Clinical and Therapeutic Features of Pulmonary Nontuberculous Mycobacterial Disease, Brazil, 1993-2011
Clinical and Therapeutic Features of Pulmonary Nontuberculous Mycobacterial Disease, Brazil, 1993-2011
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DOI：
10.3201/eid/1903.120735
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发表时间：
2013-03-01
影响因子：
11.8
通讯作者：
Dalcolmo, Margareth P.
中科院分区：
文献类型：
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作者：
Couto de Mello, Karla Gripp;Queiroz Mello, Fernanda C.;Dalcolmo, Margareth P.
为了确定肺非结核分枝杆菌（PNTM）疾病的临床和治疗特征，我们对转至巴西参考中心——巴西里约热内卢Oswaldo Cruz基金会（里约热内卢de Janeiro）的患者进行了回顾性分析，这些患者在1993-2011年间被诊断为PNTM，且至少有1例呼吸道培养呈NTM阳性。相关疾病包括支气管扩张（21.8%）、慢性阻塞性肺疾病（20.7%）、心血管疾病（15.5%）、艾滋病（9.8%）、糖尿病（9.8%）和丙型肝炎（4.6%）。2例患者患有汉森病；我有马凡氏综合症。4种分枝杆菌占NTM感染的85.6%：堪萨斯分枝杆菌59例（33.9%）；鸟分枝杆菌复合体53例（30.4%）；脓肿支原体23例（13.2%）；福氏鼠14只（8.0%）。42例（24.1%）病例与快速生长的分枝杆菌相关。在结核病流行率高的国家，PNTM可能被误诊为结核病，因此需要提高分枝杆菌疾病的诊断能力，并提高对PNTM疾病流行率的认识。
To identify clinical and therapeutic features of pulmonary nontuberculous mycobacterial (PNTM) disease, we conducted a retrospective analysis of patients referred to the Brazilian reference center, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, who received a diagnosis of PNTM during 1993-2011 with at least 1 respiratory culture positive for NTM. Associated conditions included bronchiectasis (21.8%), chronic obstructive pulmonary disease (20.7%), cardiovascular disease (15.5%), AIDS (9.8%), diabetes (9.8%), and hepatitis C (4.6%).Two patients had Hansen disease; 1 had Marfan syndrome. Four mycobacterial species comprised 85.6% of NTM infections: Mycobacterium kansasii, 59 cases (33.9%); M. avium complex, 53 (30.4%); M. abscessus, 23 (13.2%); and M. fortuitum, 14 (8.0%). A total of 42 (24.1%) cases were associated with rapidly growing mycobacteria. In countries with a high prevalence of tuberculosis, PNTM is likely misdiagnosed as tuberculosis, thus showing the need for improved capacity to diagnose mycobacterial disease as well as greater awareness of PNTM disease prevalence.