Sixty-three cases of Mycobacterium marinum infection -: Clinical features, treatment, and antibiotic susceptibility of causative isolates
Sixty-three cases of Mycobacterium marinum infection -: Clinical features, treatment, and antibiotic susceptibility of causative isolates
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DOI：
10.1001/archinte.162.15.1746
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发表时间：
2002-08-12
影响因子：
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通讯作者：
Cambau, E
中科院分区：
文献类型：
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作者：
Aubry, A;Chosidow, O;Cambau, E
背景：海洋分枝杆菌是一种引起皮肤感染的非结核分枝杆菌。虽然病例很少报告，但最近没有一系列海洋结核杆菌感染的报告，治疗也不规范。方法：对1996年1月1日至1998年12月31日在法国发生的经培养证实的海洋结核杆菌感染病例进行调查。分析临床特点和治疗资料，确定11种抗生素对病原菌的最低抑菌浓度。结果：对63例海洋分枝杆菌感染进行了分析。在53例（84%）患者中，接种与鱼缸暴露有关。63例患者中感染部位以上肢为主（60例[95%]），18例（29%）患者感染向深部结构扩散。所有患者均接受抗生素治疗（中位时间为3个半月），30例（48%）接受手术治疗。处方了各种抗生素方案，22例（35%）患者修改了初始方案。克拉霉素、环霉素和利福平是最常用的抗生素。55例（87%）患者出现立方体。失败与深部结构受损伤有关（45例中3例vs 5例IS患者；P= 0.04），但与任何抗生素治疗方案无关。所有菌株均表现出相同的敏感性，无获得性抗性。利福平和利福丁的90%最低抑菌浓度（分别为0.5和0.06马克杯/mL）远低于克拉霉素（2马克杯/mL）和环素（米诺环素4马克杯/mL，强力霉素8马克杯/mL）的90%最低抑菌浓度。结论：海洋分枝杆菌感染是与鱼缸嗜好有关的新发感染，由于病例的严重程度和感染的传播性，临床对海洋分枝杆菌感染及其相关危险因素的认识对及时诊断和治疗至关重要。
Background: Mycobacterium marinum is a nontuberculous mycobacterium responsible for skin infections. Although cases have been seldom reported, no series of M marinum infection has been recently reported and the treatment is not standardized.Methods: A national survey was conducted on culture-confirmed M marinum infections that occurred in France from January 1, 1996, to December 31, 1998. Clinical characteristics and therapeutic data were analyzed, and the minimum inhibitory concentrations of 11 antibiotics were determined against the causative isolates.Results: Sixty-three cases of M marinum infection were studied. In 53 (84%) of the patients, inoculation was related to fish tank exposure. The site of infection was mainly the upper limb (in 60 [95%] of the 63 patients), and infection was spread to deeper structures in 18 (29%) of the patients. All patients were treated with antibiotics (median time, 3 1/2 months), and 30 (48%) underwent surgery. Various antibiotic regimens were prescribed, and the initial regimen was modified in 22 (35%) of the patients. Clarithromycin, cyclines, and rifampin were the most commonly prescribed antibiotics. Cube was observed for 55 (87%) of the patients. Failure was related to deep structure involvement (3 of 45 vs 5 of IS patients; P=.04) but not to any antibiotic regimen. All strains showed the same susceptibility pattern without acquired resistance. The 90% minimum inhibitory concentrations of rifampin and rifabutin were far lower (0.5 and 0.06 mug/mL, respectively) than the 90% minimum inhibitory concentrations of clarithromycin (2 mug/mL) and the cyclines (minocycline, 4 mug/mL; and doxycycline, 8 mug/mL).Conclusions: Mycobacterium marinum infections are emerging infections related to fish tank hobby, Because of the severity of the cases with spread of infection, clinical awareness of M marinum infection and its associated risk factors is important so that the diagnosis can be trade and therapy can be initiated promptly.