Extrapulmonary infections associated with nontuberculous mycobacteria in immunocompetent persons.

Extrapulmonary infections associated with nontuberculous mycobacteria in immunocompetent persons.
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DOI:
10.3201/eid1509.081259
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发表时间:
2009-09
影响因子:
11.8
通讯作者:
Scarparo C
Scarparo C
中科院分区:
医学2区
文献类型:
--
作者:
Piersimoni C;Scarparo C

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发病率数据缺乏,诊断仍然困难。在过去的几年中,由非结核分枝杆菌(NTM)引起的人类疾病的患病率有所增加。目前尚不清楚病例的增加是否真实,或者是否有更多病例被确认。尽管对NTM感染的认识有了相当大的提高,但由于以下几个原因,它们仍然是诊断和治疗的挑战:1)病原分离株可能与污染物或腐生菌分离株难以区分;2)及时可靠地鉴定分离株可能取决于临床医生和实验室工作人员之间的适当沟通;3)缺乏标准化的药敏检测,采用量身定制的治疗方法不切实际;4)缺乏治疗指南使患者暴露于有毒药物和令人失望的结果。需要实验室研究和多中心对照试验来改进这些感染的诊断和治疗。
Incidence data are lacking, and diagnosis remains difficult. Over the past several years, the prevalence of human disease caused by nontuberculous mycobacteria (NTM) has increased. Whether the increase in cases is real or whether more cases are being recognized remains unclear. Despite a considerable increase in knowledge about NTM infections, they still represent a diagnostic and therapeutic challenge for several reasons: 1) pathogenic isolates may be indistinguishable from contaminant or saprophytic isolates; 2) timely and reliable identification of isolates may depend on proper communication between clinicians and laboratory staff; 3) lack of standardized susceptibility testing makes adoption of tailored therapies unrealistic; and 4) lack of treatment guidelines exposes patients to toxic drugs and disappointing outcomes. Laboratory research and multicenter controlled trials are needed to improve diagnosis and treatment of these infections.
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