸杂志 2020;56： 2000535 [https://doi.org/10.1183/13993003.00535-2020]。
ABSTRACT Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.
摘要 非结核分枝杆菌 （NTM） 代表 190 多个物种和亚种，其中一些可以在所有年龄段的人类中产生疾病，并可影响肺和肺外部位。本指南侧重于由最常见的 NTM 病原体引起的成人肺部疾病（无囊性纤维化或人类免疫缺陷病毒感染），例如生长缓慢的 NTM 中的鸟分枝杆菌复合体、堪萨斯分枝杆菌和异种分枝杆菌，以及快速生长的 NTM 中的脓肿分枝杆菌。专家小组由领先的国际呼吸医学和传染病学会（ATS、ERS、ESCMID、IDSA）精心挑选，其中包括肺医学、传染病和临床微生物学、实验室医学和患者宣传方面的专家。围绕 22 个 PICO （人群、干预、比较、结果） 问题中的每一个问题进行系统评价，并使用 GRADE （建议分级评估、开发和评估） 方法制定、编写和分级建议。提供了 31 项关于 NTM 肺病治疗的循证建议。本指南旨在供护理 NTM 肺病患者的医疗保健专业人员使用，包括传染病和肺部疾病专家。

Executive summary 摘要

The American Thoracic Society (ATS), European Respiratory Society (ERS), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), and Infectious Diseases Society of America (IDSA) jointly sponsored the development of this Guideline to update the treatment recommendations for nontuberculous mycobacterial (NTM) pulmonary disease in adults. NTM represent over 190 species and subspecies (http://www.bacterio.net/mycobacterium.html), many of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. Attempting to cover such a broad array of species and disease in a guideline using current guideline development methods is impossible. Therefore, this guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus [HIV] infection) caused by the most common NTM pathogens comprising Mycobacterium avium complex (MAC), Mycobacterium kansasii, and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. Twenty-two PICO (Population, Intervention, Comparators, Outcomes) questions and associated recommendations are included in the Guideline. A panel of experts was carefully selected and screened for conflicts of interest and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. The recommendations were developed based on the evidence that was appraised using GRADE (Grading of Recommendations Assessment, Development, and Evaluation) and are summarized below [1, 2]. Recommendations were either “strong” or “conditional” (table 1), and as suggested by GRADE, the phrase “we recommend” was used for strong recommendations and “we suggest” for conditional recommendations [3].
美国胸科学会 （ATS）、欧洲呼吸学会 （ERS）、欧洲临床微生物学和传染病学会 （ESCMID） 和美国传染病学会 （IDSA） 共同发起了本指南的制定，以更新成人非结核分枝杆菌 （NTM） 肺疾病的治疗建议。NTM 代表 190 多个物种和亚种 （http://www.bacterio.net/mycobacterium.html），其中许多可以在所有年龄段的人类中产生疾病，并可影响肺和肺外部位。试图使用当前的指南制定方法在指南中涵盖如此广泛的物种和疾病是不可能的。因此，本指南侧重于由最常见的 NTM 病原体引起的成人肺部疾病（无囊性纤维化或人类免疫缺陷病毒 [HIV] 感染），这些病原体包括生长缓慢的 NTM 中的鸟分枝杆菌复合体 （MAC）、堪萨斯分枝杆菌和异种分枝杆菌，以及快速生长的 NTM 中的脓肿分枝杆菌。指南包括 22 个 PICO （人群、干预、比较、结果） 问题和相关建议。一个专家小组经过精心挑选和利益冲突筛选，包括肺病学、传染病和临床微生物学、实验室医学和患者宣传方面的专家。这些建议是根据使用 GRADE（建议评估、开发和评估分级）评估的证据制定的，总结如下 [1， 2]。 推荐是“强推荐”或“条件性推荐”（表 1），正如 GRADE 所建议的那样，“we recommend”一词用于强推荐，“we suggest”表示有条件推荐 [3]。
This executive summary is a condensed version of the panel’s recommendations for the 22 PICO questions. A detailed description of background, methods, evidence summary, and rationale that support each recommendation can be found online in the full text and accompanying supplementary material.
