Environment or Host? A Case-Control Study of Risk Factors for Mycobacterium avium Complex Lung Disease
Environment or Host? A Case-Control Study of Risk Factors for Mycobacterium avium Complex Lung Disease
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DOI：
10.1164/rccm.201205-0825oc
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发表时间：
2012-10-01
影响因子：
24.7
通讯作者：
Cangelosi, Gerard A.
中科院分区：
文献类型：
--
作者：
Dirac, M. Ashworth;Horan, Kathleen L.;Cangelosi, Gerard A.
基本原理：鸟分枝杆菌复合体肺病是一种日益常见的慢性衰弱性疾病。一些主机特性已被建议或确认为风险因素。也提出了潜在的环境和行为风险因素。比较研究中进行了评估。Objectives：为了确定是否在家庭和花园中的气溶胶生成活动，家庭供水的功能，或几个肺和免疫妥协的条件与鸟分枝杆菌复杂的肺diseases.Methods：病例招募从学术医疗中心和非大学的做法在华盛顿和俄勒冈州的非正式转介。对照组受试者通过随机数字拨号招募，并按年龄、性别和部分电话号码与病例匹配。相关性采用条件logistic regression.Measurements和主要结果：已知和潜在的危险因素通过家庭访谈进行测量。研究了52对匹配的配对。12个受检宿主特征中有6个与疾病相关，包括慢性阻塞性肺疾病史（OR，10; 95%置信区间[CI]，1.2-80）、肺炎住院（OR，3.4; 95% CI，1.1-11）和类固醇使用（OR，8; 95% CI，1.6-41）。相比之下，11的14个气溶胶生成活动和所有五个功能的家庭供水研究孔很少或没有关联diseases.Conclusions：气溶胶生成活动似乎不是艾滋病毒阴性成人鸟分枝杆菌复杂的肺部疾病的危险因素，但以前的肺部疾病和免疫抑制药物似乎与易感性。
Rationale: Mycobacterium avium complex lung disease is an increasingly common and chronically debilitating problem. Several host traits have been suggested or confirmed as risk factors. Potential environmental and behavioral risk factors have also been proposed. Few have been evaluated in comparative studies.Objectives: To determine if aerosol-generating activities in the home and garden, features of the home water supply, or several pulmonary and immune-compromising conditions are associated with Mycobacterium avium complex lung disease.Methods: Cases were recruited from academic medical centers and by informal referrals from nonuniversity practices in Washington and Oregon. Control subjects were recruited by random-digit dialing and matched to cases by age, sex, and partial telephone number. Associations were measured as odds ratios (OR) estimated using conditional logistic regression.Measurements and Main Results: Known and potential risk factors were measured by in-home interview. Fifty-two matched pairs were studied. Six of 12 examined host traits were associated with disease, including history of chronic obstructive pulmonary disease (OR, 10; 95% confidence interval [CI], 1.2-80), pneumonia hospitalization (OR, 3.4; 95% Cl, 1.1-11), and steroid use (OR, 8; 95% CI, 1.6-41). In contrast, 11 of the 14 aerosol-generating activities and all five features of home water supply studied bore little or no association with disease.Conclusions: Aerosol-generating activities seem not to be risk factors for Mycobacterium avium complex lung disease in HIV-negative adults, but prior lung disease and immune-suppressing drugs seem to be associated with susceptibility.