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人类免疫缺陷病毒感染患者中堪萨斯分枝杆菌和结核分枝杆菌所致疾病的流行病学、临床及预后差异:一项多中心研究

Epidemiological, clinical, and prognostic differences between the diseases caused by Mycobacterium kansasii and Mycobacterium tuberculosis in patients infected with human immunodeficiency virus: a multicenter study.

作者信息

Canueto-Quintero Jesús, Caballero-Granado Francisco Javier, Herrero-Romero Marta, Domínguez-Castellano Angel, Martín-Rico Patricia, Verdú Elisa Vidal, Santamaría Daniel Selma, Cerquera Ricardo Creagh, Torres-Tortosa Manuel

机构信息

Infectious Diseases Section, Punta de Europa Hospital, Algeciras, Spain.

出版信息

Clin Infect Dis. 2003 Aug 15;37(4):584-90. doi: 10.1086/376987. Epub 2003 Aug 1.

Abstract

A multicenter, comparative study was performed to determine the epidemiological, clinical, and prognostic differences between the diseases caused by Mycobacterium tuberculosis and Mycobacterium kansasii in human immunodeficiency virus (HIV)-infected patients. From 1 January 1995 through 31 December 1999, 25 HIV-infected patients received diagnoses of M. kansasii infection, and another 75 were selected as control subjects from among patients who had M. tuberculosis infection. Variables associated with M. tuberculosis disease in the multivariate analysis were previous intravenous drug use (odds ratio [OR], 8; 95% confidence interval [CI], 1.5-41.4) and interstitial radiologic pattern (OR, 12.7; 95% CI, 1.7-94.3). Variables associated with M. kansasii were previous diagnosis of acquired immunodeficiency syndrome (OR, 15.8; 95% CI, 4.2-59.6) and concomitant opportunistic infections (OR, 14.2; 95% CI, 2-105.7). Clinical and radiologic features were similar for both groups, but epidemiological characteristics and prognosis were different. M. kansasii disease was associated more closely with level of immunosuppression and progression of HIV infection than was disease caused by M. tuberculosis.

摘要

开展了一项多中心比较研究,以确定人类免疫缺陷病毒(HIV)感染患者中结核分枝杆菌和堪萨斯分枝杆菌所致疾病在流行病学、临床及预后方面的差异。1995年1月1日至1999年12月31日期间,25例HIV感染患者被诊断为堪萨斯分枝杆菌感染,另外75例从结核分枝杆菌感染患者中选为对照。多变量分析中与结核分枝杆菌病相关的变量为既往静脉吸毒史(比值比[OR],8;95%置信区间[CI],1.5 - 41.4)和间质放射学表现(OR,12.7;95% CI,1.7 - 94.3)。与堪萨斯分枝杆菌相关的变量为既往获得性免疫缺陷综合征诊断(OR,15.8;95% CI,4.2 - 59.6)和合并机会性感染(OR,14.2;95% CI,2 - 105.7)。两组的临床和放射学特征相似,但流行病学特征和预后不同。与结核分枝杆菌所致疾病相比,堪萨斯分枝杆菌病与免疫抑制水平及HIV感染进展的关联更为密切。

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