Vaping Associated Pulmonary Nontuberculous Mycobacteria.
Vaping Associated Pulmonary Nontuberculous Mycobacteria.
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DOI：
10.1007/s00408-020-00414-6
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发表时间：
2021-03
期刊：
影响因子：
5
通讯作者：
Robinson RT
中科院分区：
文献类型：
--
作者：
Chen L;Arens R;Chidambaram AG;Capponi S;Alshawa L;Claeys TA;Hayes D Jr;Robinson RT
电子烟或电子烟产品使用相关肺损伤 (EVALI) 一直是儿童和成人的重要健康风险。 EVALI 的病理生理学尚不清楚。然而，据推测，某些物质，如维生素 E 醋酸酯 (VEA)，特别是含有大麻的电子烟弹可能会导致肺损伤并导致呼吸功能障碍。 EVALI 通常在没有感染的情况下出现，但已发现它与真菌和细菌感染有关。与 EVALI 一样，非结核分枝杆菌 (NTM) 肺部疾病也在增加，但主要发生在免疫功能低下的个体中。在这里，我们介绍了三名免疫功能正常的个体，其中肺部 NTM 感染与电子烟同时发生。包括患者病史、实验室和射线照相报告在内的医疗信息是从位于纽约州布朗克斯、宾夕法尼亚州费城和肯塔基州列克星敦的参与机构的电子病历中提取的。所有三例病例都是免疫功能正常的个体，具有吸食含尼古丁和/或大麻产品的显着历史。分离出的病原体包括鸟分枝杆菌复合体、蟾蜍分枝杆菌和戈登分枝杆菌。所有三名患者都接受了 NTM 治疗。关于电子烟与 NTM 之间关联的报道很少。电子烟可能使这些人更容易受到 NTM 定植和感染。讨论了电子烟肺损伤和肺 NTM 的可能机制。
E-cigarette or vaping product use associated lung injury (EVALI) has been an important health risk in both children and adults. The pathophysiology of EVALI is not well understood. However, it is speculated that certain substances such as Vitamin E Acetate (VEA), particularly in marijuana containing vape cartridges may result in lung injury and lead to respiratory dysfunction. EVALI is often seen in the absence of infections, but it has been found to be associated with both fungal and bacterial infections. Like EVALI, nontuberculous mycobacteria (NTM) pulmonary disease is also on the rise, but is primarily reported in immunocompromised individuals. Here, we present three immunocompetent individuals wherein pulmonary NTM infection co-occurred with vaping. Medical information including patient history, laboratory, and radiograph reports were abstracted from electronic medical records from participating institutions located in the Bronx, NY, Philadelphia, PA, and Lexington, KY. All three cases were otherwise immunocompetent individuals with a significant history of vaping either nicotine and/or marijuana containing products. The pathogens isolated include Mycobacterium avium complex, M. xenopi, and M. gordonae. All three patients were treated for NTM. There is little reported on the association between vaping and NTM. It is possible that vaping may have rendered these individuals to be more susceptible to NTM colonization and infection. The possible mechanisms of vaping lung injury and pulmonary NTM are discussed.
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