Clinical features of infection caused by non-tuberculous mycobacteria: 7 years' experience
Clinical features of infection caused by non-tuberculous mycobacteria: 7 years' experience
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DOI：
10.1007/s15010-018-1128-2
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发表时间：
2018-06-01
期刊：
影响因子：
7.5
通讯作者：
Rubino, Salvatore
中科院分区：
文献类型：
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作者：
Adzic-Vukicevic, Tatjana;Barac, Aleksandra;Rubino, Salvatore
非结核分枝杆菌（NTM）是与各种感染相关的普遍存在的生物体。该研究的目的是确定7年期间NTM最相关的临床特征。在2009年1月至2016年12月期间对NTM感染进行了回顾性研究。采用美国胸科学会/美国传染病学会标准来定义肺或肺外部位的病例。肺部病例占83/85例（98%），而肺外NTM存在于2/95例（2%）患者中。总体而言，分离出10种不同的NTM物质。最常见的微生物是缓慢生长的分枝杆菌（SGM），出现在70/85（82.35%）例患者中。85例SGM中25例（29.41%）为鸟分枝杆菌复合群（MAC）; 20/85例（23.53%）患者检出xenopi; kansasii 15/85例（17.65%）; peregrinum和M.戈登氏病各5例（5.88%）。分离的快速生长分枝杆菌（RGM）菌株为M。8/85例（9.41%）患者出现肿胀，M. 4/85例（4.71%）为偶发性; 3/85例（3.53%）有龟类感染。几乎所有患者（98%; 83/85）都有合并症。在75例（88.24%）完成随访的患者中，治愈59例（69.41%），复发10例（11.76%），死亡6例（7%）。SGM是最常见的分离株，MAC肺病是最常见的，合并症是NTM发生的重要原因。进一步的调查应侧重于NTM药物敏感性试验。
Non-tuberculous mycobacteria (NTM) are ubiquitous organisms associated with various infections. The aim of the study was to determine the most relevant clinical characteristics of NTM during the 7-year period.A retrospective study of NTM infections was conducted between January 2009 and December 2016. The American Thoracic Society/Infectious Disease Society of America criteria were used to define cases of pulmonary or an extrapulmonary site.A total of 85 patients were included in the study. Pulmonary cases predominated 83/85 (98%), while extrapulmonary NTM were present in 2/95 (2%) patients. Overall, ten different NTM species were isolated. The most common organisms were slow-growing mycobacteria (SGM) presented in 70/85 (82.35%) patients. Isolated SGM strains were Mycobacterium avium complex (MAC) in 25/85 (29.41%) patients, M. xenopi in 20/85 (23.53%) patients, M. kansasii in 15/85 (17.65%) patients and M. peregrinum and M. gordonae in 5/85 (5.88%) patients each. Isolated rapid-growing mycobacteria (RGM) strains were M. abscessus in 8/85 (9.41%) patients, M. fortuitum in 4/85 (4.71%) patients and M. chelonae in 3/85 (3.53%) patients. Almost all patients (98%; 83/85) had comorbidities. Among 75 (88.24%) patients who completed follow-up, 59 (69.41%), 10 (11.76%) and 6 (7%), were cured, experienced relapse and died, respectively.In the present study, pulmonary NTM infections were more frequent compared to extrapulmonary disease forms. SGM were most common isolates with MAC pulmonary disease the most frequently found. Comorbidities have an important role in NTM occurrence. Further investigation should focus on an NTM drug susceptibility testing.