Nontuberculous Mycobacterial Lung Diseases
Nontuberculous Mycobacterial Lung Diseases
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DOI：
10.1016/j.idc.2010.04.008
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发表时间：
2010-09-01
影响因子：
4.4
通讯作者：
Glassroth, Jeff
中科院分区：
文献类型：
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作者：
Taiwo, Babafemi;Glassroth, Jeff
非结核分枝杆菌(NTM)通常是一种耐寒、普遍存在的环境细菌，其地理分布和肺部致病性各不相同。在115多种非结核杆菌中，与肺部疾病相关的相对较少。NTM所致疾病的诊断依赖于临床、影像和微生物学数据的结合。由于NTM可能以抗酸杆菌的形式出现在具有类似结核病的临床和放射学特征的患者的呼吸道分泌物中，因此实验室区分NTM和结核分枝杆菌是优先考虑的。这种区分现在通常可以通过分子技术快速实现，尽管一些测试的灵敏度有限。NTM种类有不同的抗生素反应模式，仅在药物治疗方面的成功也各不相同。大环内酯类化合物是许多物种治疗的基本成分，但必须与其他药物联合使用。
Nontuberculous mycobacteria (NTM) are generally hardy, ubiquitous environmental bacteria that vary in geographic distribution and pulmonary pathogenicity. Relatively few of the more than 115 species of NTM have been associated with lung disease. Diagnosis of disease due to NTM relies on a combination of clinical, imaging, and microbiologic data. Because NTM may present as acid-fast bacilli in respiratory secretions of patients with clinical and radiologic features that mimic tuberculosis, laboratory discrimination of NTM from Mycobacterium tuberculosis is a priority. This discrimination is now often rapidly achievable using molecular techniques, although some tests have limited sensitivity. NTM species have different antibiotic response patterns, and success with medical treatment alone varies. Macrolides are an essential component of therapy for many species but must be combined with other drugs.