本执行摘要是专家组对 22 个 PICO 问题的建议的精简版。支持每项建议的背景、方法、证据摘要和理由的详细说明可在全文和随附的补充材料中找到。

Diagnostic criteria for NTM pulmonary disease
NTM 肺疾病的诊断标准

The 2007 guideline included clinical, radiographic, and microbiologic criteria for diagnosing NTM pulmonary disease [4]. The current guideline also recommends use of these criteria to classify patients as having NTM pulmonary disease (table 2). The significance of NTM isolated from the sputum of individuals who meet the clinical and radiographic criteria in table 2 must be interpreted in the context of the number of positive cultures and specific species isolated. Because NTM can be isolated from respiratory specimens due to environmental contamination and because some patients who have an NTM isolated from their respiratory tract do not show evidence of progressive disease, > 1 > 1 > 1>1 positive sputum culture is recommended for diagnostic purposes, and the same NTM species (or subspecies in the case of M. abscessus) should be isolated in ⩾ 2 ⩾ 2 >= 2\geqslant 2 sputum cultures. Clinically significant MAC pulmonary disease is
2007 年指南包括诊断 NTM 肺疾病的临床、影像学和微生物学标准 [4]。当前指南还推荐使用这些标准将患者分类为 NTM 肺疾病（表 2）。从符合表 2 中临床和影像学标准的个体的痰液中分离出 NTM 的意义，必须结合阳性培养物的数量和分离出的特定物种来解释。由于环境污染可以从呼吸道标本中分离出 NTM，并且由于一些从呼吸道分离出 NTM 的患者没有表现出疾病进展的证据， > 1 > 1 > 1>1 因此建议进行痰培养阳性以进行诊断，并且应在痰培养中 ⩾ 2 ⩾ 2 >= 2\geqslant 2 分离相同的 NTM 种属（或脓肿分枝杆菌病例中的亚种）。有临床意义的 MAC 肺部疾病
TABLE 1 Interpretation of strong and conditional (weak) recommendations
表 1 强和有条件（弱）建议的解释
Recommendations 建议
Strong 强 Conditional 有條件的
Patients 病人 - Most individuals in this situation would want the recommended course of action, and only a small proportion would not.
- 在这种情况下，大多数人都希望采取建议的行动方案，只有一小部分人不会。		 - The majority of individuals in this situation would want the suggested course of action, but many would not.
- 在这种情况下，大多数人都希望得到建议的行动方案，但许多人不会。
Clinicians 临床 医师

- 大多数人应该接受干预。 - 根据指南遵守建议可以用作质量标准或绩效指标。 - 不太可能需要正式的决策辅助工具来帮助个人做出符合其价值观和偏好的决策。
- Most individuals should receive the intervention.
- Adherence to the recommendation according to the guideline could be used as a quality criterion or performance indicator.
- Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences.
- Most individuals should receive the intervention. - Adherence to the recommendation according to the guideline could be used as a quality criterion or performance indicator. - Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences.| - Most individuals should receive the intervention. | | :--- | | - Adherence to the recommendation according to the guideline could be used as a quality criterion or performance indicator. | | - Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences. |
 - Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with his or her values and preferences. Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences.
- 认识到不同的选择适合个体患者，您必须帮助每位患者做出符合其价值观和偏好的管理决策。决策辅助工具可能有助于帮助个人做出符合其价值观和偏好的决策。
Policy makers 决策者 - The recommendation can be adopted as policy in most situations.
- 在大多数情况下，该建议可以作为策略采用。		 - Policy making will require substantial debate and involvement of various stakeholders.
- 政策制定需要各利益相关者的大量辩论和参与。
Recommendations Strong Conditional Patients - Most individuals in this situation would want the recommended course of action, and only a small proportion would not. - The majority of individuals in this situation would want the suggested course of action, but many would not. Clinicians "- Most individuals should receive the intervention. - Adherence to the recommendation according to the guideline could be used as a quality criterion or performance indicator. - Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences." - Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with his or her values and preferences. Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences. Policy makers - The recommendation can be adopted as policy in most situations. - Policy making will require substantial debate and involvement of various stakeholders.| | Recommendations | | | :---: | :---: | :---: | | | Strong | Conditional | | Patients | - Most individuals in this situation would want the recommended course of action, and only a small proportion would not. | - The majority of individuals in this situation would want the suggested course of action, but many would not. | | Clinicians | - Most individuals should receive the intervention. <br> - Adherence to the recommendation according to the guideline could be used as a quality criterion or performance indicator. <br> - Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences. | - Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with his or her values and preferences. Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences. | | Policy makers | - The recommendation can be adopted as policy in most situations. | - Policy making will require substantial debate and involvement of various stakeholders. |
Source: Grading of Recommendations Assessment, Development and Evaluation Working Group [1, 2].
