Nontuberculous mycobacteria I: Multicenter prevalence study in cystic fibrosis
Nontuberculous mycobacteria I: Multicenter prevalence study in cystic fibrosis
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DOI：
10.1164/rccm.200207-678oc
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发表时间：
2003-03-15
影响因子：
24.7
通讯作者：
Knowles, MR
中科院分区：
文献类型：
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作者：
Olivier, KN;Weber, DJ;Knowles, MR
非结核分枝杆菌（NTM）是囊性纤维化（CF）的潜在呼吸道病原体。为了评估特定物种的患病率和感染的风险因素，我们对美国 21 个中心的 NTM 患病率和患者的临床特征进行了一项前瞻性横断面研究。几乎 10% 的 10 岁或以上的 CF 患者被纳入其中 (n = 986)。痰液中 NTM 的总体患病率为 13.0%（中心范围为 7-24%）。鸟分枝杆菌复合体（72%）和脓肿分枝杆菌（16%）是最常见的菌种。与无 NTM 的 CF 患者相比，培养阳性受试者年龄较大（26 岁 vs. 22 岁，p < 0.001），FEV1 较高（60 vs. 54%，p < 0.01），金黄色葡萄球菌频率较高（43 vs. 31%，p < 0.01），铜绿假单胞菌频率较低（71 vs. 82%，p < 0.01）。 0.01）。分子分型显示，每个中心内几乎所有患者都具有独特的 NTM 菌株。总之，NTM 在 CF 患者中很常见，但人与人之间或医院内获得都无法解释其高患病率。年龄较大是 NTM 分离的最重要预测因素。 CF 中 NTM 的临床意义尚未完全确定，但患有这些微生物的患者应通过重复培养进行监测。
Nontuberculous mycobacteria (NTM) are potential respiratory pathogens in cystic fibrosis (CF). To assess the species-specific prevalence and risk factors for acquisition, we conducted a prospective, cross-sectional study of the prevalence of NTM and clinical features of patients at 21 U.S. centers. Almost 10% of patients with CF who were 10 years or older were included (n = 986). The overall prevalence of NTM in sputum was 13.0% (range by center, 7-24%). Mycobacterium avium complex (72%) and Mycobacterium abscessus (16%) were the most common species. When compared with patients with CF without NTM, culture-positive subjects were older (26 vs. 22 years, p < 0.001), had a higher FEV1 (60 vs. 54%, p < 0.01), higher frequency of Staphylococcus aureus (43 vs. 31%, p < 0.01), and lower frequency of Pseudomonas aeruginosa (71 vs. 82%, p < 0.01). Molecular typing revealed that almost all patients within each center had unique NTM strains. In summary, NTM are common in patients with CF, but neither person-to-person nor nosocomial acquisition explained the high prevalence. Older age was the most significant predictor for isolation of NTM. The clinical significance of NTM in CF is incompletely defined, but patients with these organisms should be monitored with repeat cultures.