Primm Todd P, Lucero Christie A, Falkinham Joseph O
Department of Biological Sciences and Border Biomedical Research Center, University of Texas at El Paso, El Paso, Texas 79968, USA.
Clin Microbiol Rev. 2004 Jan;17(1):98-106. doi: 10.1128/CMR.17.1.98-106.2004.
Environmental mycobacteria are emerging pathogens causing opportunistic infections in humans and animals. The health impacts of human-mycobacterial interactions are complex and likely much broader than currently recognized. Environmental mycobacteria preferentially survive chlorination in municipal water, using it as a vector to infect humans. Widespread chlorination of water has likely selected more resistant environmental mycobacteria species and potentially explains the shift from M. scrofulaceum to M. avium as a cause of cervical lymphadenitis in children. Thus, human activities have affected mycobacterial ecology. While the slow growth and hydrophobicity of environmental mycobacteria appear to be disadvantages, the unique cell wall architecture also grants high biocide and antibiotic resistance, while hydrophobicity facilitates nutrient acquisition, biofilm formation, and spread by aerosolization. The remarkable stress tolerance of environmental mycobacteria is the major reason they are human pathogens. Environmental mycobacteria invade protozoans, exhibiting parasitic and symbiotic relationships. The molecular mechanisms of mycobacterial intracellular pathogenesis in animals likely evolved from similar mechanisms facilitating survival in protozoans. In addition to outright infection, environmental mycobacteria may also play a role in chronic bowl diseases, allergies, immunity to other pulmonary infections, and the efficacy of bacillus Calmette-Guerin vaccination.
环境分枝杆菌是新兴病原体，可在人和动物中引起机会性感染。人与分枝杆菌相互作用对健康的影响很复杂，可能比目前所认识到的要广泛得多。环境分枝杆菌在市政供水中能优先耐受氯化作用，并以此作为感染人类的媒介。广泛的水氯化处理可能筛选出了更具抗性的环境分枝杆菌物种，这可能解释了儿童颈部淋巴结炎的病因从瘰疬分枝杆菌向鸟分枝杆菌的转变。因此，人类活动已经影响了分枝杆菌的生态。虽然环境分枝杆菌生长缓慢且具有疏水性，这似乎是劣势，但独特的细胞壁结构也赋予了它们对杀菌剂和抗生素的高抗性，而疏水性则有助于营养获取、生物膜形成以及通过气溶胶传播。环境分枝杆菌对压力的显著耐受性是它们成为人类病原体的主要原因。环境分枝杆菌可侵入原生动物，表现出寄生和共生关系。分枝杆菌在动物体内细胞内致病的分子机制可能是从促进其在原生动物中生存的类似机制进化而来的。除了直接感染外，环境分枝杆菌还可能在慢性肠道疾病、过敏、对其他肺部感染的免疫以及卡介苗接种效果方面发挥作用。