来源：建议分级评估、制定和评估工作组 [1， 2]。
unlikely in patients who have a single positive sputum culture during the initial evaluation [5-7] but can be as high as 98 % 98 % 98%98 \% in those with ⩾ 2 ⩾ 2 >= 2\geqslant 2 positive cultures [5].
在初始评估期间有1个痰培养阳性的患者不太可能[5-7]，但可能与培养 ⩾ 2 ⩾ 2 >= 2\geqslant 2 阳性的患者一样高 98 % 98 % 98%98 \% [5]。
The pathogenicity of NTM varies significantly from organisms like M. gordonae, which rarely cause disease in humans, to M. kansasii, which should usually be considered pathogenic [8]. For species of low pathogenicity such as M. gordonae, several repeated positive cultures over months, along with strong clinical and radiological evidence of disease, would be required to determine if it was causing disease, whereas a single positive culture for M M MM. kansasii in the proper context may be enough evidence to initiate treatment [9]. The pathogenicity of NTM species may differ between geographic areas [9, 10].
NTM 的致病性差异很大，从戈登分枝杆菌（很少在人类中引起疾病）到堪萨斯分枝杆菌（通常应被认为是致病性的）[8]。对于低致病性的物种，例如 M. gordonae，需要在数月内进行几次重复的阳性培养，以及强有力的临床和放射学疾病证据，以确定它是否导致疾病，而 M M MM 的单次阳性培养。Kansasii 在适当的背景下可能足以开始治疗 [9]。NTM 物种的致病性可能因地理区域而异 [9， 10]。
Importantly, just because a patient meets diagnostic criteria for NTM pulmonary disease does not necessarily mean antibiotic treatment is required. A careful assessment of the pathogenicity of the organism, risks and benefits of therapy, the patient’s wish and ability to receive treatment as well as the goals of therapy should be discussed with patients prior to initiating treatment. In some instances, “watchful waiting” may be the preferred course of action.
重要的是，仅仅因为患者符合 NTM 肺病的诊断标准并不一定意味着需要抗生素治疗。在开始治疗之前，应与患者仔细讨论病原体的致病性、治疗的风险和益处、患者接受治疗的意愿和能力以及治疗目标。在某些情况下，“观察等待”可能是首选的行动方案。

Recommendations for specific PICO questions
针对特定 PICO 问题的建议

Twenty-two PICO questions are addressed in this Guideline resulting in 31 recommendations. For each NTM covered, the recommendations are organized by the drugs to be included in the regimen, frequency of administration, and duration of therapy.
本指南解决了 22 个 PICO 问题，得出了 31 条建议。对于所涵盖的每种 NTM，建议按方案中要包含的药物、给药频率和治疗持续时间进行组织。
TABLE 2 Clinical and microbiologic criteria for diagnosis of nontuberculous mycobacterial pulmonary disease#
表 2 诊断非结核分枝杆菌性肺疾病的临床和微生物学标准#
Clinical 临床 Pulmonary or systemic symptoms Both clinical and radiologic
肺部或全身症状 临床和放射学症状
Radiologic 放射 学 Nodular or cavitary opacities on chest radiograph, or a high-resolution computed tomography scan that shows bronchiectasis with multiple small nodules
胸片上结节状或空洞性混浊，或高分辨率计算机体层成像扫描显示支气管扩张伴多个小结节
And 和 Appropriate exclusion of other diagnoses
适当排除其他诊断
Microbiologic I I  ^("I "){ }^{\text {I }} 微生物 I I  ^("I "){ }^{\text {I }} 1) Positive culture results from at least two separate expectorated sputum samples. If the results are nondiagnostic, consider repeat sputum AFB smears and cultures
1） 至少两个单独的咳痰样本的阳性培养结果。如果结果无诊断性，则考虑重复痰 AFB 涂片和培养
or 或
2) Positive culture results from at least one bronchial wash or lavage
2） 至少一次支气管冲洗或灌洗后培养呈阳性
or 或
3) Transbronchial or other lung biopsy with mycobacterial histologic features (granulomatous inflammation or AFB) and positive culture for NTM or biopsy showing mycobacterial histologic features (granulomatous inflammation or AFB) and one or more sputum or bronchial washings that are culture positive for NTM
3） 经支气管或其他肺活检具有分枝杆菌组织学特征（肉芽肿性炎症或 AFB）和 NTM 培养阳性，或活检显示分枝杆菌组织学特征（肉芽肿性炎症或 AFB）和一个或多个痰液或支气管冲洗液对 NTM 培养呈阳性
