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Characteristics
Morphology
Aerobic, non-spore forming, non-motile, slightly curved or straight rods (0.2 to 0.6 μm by 1.0 to 10 μm) which may branch
Disease
Non-tuberculous mycobacteria (NTM) infections occur mainly in immunosuppressed individuals, although immunocompetent patients can also be affected. Non tuberculous mycobacteria cause many different diseases in humans.
Zoonosis
Yes for some species: M. marinum from pet fish, M. avium complex from swine, and from other domestic and wild animals
Health Hazards
Host Range
Humans, domestic and wild animals
Modes of Transmission
Nosocomial, direct contact with a contaminated environment
Signs and Symptoms
Cutaneous or skin infections
Infectious Dose
Unknown.
Incubation Period
unknown
Medical Precautions/Treatment
Prophylaxis
None available.
Vaccines
None available.
Treatment
A combination of several antibiotics over long periods of time is recommended for treatment of NTM infections. The most important antibiotics used in antimycobacterial therapy include: rifampin, isoniazid, ethambutol, macrolides (clarithromycin, azithromycin), quinolones (ciprofloxacin, moxifloxacin, gatifloxacin), aminoglycosides (streptomycin, amikacin) and linezolid.
Surveillance
Monitor for symptoms. Diagnosis of NTM infection can be done via culture of clinical specimens, serotyping, and PCR.
MSU Requirements
Report any exposures
Laboratory Hazards
Laboratory Acquired Infections (LAIs)
40 cases of non pulmonary tuberculosis due to laboratory or autopsy room accidents have been reported.
Sources
NTM can be isolated from sputa, exudates from lesions, tissues, environmental samples (soil, water), and from wounds. Cultures, frozen stocks, other samples described in IBC protocol.
Supplemental References
BMBL
https://www.cdc.gov/labs/BMBL.html
CDC
https://www.cdc.gov/nontuberculous-mycobacteria/about/mycobacterium-abscessus.html
NIH Guidelines
https://osp.od.nih.gov/wp-content/uploads/NIH_Guidelines.pdf
Risk Group & Containment Requirements
Risk Group 2

Agents that are associated with human disease which is rarely serious and for which preventive or therapeutic interventions are often available.
BSL2
For all procedures involving suspected or known infectious specimen or cultures.
ABSL2
For all procedures utilizing infected animals.
 
Spill Procedures
Small
Notify others working in the lab. Remove PPE and don new PPE. Cover area of the spill with absorbent material and add fresh 1:10 bleach:water. Allow 20 munutes (or as directed) of contact time. After 20 minutes, cleanup and dispose of materials.
Large
  • Immediately notify all personnel in the lab and clear all personnel from the area. Remove any contaminated PPE/clothing and leave the lab. 
  • Secure the area by locking doors, posting signage and guarding the area to keep people out of the space. 
For assistance, contact MSU's Biosafety Officer (406-994-6733) or Safety and Risk Management (406-994-2711).
Exposure Procedures
Mucous membrane
Flush eyes, mouth, or nose for 5 minutes at eyewash station.
Other Exposures
Wash area with soap and water for 5 minutes.
Reporting
Immediately report incident to supervisor, complete a First Report of Injury form, and submit to Safety and Risk Management.
Medical Follow-up
During business hours: Bridger Occupational Health 3406 Laramie Drive. Weekdays 8am -6pm.  Weekends 9am-5pm
After business hours: Bozeman Deaconess Hospital Emergency Room 915 Highland Blvd Bozeman, MT
Viability
Disinfection
Mycobacteria are more resistant to disinfectants than vegetative bacteria. Susceptible to sodium hydroxide, chlorine dioxide, ethylene oxide, 0.35% peracetic acid, and orthophthalaldehyde.
Inactivation
Inactivated by moist heat (60 minutes at 121oC) and dry heat (1 hour at 160-170oC).
Survival Outside Host
Weeks to months on inanimate objects if protected from sunlight.
Personal Protective Equipment (PPE)
Minimum PPE Requirements
Lab coat, disposable gloves, safety glasses, closed toed shoes, long pants
Additional Precautions
 Additioanl PPE may be required depending on lab specific SOPs and IBC Protocol.