Environmental mycobacteria, also known as Non Tubercule Mycobacteria (NTM) and mycobacteria other than tuberculosis (MOTT) are widely distributed in the environment, particularly in wet soil, marshland, streams, rivers and estuaries. They belong to the same family as the organisms that cause tuberculosis and leprosy, but unlike those organisms, NTM vary greatly in their ability to cause disease, and are not spread from person to person.
Mycobacterial infections are notoriously difficult to treat due to the organism’s cell wall, which is neither truly Gram negative nor positive. All Mycobacterium species share a characteristic cell wall, thicker than in many other bacteria, which is hydrophobic, waxy, and rich in mycolic acids/mycolates. The cell wall makes a substantial contribution to the hardiness of these organisms enabling them to survive long exposure to acids, alkalis, detergents, oxidative bursts, lysis, heat and many antibiotics.
Environmental mycobacteria also have extraordinary starvation survival persisting despite low nutrient levels in tap water. Furthermore, tolerance of temperature extremes results in contamination of hot tap water, spas, and ice machines by environmental mycobacteria.