Clinical Pulmonary or systemic symptoms Both clinical and radiologic Radiologic Nodular or cavitary opacities on chest radiograph, or a high-resolution computed tomography scan that shows bronchiectasis with multiple small nodules And Appropriate exclusion of other diagnoses Microbiologic ^("I ") 1) Positive culture results from at least two separate expectorated sputum samples. If the results are nondiagnostic, consider repeat sputum AFB smears and cultures or 2) Positive culture results from at least one bronchial wash or lavage or 3) Transbronchial or other lung biopsy with mycobacterial histologic features (granulomatous inflammation or AFB) and positive culture for NTM or biopsy showing mycobacterial histologic features (granulomatous inflammation or AFB) and one or more sputum or bronchial washings that are culture positive for NTM| Clinical | Pulmonary or systemic symptoms Both clinical and radiologic | | :---: | :---: | | Radiologic | Nodular or cavitary opacities on chest radiograph, or a high-resolution computed tomography scan that shows bronchiectasis with multiple small nodules | | And | Appropriate exclusion of other diagnoses | | Microbiologic ${ }^{\text {I }}$ | 1) Positive culture results from at least two separate expectorated sputum samples. If the results are nondiagnostic, consider repeat sputum AFB smears and cultures | | | or | | | 2) Positive culture results from at least one bronchial wash or lavage | | | or | | | 3) Transbronchial or other lung biopsy with mycobacterial histologic features (granulomatous inflammation or AFB) and positive culture for NTM or biopsy showing mycobacterial histologic features (granulomatous inflammation or AFB) and one or more sputum or bronchial washings that are culture positive for NTM |
Source: Official ATS/IDSA statement [4]. AFB: acid-fast bacilli; NTM: nontuberculous mycobacteria. # : expert consultation should be obtained when NTM are recovered that are either infrequently encountered or that usually represent environmental contamination. Patients who are suspected of having NTM pulmonary disease but do not meet the diagnostic criteria should be followed until the diagnosis is firmly established or excluded. Making the diagnosis of NTM pulmonary disease does not per se, necessitate the institution of therapy, which is a decision based on the potential risks and benefits of therapy for individual patients. 1 1 ^(1){ }^{1} : when 2 positive cultures are obtained, the isolates should be the same NTM species (or subspecies in the case of M. abscessus) in order to meet disease criteria.
来源：ATS/IDSA 官方声明 [4]。AFB： 抗酸杆菌;NTM： 非结核分枝杆菌。# ： 当回收不经常遇到或通常代表环境污染的 NTM 时，应获得专家咨询。对于疑似 NTM 肺疾病但不符合诊断标准的患者，应进行随访，直到明确确诊或排除诊断。诊断 NTM 肺病本身并不需要进行治疗，这是根据治疗对个体患者的潜在风险和益处做出的决定。 1 1 ^(1){ }^{1} ：当获得 2 个阳性培养物时，分离株应为相同的 NTM 种属（或脓肿分枝杆菌的亚种），以满足疾病标准。
  1. This article has supplementary material available from erj.ersjournals.com
    本文提供了 erj.ersjournals.com 提供的补充材料
    The guidelines published by the European Respiratory Society (ERS) incorporate data obtained from a comprehensive and systematic literature review of the most recent studies available at the time. Health professionals are encouraged to take the guidelines into account in their clinical practice. However, the recommendations issued by this guideline may not be appropriate for use in all situations. It is the individual responsibility of health professionals to consult other sources of relevant information, to make appropriate and accurate decisions in consideration of each patient’s health condition and in consultation with that patient and the patient’s caregiver where appropriate and/or necessary, and to verify rules and regulations applicable to drugs and devices at the time of prescription.
