Nontuberculous Mycobacterial Infection in Children A Prospective National Study
Nontuberculous Mycobacterial Infection in Children A Prospective National Study
复制标题
DOI：
10.1097/inf.0b013e31819f7b3f
复制
发表时间：
2009-09-01
影响因子：
3.6
通讯作者：
Palasanthiran, Pamela
中科院分区：
文献类型：
--
作者：
Blyth, Christopher C.;Best, Emma J.;Palasanthiran, Pamela
背景资料：澳大利亚儿童非结核分枝杆菌（NTM）感染的流行病学和管理是未知的：方法：从2004年7月至2007年6月，临床医生确定与NTM感染的儿童作为一个全国性的主动监测网络的一部分。结果：从192份报告中，收到了153例病例的数据（应答率：79.7%）。其中，102例符合入选标准。中位年龄为2.9岁。诱发疾病不常见，包括慢性呼吸道疾病（n = 12）和免疫抑制（n = 6）。淋巴结炎是最常见的表现（n = 68），肺部和播散性疾病少见（分别为n = 14和3），NTM在68例病例中分离，鸟-细胞内分枝杆菌复合体最常见（33/68; 48.5%）。手术治疗78例，抗结核治疗42例。25例受试者接受了手术和抗分枝杆菌治疗。随访77例，复发18例。与所有其他疗法相比，完全切除与更高的治疗成功率相关（OR：9.48 [95% CI：2.00-44.97]，P = 0.001）。慢黄分枝杆菌感染占培养确诊病例的4.4%，治疗成功率低于其他菌种（0%对78.2%; P = 0.016）。结论：澳大利亚儿童NTM感染的发病率为0.84/100，000（95%CI：0.68-1.02）。感染最常发生在没有易感条件的幼儿中。尽管治疗，有23.4%的病例复发。
Background: The epidemiology and management of nontuberculous mycobacterial (NTM) infection in Australian children is unknown.Methods: From July 2004 to June 2007, clinicians identified children with NTM infection as part of a nationwide active surveillance network. Following notification, detailed data were collected.Results: From 192 reports, data were received on 153 cases (response rate: 79.7%). Of these, 102 met inclusion criteria. The median age was 2.9 years. Predisposing conditions were infrequent and included chronic respiratory disease (n = 12) and immunosuppression (n = 6). Lymphadenitis was the most frequent presentation (n = 68) with pulmonary and disseminated disease infrequent (n = 14 and 3, respectively), NTM was isolated in 68 cases with Mycobacterium avium-intracellulare complex most frequently isolated (33/68; 48.5%). Surgery was performed in 78 cases and 42 children were treated with antimycobacterial therapy. Twenty-five subjects received surgery and antimycobacterial therapy. Follow-up data were available for 77 children with recurrence observed in 18 cases. Complete excision was associated with a higher rate of treatment success when compared with all other therapies (OR: 9.48 [95% CI: 2.00-44.97], P = 0.001). Mycobacterium lentiflavum infection accounted for 4.4% of culture confirmed cases and had a lower rate of treatment success than other species (0% vs. 78.2%; P = 0.016).Conclusions: The incidence of NTM infection in Australian children is 0.84 of 100,000 (95% CI: 0.68-1.02). Infection occurs most often in young children without predisposing conditions. Despite therapy, there was recurrence in 23.4% of cases.