Kilby J M, Gilligan P H, Yankaskas J R, Highsmith W E, Edwards L J, Knowles M R
Department of Medicine, University of North Carolina School of Medicine, Chapel Hill.
Chest. 1992 Jul;102(1):70-5. doi: 10.1378/chest.102.1.70.
Because patients with cystic fibrosis (CF) may be predisposed to airway infections with unusual microorganisms, we screened the sputum of adult CF patients for mycobacterial organisms. Acid-fast bacilli (AFB) smears and mycobacterial culture were performed on 297 sputum specimens from 87 patients. Cultures for mycobacteria were frequently overgrown with other bacteria; 22.6 percent of cultures were contaminated. Despite this limitation of mycobacterial culture, 17 patients had at least one positive culture for a Mycobacterium other than tuberculosis (MOTT). Eleven patients were positive for Mycobacterium avium-intracellulare (MAI), two for MAI and M chelonei, three for M chelonei, and one for M fortuitum. None was positive for M tuberculosis. Patients with CF with MOTT were similar to patients with CF without MOTT; only a slightly different (older) age distribution was recognized. The clinical significance of MOTT was difficult to determine in any individual patient, but patients with positive AFB smears appeared more likely to suffer pathogenic effects. We conclude that MOTT is frequently recovered from adult CF patients in the southeastern United States. A specific risk factor for colonization and/or pathogenic infection in this patient group was not evident. The general prevalence and clinical pathogenesis in CF patients in the United States remains to be determined.
由于囊性纤维化（CF）患者可能易患由不常见微生物引起的气道感染，我们对成年CF患者的痰液进行了分枝杆菌筛查。对87例患者的297份痰液标本进行了抗酸杆菌（AFB）涂片和分枝杆菌培养。分枝杆菌培养物常被其他细菌过度生长；22.6%的培养物被污染。尽管分枝杆菌培养存在这一局限性，但17例患者至少有一次非结核分枝杆菌（MOTT）培养阳性。11例患者鸟分枝杆菌-胞内分枝杆菌（MAI）培养阳性，2例MAI和龟分枝杆菌培养阳性，3例龟分枝杆菌培养阳性，1例偶然分枝杆菌培养阳性。无一例结核分枝杆菌培养阳性。有MOTT的CF患者与无MOTT的CF患者相似；仅发现年龄分布略有不同（年龄较大）。在任何个体患者中，MOTT的临床意义都难以确定，但AFB涂片阳性的患者似乎更易出现致病效应。我们得出结论，在美国东南部，成年CF患者中经常分离出MOTT。该患者群体中定植和/或致病感染的特定危险因素尚不明显。美国CF患者中的总体患病率和临床发病机制仍有待确定。