    欧洲呼吸学会 （European Respiratory Society， ERS） 发布的指南纳入了从当时可用的最新研究的全面和系统文献综述中获得的数据。鼓励卫生专业人员在临床实践中考虑这些指南。但是，本指南发布的建议可能并不适合在所有情况下使用。卫生专业人员个人有责任咨询其他信息的其他来源，根据每位患者的健康状况做出适当和准确的决定，并在适当和/或必要时咨询该患者和患者的护理人员，并在开具处方时核实适用于药物和设备的规则和法规。
    Received: 3 March 2020 | Accepted: 3 March 2020
    收稿日期： 2020-03-03 |录用日期： 2020-03-03
    Copyright © The Author(s) 2020. This version published by the European Respiratory Society in the European Respiratory Journal, and jointly with Clinical Infectious Diseases. The articles are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Either citation can be used when citing this article.
    版权所有 © The Author（s） 2020。此版本由欧洲呼吸学会 （European Respiratory Society） 发表在《欧洲呼吸杂志》（European Respiratory Journal） 上，并与《临床传染病》（Clinical Infectious Diseases） 联合发表。这些文章是相同的，除了与每本期刊的风格保持一致的细微风格和拼写差异。引用本文时，可以使用任何一种引用方式。
  2. Affiliations: 1 1 ^(1){ }^{1} Dept of Medicine, National Jewish Health, Denver, CO, USA. 2 2 ^(2){ }^{2} Dept of Medicine, University of Colorado School of Medicine, Aurora, CO, USA. 3 3 ^(3){ }^{3} Pulmonary Center, Boston University School of Medicine, Boston, MA, USA. 4 4 ^(4){ }^{4} Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany. 5 5 ^(5){ }^{5} German Center for Infection Research (DZIF), Clinical Tuberculosis Unit, Borstel, Germany. 6 6 ^(6){ }^{6} Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany. 7 7 ^(7){ }^{7} Dept of Medicine, Karolinska Institute, Stockholm, Sweden. 8 8 ^(8){ }^{8} National Reference Center for Mycobacteria and Antimycobacterial Resistance, APHP -Hôpital Lariboisière, Bacteriology; Inserm, University Paris Diderot, IAME UMR1137, Paris, France. 9 9 ^(9){ }^{9} Mycobacteria/Nocardia Laboratory, Dept of Microbiology, The University of Texas Health Science Center, Tyler, TX, USA. 10 10 ^(10){ }^{10} Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, France. 11 11 ^(11){ }^{11} EA 4294, AGIR, Jules Verne Picardy University, Amiens, France. 12 12 ^(12){ }^{12} Institute of Medical Microbiology, National Reference Center for Mycobacteria, University of Zurich, Zurich, Switzerland. 13 13 ^(13){ }^{13} Dept of Clinical Epidemiology and Biostatistics, McMaster University Health Sciences Centre, Hamilton, ON, Canada. 14 14 ^(14){ }^{14} Pulmonary Infectious Disease Section, University of Texas Health Science Center, Tyler, TX, USA. 15 15 ^(15){ }^{15} Team E13 (Bactériologie), Centre d’Immunologie et des Maladies Infectieuses, Sorbonne Université, Université Pierre et Marie Curie, Université Paris 06, Centre de Recherche 7, INSERM, IAME UMR1137, Paris, France. 16 16 ^(16){ }^{16} Library and Knowledge Services, National Jewish Health, Denver, CO, USA. 17 17 ^(17){ }^{17} NTM Info and Research, Miami, FL, USA. 18 18 ^(18){ }^{18} Dept of Medicine, University of Toronto and University Health Network, Toronto, ON, Canada. 19 19 ^(19){ }^{19} Pulmonary Branch, National Heart, Lung and Blood Institute, Bethesda, MD, USA. 20 20 ^(20){ }^{20} Service of Infectious Diseases, Bellvitge University Hospital-IDIBELL, University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain. 21 21 ^(21){ }^{21} Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA. 22 22 ^(22){ }^{22} Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. 23 23 ^(23){ }^{23} Radboud Center for Infectious Diseases, Dept of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands. 24 24 ^(24){ }^{24} Division of Infectious Diseases, Dept of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. 25 25 ^(25){ }^{25} Divisions of Infectious Diseases, Schools of Public Health and Medicine, Oregon Health and Science University, Portland, OR, USA. 26 26 ^(26){ }^{26} C.L. Daley, C. Lange, E. Cambau and R.J. Wallace Jr are cochairs of this guideline committee.
