Natural history of disseminated Mycobacterium avium complex infection in AIDS.
Natural history of disseminated Mycobacterium avium complex infection in AIDS.
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DOI：
10.1093/infdis/164.5.994
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发表时间：
1991-11
期刊：
影响因子：
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通讯作者：
M. Jacobson;P. Hopewell;D. Yajko;W. Hadley;Elizabeth Lazarus;Prasanna K. Mohanty;G. Modin;D. Feigal;Paul S. Cusick;M. Sande
中科院分区：
文献类型：
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作者：
M. Jacobson;P. Hopewell;D. Yajko;W. Hadley;Elizabeth Lazarus;Prasanna K. Mohanty;G. Modin;D. Feigal;Paul S. Cusick;M. Sande
本研究旨在更好地描述艾滋病相关播散性鸟分枝杆菌复合体（MAC）感染的自然史。为此，进行了两项回顾性研究：病例对照生存研究和MAC呼吸道定植研究。在137名连续患者中，在首次AIDS定义的卡氏肺孢子虫肺炎发作3个月内，无菌身体部位进行分枝杆菌培养，播散性MAC感染患者的中位生存期明显较短（107天; 95%置信区间[CI] 55-179）（275天; 95% CI 230-318; P <0.01），即使在控制了年龄、绝对淋巴细胞计数和血红蛋白浓度后。在34例患有AIDS和呼吸道MAC定植的患者中，22例后来发展为播散性感染（65%的预测值为随后的MAC传播）。播散性MAC感染与艾滋病患者的生存期显著缩短相关，呼吸道标本中MAC的存在对随后的播散性感染具有实质性的预测价值。
This study sought to better characterize the natural history of AIDS-associated disseminated Mycobacterium avium complex (MAC) infection. Towards that end two retrospective studies were done: a case-control survival study and a MAC respiratory colonization study. Among 137 consecutive patients who had a sterile body site cultured for mycobacteria within 3 months of their first AIDS-defining episode of Pneumocystis carinii pneumonia, median survival was significantly shorter in those with disseminated MAC infection (107 days; 95% confidence interval [CI] 55-179) than those with negative cultures (275 days; 95% CI 230-318; P less than .01), even after controlling for age, absolute lymphocyte count, and hemoglobin concentration. Among 34 patients with AIDS and respiratory MAC colonization, 22 later developed disseminated infection (65% predictive value for subsequent MAC dissemination). Disseminated MAC infection was associated with significantly shorter survival for patients with AIDS, and the presence of MAC in respiratory specimens has substantial predictive value for subsequent disseminated infection.