Mycobacterium abscessus: an emerging rapid-growing potential pathogen
Mycobacterium abscessus: an emerging rapid-growing potential pathogen
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DOI：
10.1111/j.1600-0463.2006.apm_390.x
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发表时间：
2006-05-01
期刊：
影响因子：
2.8
通讯作者：
Petrini, Bjorn
中科院分区：
文献类型：
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作者：
Petrini, Bjorn
脓肿分枝杆菌是一种致病性最强、对化疗耐药最强的快速生长分枝杆菌。它通常与受污染的创伤性皮肤伤口和手术后软组织感染有关。它也是最常从囊性纤维化患者中分离出来的分枝杆菌之一。这是必要的区别与以前模糊的“龟分枝杆菌复合体”，因为化疗是特别困难的脓肿分枝杆菌。克拉霉素或阿奇霉素是唯一对脓肿分枝杆菌有效的常规口服抗菌药物，由于长期单一治疗可能导致耐药性，因此最好辅以其他药物。阿米卡星是一种主要的治疗脓肿分支杆菌的非肠道药物，也应与另一种药物联合使用。最近推出的药物替吉环素可能被证明是化疗的重要补充，但尚未作为抗分枝杆菌药物进行全面的临床评估。手术可以治愈或至少有助于脓肿分枝杆菌感染的愈合，如果进行手术，应该包括移除所有异物或坏死物。人们越来越认识到脓肿分枝杆菌是一种新出现的病原体。
Mycobacterium abscessus is the most pathogenic and chemotherapy-resistant rapid-growing mycobacterium. It is commonly associated with contaminated traumatic skin wounds and with post-surgical soft tissue infections. It is also one of the mycobacteria that are most often isolated from cystic fibrosis patients. It is essential to differentiate this species from the formerly indistinct "M. chelonae-complex", as chemotherapy is especially difficult in M. abscessussenso strictu. Clarithromycin or azithromycin are the only regular oral antimycobacterial agents with an effect on M. abscessus, and should preferably be supplemented with other drugs since long-term monotherapy may cause resistance. Amikacin is a major parenteral drug against M. abscessus that should also be given in combination with another drug. The recently introduced drug tigecycline may prove to be an important addition to chemotherapy, but has yet to be fully clinically evaluated as an antimycobacterial agent. Surgery can be curative, or at least helpful, in the healing of M. abscessus infection, and if conducted, it should include the removal of all foreign or necrotic material. There is increasing awareness of M. abscessus as an emerging pathogen.