    隶属关系： 1 1 ^(1){ }^{1} 美国科罗拉多州丹佛市国家犹太健康部医学部。 2 2 ^(2){ }^{2} 美国科罗拉多州奥罗拉市科罗拉多大学医学院医学系。 3 3 ^(3){ }^{3} 波士顿大学医学院肺中心，美国马萨诸塞州波士顿。 4 4 ^(4){ }^{4} 德国 Borstel 研究中心临床传染病部。 5 5 ^(5){ }^{5} 德国感染研究中心 （DZIF），临床结核病科，Borstel，德国。 6 6 ^(6){ }^{6} 呼吸医学和国际健康，吕贝克大学，德国吕贝克。 7 7 ^(7){ }^{7} 瑞典斯德哥尔摩卡罗林斯卡研究所医学系。 8 8 ^(8){ }^{8} 国家分枝杆菌和抗分枝杆菌耐药性参考中心，APHP -Hôpital Lariboisière，细菌学;Inserm，巴黎狄德罗大学，IAME UMR1137，法国巴黎。 9 9 ^(9){ }^{9} 德克萨斯大学健康科学中心微生物学系分枝杆菌/诺卡氏菌实验室，美国德克萨斯州泰勒。 10 10 ^(10){ }^{10} 法国亚眠大学医院呼吸和重症监护室。 11 11 ^(11){ }^{11} EA 4294，AGIR，儒勒·凡尔纳·皮卡第大学，亚眠，法国。 12 12 ^(12){ }^{12} 瑞士苏黎世大学国家分枝杆菌参考中心医学微生物学研究所。 13 13 ^(13){ }^{13} 麦克马斯特大学健康科学中心临床流行病学和生物统计学系，加拿大安大略省汉密尔顿。 14 14 ^(14){ }^{14} 美国德克萨斯州泰勒市德克萨斯大学健康科学中心肺传染病科。 15 15 ^(15){ }^{15} E13 团队（Bactériologie），免疫学和传染病中心，索邦大学，皮埃尔和玛丽居里大学，巴黎 06 大学，Centre de Recherche 7，INSERM，IAME UMR1137，法国巴黎。 16 16 ^(16){ }^{16} 图书馆和知识服务，美国科罗拉多州丹佛市国家犹太健康中心。 17 17 ^(17){ }^{17} NTM Info and Research，美国佛罗里达州迈阿密。 18 18 ^(18){ }^{18} 多伦多大学医学系和加拿大安大略省多伦多市大学健康网络。 19 19 ^(19){ }^{19} 美国马里兰州贝塞斯达国家心肺血液研究所肺科。 20 20 ^(20){ }^{20} 西班牙巴塞罗那大学 L'Hospitalet de Llobregat 贝尔维奇大学医院-IDIBELL 传染病服务处。 21 21 ^(21){ }^{21} 杜克大学医学中心传染病和国际卫生部，美国北卡罗来纳州达勒姆。 22 22 ^(22){ }^{22} 意大利米兰 IRCCS 圣拉斐尔科学研究所新兴细菌病原体部门。 23 23 ^(23){ }^{23} 荷兰奈梅亨拉德堡德大学医学中心医学微生物学系 Radboud 传染病中心。 24 24 ^(24){ }^{24} 德国弗莱堡大学医学院医学中心医学二系传染病科。 25 25 ^(25){ }^{25} 美国俄勒冈州波特兰市俄勒冈健康与科学大学公共卫生与医学院传染病科。 26 26 ^(26){ }^{26} C.L. Daley、C. Lange、E. Cambau 和 R.J. Wallace Jr 是该指南委员会的联合主席。
    Correspondence: Charles L. Daley, National Jewish Health, 1400 Jackson St, Denver, CO 80206, USA. E-mail: daleycIanjhealth.org
    通信地址：Charles L. Daley，国家犹太健康中心，1400 Jackson St， Denver， CO 80206， USA。电子邮件： daleycIanjhealth.org